Like mother, (not) like daughter: The social construction of menopause and aging

In recent American history, the definition of menopause has shifted from a natural, developmental transition to an increasingly more medicalized perspective that emphasizes biological deficits of the aging female body. Using qualitative data from two generations of women, this essay explores how and why this redefinition has occurred and what effect it has had on women's attitudes toward health and aging. The physical experiences of menopause were remarkably similar across mother-daughter pairs; however, daughters (who represented a slice of the baby boom cohort) differed from their mothers in how they talked about menopause, how they defined and treated menopause, and how willingly they accepted or fought the changes associated with menopause. Major social institutions, including the media and pharmaceutical industry, have played a significant role in reshaping the cultural lens through which women experience issues of health, body, and aging. This essay emphasizes the baby boomers' desire to maintain control over their bodies and considers how this cohort of women, as a result, may experience late-life issues of body and health.     

Management of premature menopause

There has been some confusion among women and health professionals since the publication of the Women's Health Initiative and Million Women studies about the management of premature ovarian failure (POF). Both studies were undertaken in women aged 50 and over, and cannot be extrapolated to their younger counterparts, who would normally be producing their endogenous estrogen, since they have functioning ovaries. Estrogen-based replacement therapy is the main stay of treatment for women with POF and is recommended at least until the average age of natural menopause (52 years in the UK). This view is endorsed by regulatory bodies such as the Committee on Safety of Medicines (now the Commission on Human Medicines) in the UK. No evidence shows that estrogen replacement increases the risk of breast cancer to a level greater than that found in normally menstruating women, and women with POF do not need to start mammographic screening early unless other risk factors are present, such as family history.     

The Evolution of Understanding Menopause in Clinical Treatment

This paper integrates the meanings created about menopause through a biopsychosocial perpective. Once understood only as a biological illness creating affective disorders, new paradigms provide understanding based on the psychological and social constructions of the process. History emphasizes a view of women experiencing increasing deficiency and loss, while modern interpretations view women as gaining new freedoms. Case material is presented to direct attention to the meanings of menopause as it emerges in the treatment process.     

Mental health around and after the menopause

The menopause is a time in a woman's life when it is recognized that biological and social changes can impact upon mental wellbeing. Several studies have investigated the relationship between menopause and psychological symptoms, especially depression, with mixed results. In part, this is due to a considerable overlap between depressive symptoms and those due to declining estrogen levels, causing challenges in assessment. However it appears that vulnerable women are at a higher risk of succumbing to depression during menopausal transition. Antidepressants remain the mainstay of treating depressive symptoms, with little conclusive evidence for hormone replacement therapy. Memory problems during menopause are a common complaint, but there is no demonstrated link to subsequent dementia. This paper also reviews considerations of diagnosis and treatment of postmenopausal depression.     

I don't know who I am: severely mental ill Latina WSW navigating differentness

We examine interviews from a qualitative study designed to examine HIV perceptions, risk, and risk management among Puerto Rican women who have sex with women (WSW) and who also have been diagnosed with major depression, bipolar disorder, or schizophrenia. These women's stories challenge both the lesbian and the Latino communities to reexamine how and why they claim individuals as their own and they similarly challenge professional communities, including HIV educators, health researchers, and medical care providers, to develop effective HIV prevention programs and counseling approaches that facilitate patient/client self-disclosure and consider cultural and contextual barriers to both self-disclosure and the provision of services.     

Harnessing hormonal signaling for cardioprotection

Cardiovascular disease is the leading cause of death in women in the Western world and is predominant among the elderly. A large body of evidence suggests that hormonal signaling plays a critical role in the regulation of cardioprotective mechanisms, as premenopausal women are at significantly lower risk of heart disease compared with men, but the risk greatly increases with the onset of menopause. This association indicates that estrogen may protect the heart from cardiovascular disease. Whereas a number of analyses of the effects of hormone replacement therapy (HRT) on postmenopausal women supported the idea that estrogen is a cardioprotective factor, the findings of the more recent Women's Health Initiative (WHI) study suggested that HRT may actually increase the risk of cardiovascular events. These conflicting reports have left both patients and clinicians reluctant to continue using current HRT regimes. The WHI findings do not, however, negate the epidemiological link between menopause and increased cardiovascular risk. Hence, the identification of the specific actions of estrogen that promote cardioprotective pathways without enhancing deleterious vascular mechanisms may provide novel estrogen-based alternatives to current HRT strategies. In this Review, we outline the known actions of estrogen on the cardiovascular system, focusing on cardioprotective mechanisms that may be targeted for the development of new therapeutic approaches.     

Childhood Developmental Risk for Teen Childbearing in Britain

Adolescence is often assumed to be the most important period of life for understanding teen childbearing risk. Developmental perspectives challenge that assumption, offering the possibility that early childhood characteristics may have unique and lasting effects on the risk for teen childbearing. This study examined family life risk factors (socioeconomic status, family stress, and parental involvement in education) and how their effects on teen childbearing risk varied, depending on the childhood age at which they were experienced. Prospective life history data from the National Child Development Study of Great Britain were used to study a birth cohort of 4,928 British women, 15.3% of who became pregnant as teens. This study demonstrated that data from early childhood significantly contribute to the understanding of teen childbearing risk.     

Metabolic syndrome and the menopause

The metabolic syndrome consists of a combination of risk factors that include abdominal obesity, atherogenic dyslipidaemia, hypertension and insulin resistance. It increases the risk of cardiovascular disease and type 2 diabetes. The increased risk of cardiovascular disease is higher in women than in men. The first manifestation of metabolic syndrome may occur in pregnancy presenting as gestational diabetes or preeclampsia. Both conditions are associated with increased insulin resistance. Also metabolic syndrome is more common in polycystic ovarian syndrome. It has been suggested that there is a metabolic syndrome resulting from the menopause due to estrogen deficiency, as many of the risk factors are more prevalent in postmenopausal women. Also estrogen replacement improves insulin sensitivity and reduces the risk of diabetes. The key elements in managing the metabolic syndrome are weight reduction, increasing physical activity and diet modification. If blood pressure, lipid and glycaemic control are not achieved through these interventions then pharmacological therapy will be required.     

The color of welfare sanctioning: exploring the individual and contextual roles of race on TANF case closures and benefit reductions

This article investigates the individual and contextual roles of race on welfare sanctions: benefit cuts for failing to comply with work or other behavioral requirements under the Temporary Assistance for Needy Families program. Using six years of federal administrative data, I advance previous welfare research by providing a nationally representative analysis of participant-, county-, and state-level predictors of welfare sanctioning. Using theories of racial classification, racialized social systems, and racial threat as guiding frameworks, I find that black and Latina women are at a greater risk of being sanctioned than white women. Further, although odds of a sanction are slightly reduced for black women living in counties with greater percentages of blacks, the opposite holds for Latinas, who are at an increased risk of being sanctioned in counties with greater percentages of Latinos.     

The development of synchronous text-based instant messaging as an online interviewing tool

The article reports the development of a synchronous text-based online interviewing tool with a continuity of private discussion that is not achieved in open-ended questionnaires, email interviews and online discussion boards. The participants were women who had undergone a surgical or natural menopause, who in a pilot interview highlighted the potential sensitivity of this subject and inspired the implementation of this method. The overall feedback was positive with the main advantages centred on feelings of anonymity, convenience and a more comfortable interview environment. Disadvantages included lack of body language and technical issues with computers. This technique ensures a degree of confidentiality while still obtaining depth of enquiry, where other qualitative methods potentially risk invading a participant’s privacy. It can be offered both alongside other interviewing techniques to allow participant choice and on its own when exploring sensitive and personal topics or when extra participant anonymity is appropriate.     

Social Psychological Processes that Facilitate Sexual Assault within the Fraternity Party Subculture

Rape on the college campus has gained increasing amounts of attention in higher education, mainstream news, and public policy. The prevalence rates of rape are especially high among students who frequent campus parties, such as those hosted by fraternities. Researchers have described this increased risk by focusing on individual attitudes and behaviors of fraternity members or on the organizational norms and practices within the fraternity party subculture. To incorporate these studies into a single theoretical framework, this essay uses a social psychological approach to connect individual‐level attitudes, (sub)culture, and behavior. I describe and apply identity theory and affect control theory, two structural symbolic interactionist theories, to explain why certain men are drawn to high‐risk fraternities and how membership reinforces hostility toward and abuse of women. In doing so, I suggest several avenues for future research that would increase social psychological understanding of the heightened prevalence of sexual victimization within the fraternity party subculture.     

Sexually transmitted infections in the older woman

Dependent upon sexual behaviour peri- and postmenopausal women are increasingly at risk of sexually transmitted infections, although the overall rates remain low when compared with younger people. Symptoms are often non-specific or absent and may be misinterpreted as being due to the menopause. In addition, both the women and their clinicians may not be aware of their infection risk, thus leading to a delayed or missed diagnosis. Risk assessment and referral for screening of infections should be carried out wherever appropriate.     

It takes a sister: sisterhood and Black womanhood in families of people with intellectual and developmental disabilities

This study explores the sibling relationships of Black women with sisters who have intellectual and developmental disabilities in the southeast United States including Georgia, South Carolina, Florida, and Louisiana. The researchers used disability/critical race theory to understand the perceptions and stigmas associated with disability relating to social, cultural, and psychological structures within sibling relationships. Results were captured in four themes: cultural perceptions of family and extended kin; sibling relationships; beliefs about the self as a sister; and siblings’ identities. The findings from this study will contribute to research in disability studies by providing a better understanding of the intersections of identities and the familial experiences of diverse families.     

Women's perceptions of the effects of menopause and hormone replacement therapy on skin

Although women frequently associate skin issues with menopause and hormone replacement therapy (HRT), little work has been done to investigate a possible relationship. A questionnaire was given to women attending a specialist menopause clinic; 87 women responded. Skin problems generally were common, with over 64% of respondents reporting past problems. Around half felt that the menopause had resulted in skin changes; dry skin was the predominant complaint at this stage. However, use of HRT in the short term did not result in any conclusive trends in skin condition in the majority of users.     

Older Lesbians and Work in the Australian Health and Aged Care Sector

While research has identified challenges lesbians face in the workplace, there is limited understanding of the particular experiences of older lesbians, especially those working in the health and aged care sector. This article draws on the stories of four women who participated in a narrative research project on lesbian and gay people's experiences of health and aged care. It highlights the need for future research to examine the complexity of identity expression and community affiliation, how people negotiate “coming out” in the workplace, the impact of discrimination, and the resources (such as friends) available to lesbians in the workplace.     

The effects of maternal depression on children

The importance of identifying children at risk because of parental pathology such as schizophrenia has been well established. It is recommended that a systematic investigation of children of depressed mothers be made. An object relations developmental model is presented as a conceptual framework for understanding the consequences to children of being cared for by depressed mothers.     

SOCIOLOGICAL EXPLORATIONS: What Is Religious Agency?

This article proposes religious agency as a sociological concept providing a lens that sharpens our understanding of the ways that individuals claim and enact a meaningful religious identity. Interview data from the case of woman-conscious Catholic women demonstrate how religious agency is enacted in emotional, intellectual, and behavioral strategies, thereby enabling individuals to negotiate overlapping and valued identities. The strategies emerge from specific social contexts and are categorized as strategies of gaining voice, negotiating place and space, and flexible alignment. The article also suggests that religious agency has merit beyond this initial case of woman-conscious Catholics.     

‘I Was Attracted to Him Because of His Money’: Changing Forms of Polygyny in Contemporary Papua New Guinea

Substantial economic transition in Papua New Guinea (PNG) is giving rise to increased wealth, rapid social change and changing cultural practices. Polygyny practices in PNG have come under increasing domestic attention in recent years, especially as pertains to reinforcing patriarchy and exacerbating gender inequality. Based on qualitative research with women, we identify a new ‘emerging polygyny’ that is located in women’s and girls’ choices, decisions, experiences and actions, and which contrasts with other research documenting polygyny from men’s perspectives. Narratives from female participants described young women and girls who actively seek polygynous relationships with men who have disposable income and other assets, with the aim of gaining access to economic wealth as co-wives. In the context of public and legal debate about the status of polygyny in PNG, these findings illustrate the need for a more balanced discussion about polygynous relationships, located within an understanding of women’s lived experiences.     

Dysfunctional sexual beliefs as vulnerability factors to sexual dysfunction

The differences on sexual beliefs presented by men and women with sexual dysfunction and their sexually functional counterparts were investigated. A total of 488 participants (160 females and 232 males without sexual problems and 47 females and 49 males with a DSM-IV diagnosis of sexual dysfunction) answered the Sexual Dysfunctional Beliefs Questionnaire. Findings showed that, although effects have only reached statistical significance for the female group, both dysfunctional men and women endorsed more sexual dysfunctional beliefs than functional. Women presented significantly more age related beliefs (after menopause women loose their sexual desire, as women age, the pleasure they get from sex decreases) and body image beliefs (women who are not physically attractive cannot be sexually satisfied). Additionally, sexually dysfunctional males presented higher scores (not statistically significant) on 'macho' belief (a real man has sexual intercourse very often) and the beliefs about women satisfaction (the quality of the erection is what most satisfies women). Overall, findings support the idea that sexual beliefs may play a role as vulnerability factors for sexual dysfunction.     

Food insufficiency and physical and mental health in a longitudinal survey of welfare recipients

Food insufficiency is a significant problem in the United States, and poor African American women with children are at especially high risk. An inadequate household food supply can potentially affect the well-being of household members, but it is difficult to distinguish the effects of food insufficiency from risk factors for poor health that are also common among the food insufficient, such as poverty. We examined food insufficiency and physical and mental health among African American and white women (n = 676) who were welfare recipients in 1997. Controlling for common risk factors, women who reported food insufficiency in both 1997 and 1998 were more likely to report fair or poor health at the later date. Food insufficiency in 1998 was significantly associated with meeting the diagnostic screening criteria for recent major depression. Food insufficiency at both times and in 1998 only was related to women's sense of mastery. These findings add to growing evidence that household food insufficiency is associated with poor physical and mental health.