In Her Own Right The Institute of Medicine's Guide to Women's Health Issues (1997) / Chapter Skim
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6 Health Through the Life Span: Menopause and Beyond
6 Health Through the Life Span: Menopause and Beyond
Pages 105-116
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From page 105... ...
Cessation before the age of 40 is technically considered "premature," a diagnosis that in itself does not imply abnormality but sometimes indicates conditions that need treatment. Over a period of time, on a schedule largely determined by genetics, a woman's aging ovaries stop responding to the hormonal signal that has, since early in her second decade, regularly urged them to send forth an egg.
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From page 106... ...
Given the great and rapidly changing significance of both this life stage and the complex and highly variable physiological processes that usher it in, medical science knows remarkably little about the issues, risks, and opportunities that women face during and after menopause. As we have seen, both medical science and the society that supports it have until very recently considered menopause the end of a woman's "useful" life and the years that follow it a sort of physiological caboose containing not much of interest except tedium, depression, and decline.
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From page 107... ...
And matriarchs actually have a lot of power and a lot of independence. And if you want to skip over a few continents to India and think of the power of the mother-in-law, the power of the senior women in the household or the power of the senior women in Africa, you'll see that there's more autonomy."1 Indeed, in societies around the world, whether in peasant Europe, the Muslim Middle East, or Pearl Buck's China, female adulthood has traditionally been a trek from the utter powerlessness of a young woman valued essentially for her ability to produce offspring but feared for her ability to dishonor the family name, toward the prestige and relative comfort of the female head of the household and often, should her husband predecease her, the unrivaled domestic ruler.
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From page 108... ...
For Scrimshaw's "missing women," "in other words, it comes too late."2 Even if large numbers in traditional societies miss out on enjoying this culminating life stage, however, it still stands in stark contrast to the treatment that older American women have come to expect. In a society composed of small, mobile nuclear families rather than of large, stationary extended households, older women lose rather than gain prestige and importance as their children mature into parenthood.
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From page 109... ...
But now that "postmenopausal" describes Supreme Court justices, university presidents, corporate executives, prominent surgeons, Nobel laureates, army generals, and even, in a few cases, movie stars, and now that less celebrated women have come to realize that the years after their children are grown represent an opportunity for largely unfettered attainment, we may witness the transformation of this third stage of female life. GETTING THE FACTS If they are not yet considered glamorous, though, the years after menopause at least are beginning to garner increased scientific and media attention.
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From page 110... ...
Her supply of the natural estrogen produced by the ovaries drops sharply, and the many tissues throughout the body affected by that hormone begin to undergo change. Among other things, the bones and vaginal lining thin, the blood cholesterol level rises, the heart and circulatory system begin to deteriorate, the skin more rapidly wrinkles.
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From page 111... ...
Age, however, in itself cannot account for the accelerating drop in physical powers that many sedentary people experience. Fully "50 percent of the decline frequently attributed to physiological aging is, in reality, disuse atrophy resulting from inactivity in an industrial world," notes IOM's Committee on Health Promotion and Disability Prevention for the Second Fifty Years.7 The belief that they were "too delicate" for sports in their younger years now truly helps make women frail as they approach their older ones.
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From page 112... ...
With cigarette smoking now widespread among young women, however, and with lung cancer, one of the disease's most deadly and least treatable forms, now the leading cancer killer among women, females may begin losing ground. For the time being, though, and for the immediately foreseeable future, women form a larger percentage of their age group the older they get.
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From page 113... ...
In a classic insight, Freud "contended that most people in the grieving state feel there has been a loss or emptiness in the world around them, while depressed patients feel empty within. A pervasive loss of self-regard or self-esteem is common in depressed patients but not in most grieving individuals," the committee adds.14 Surprisingly enough, despite older people's intimate acquaintance with grief through the accumulating losses of parents, spouses, siblings, friends, sometimes even children, the disease of depression actually afflicts them less than it does their juniors.
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From page 114... ...
. and particularly older women, tend to prefer reminiscence about the past to actual social participation." He tells of a woman living in a nursing home whose hours sitting alone at a card table laying out bridge hands had convinced staff members that she was depressed.
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From page 115... ...
And the generations younger still may well totally rearrange some important aspects of many American women's portraits. Beginning menstruation at younger and younger ages, smoking in larger and larger numbers, marrying later or not at all, giving birth either very early or very late, divorcing often, working for pay most of their adult lives, juggling multiple -- and often conflicting -- roles during the reproductive years, attaining unprecedented self-sufficiency through their own earnings, they may make many elements of our current picture obsolete.
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From page 116... ...
The answer to Scrimshaw's question "Why women? " will always be found in the concrete circumstances in which individual women pass the days and years of their lives.
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