Early menopause has been constructed by discourses of biological determinism as an untimely, but natural, failure of the female body. Medical discourses in particular have interpreted early menopause as a congenital irregularity and a rare anomaly of menopause at midlife. In this thesis I challenge the notion that early menopause is an innate imperfection related only to women’s age. I propose that early menopause is dependent upon the cultural interpretations of individual women and is constituted through the mercurial and multiple discourses of women who have this embodied experience. Moreover, I reveal that early menopause is a contemporary condition and that its location in history is inextricably bound to discourses of risk, naturalism and the self. Further I make the assumption that having an early menopause both affects and is an effect of women’s fertility, sexuality and subjectivity. I have drawn upon a broad range of sources to provide a sociological analysis of early menopause. Literature on early menopause is dominated by positivist discourses, yet many alternate discourses negotiate these influential constructions. I suggest here that the perception of early menopause as a natural fault is merely a construction by medical discourses and does not incorporate the dynamic discourses of early-menopausal women. Moreover, the restriction of early menopause to a genetic female failure excludes the majority of women who have an early menopause through iatrogenisis. This omission occurs through the failure of positivist discourses to accommodate diversity in discourses. Recent sociological and feminist studies have vindicated menopausal women. They have reconstructed menopause through notions of embodiment and have removed the veil of negativity used by the medical sciences to contain menopausal women (Komesaroff, Rothfield and Daly 1997). The visibility of menopausal women, however, remains connected to age. Menopause has been created as a predictable consequence of aging and as such has come to be synonymous with middle age. Nowadays, even men are said to experience menopause at midlife (Carruthers 1996). But early menopause is constituted within the discourses of women who have this experience. Medico-scientific discourses, based upon theories of genetic inevitability, disregard this perspective. Consequently early menopause is subsumed by naturalistic discourses that relate menopause to midlife. Such restraint reflects the unease created by menopause that does not coincide with prescribed life stages. Women's experiences of their changing bodies are largely unheard. Thus, women who have an early menopause are faced with a chasm of ‘cultural non-recognition’ (Fraser 1997). Conjointly with this discursive repression early-menopausal women face social imbalances that are transacted as both cause and consequence of early menopause. In particular the contemporary creation of early menopause is bound to the social and historical location of women as a group. Women are exploited by the institution of medicine, ‘exposure to environmental toxicity’ (Fraser 1997: 11) and commercialization as causes of early menopause. Yet the corporeal effects of practices of risk avoidance (Beck 1993), social practices (Shilling 1993) and Western consumerism (Lupton 1994) fail to be recognized. I address these problematics through a poststructural and feminist critique that assumes moments of commonality among women, while at the same time recognizes shifting and multiple differences (Nicholson 1999). I suggest here that early menopause falls into cultural misrecognition in Fraser's (1997) terms and argue that it is united concurrently with the gender injustice of androcentrism (Fraser 1997: 21). Fraser (1997: 16) suggests that it is only by relating these dual problematics that we are able to make sense of current dilemmas. Thus I have critiqued early menopause through a connection between individual embodied experiences of early menopause and early menopause as a modern phenomenon that is specific to women. I have attempted to unravel these arguments that simultaneously call to ‘... abolish gender differentiation and to valorize gender specificity’ (Fraser 1997: 21) while at the same time acknowledging their interconnectedness. An approach of merely combining women’s discourses with overarching social issues would be inadequate as not only do these problematics intersect but they also can be opposed. As Fraser (1997: 25) notes with her theory, redressing one aspect of cultural or social analysis can further imbalance another. For instance making visible the diversity and uniqueness of individual experiences of early menopause could detract from acknowledging the contemporary construction of early menopause through social inequality. Crucial to this understanding is a destabilizing of the binary construction of differences between the sexes that makes way for a reconstruction of early menopause through ‘sexual slippage’ (Matus 1995). In this thesis I look for a subtlety between the particular and the collective that views early menopause as concurrently a singular and changeable experience as well as imbedded in social practice. I suggest that these concepts are entwined as interactive effects of early menopause. Thus I have analyzed the bivalent problematics of the embodiment and social location of early menopause as imbricated, dynamic and unending discourses. From this perspective I reviewed the literature that was available on early menopause. In Chapter One I look to descriptions of early menopause and note that it has disappeared into a conglomeration of disparate, mostly medical, discourses that are contradictory. Nevertheless medical discourses offer ‘conclusive’ definitions of early menopause that are based on naturalistic views of the body (Shilling 1994). The determinants used are inconsistent and do not include women's discourses of early menopause. Thus, dominant medical discourses obscure women’s embodied experiences of early menopause and ignore the contemporary causes of early menopause. In Chapter Two I examine the causes of early menopause as a way of explaining the disparity between medical discourses and my anecdotal observations of early menopause as a fairly common contemporary occurrence. The relatively recent escalation in gynaecological surgery, especially hysterectomy, appears to account almost single-handedly for early menopause as a current phenomenon. Moreover, the extraordinary number of women who have their uterus removed at hysterectomy can be interpreted as a modern implementation of ancient anxieties. Women's sexuality has been constructed throughout history as problematic and this unease has been translated through women's bodies as dangerous and in need of control (Greer 1992). Thus social concerns which have evolved historically have emerged through the representation of a woman's uterus as an unseen, dark and mysterious risk (Beck 1993). Medical discourses define this risk and are able to negate the so-called dangers of women's sexuality through the surgical removal of their organs. Widespread negotiation of medical discourses is apparent, as hysterectomy in the modern Western world is the most common of all surgical operations (Hufnagel 1989). It is overwhelmingly the most common cause of early menopause as well. I examine also the historical condemnation of infertile women and how this anxiety has been transposed to the modern world through the commercialization of reproduction. Transactions of this social unease can cause early menopause. For instance the medical technology of in-vitro fertilization (I.V.F.) has been offered as a panacea for the infertility of early menopause but, paradoxically, can cause early menopause as well. Conception through technology has been normalized as a viable option for women who are unable to conceive and understandings of I.V.F. have moved into everyday discourse. Medical discourses have constructed fertility as a saleable item and infertile women expect that they can purchase this merchandise. Human eggs have become lucrative commodities that now are available in the market place. Egg ‘donation’ for I.V.F. programs can hasten the attrition rate of eggs and can cause early menopause in some pre-menopausal women (Rowland 1992: 24). Even the recycling of a woman’s uterus supposedly has become a possibility through the transferring of this ‘used’ organ at hysterectomy to a recipient woman who can use the other woman’s uterus as a ‘gestational garage’ (Rogers 1998). In this way women have been disembodied as mechanical systems with inter-changeable body parts and the potentially detrimental consequences of these commercial transactions are ignored. In addition I show how early menopause can be caused by the connection between the self and the social structure. Women's subjectivity is constituted through the cultural discourses available to them and these discourses affect social behaviour (Lupton 1995). For instance smoking and dieting have been identified as causes of early menopause. These activities have been related to the creation of women’s bodies as hetero-sexually desirable and are endemic to young women (Evans-Young 1995). This suggests that cultural causes of early menopause are transactions of sexual politics. Yet there is a paucity of literature that acknowledges the relationship between women’s subjectivity and early menopause. Thus the second chapter exposes a link between sexual politics and causes of early menopause through women's relationships with risk, naturalism and the self. In Chapter Three I deconstruct early menopause through theoretical considerations. I rely on an overarching poststructuralism that embraces the concept of fragmented plural discourses and the subjectivity of menopausal women as a continuous process (Komesaroff 1997: 61). I have woven these variables through broad feminist critiques (Leonard 1997). Through this eclectic approach I hoped to find some loose alignment between the corporeal, ontological and embodied dimensions of early menopause. The recurring themes of sexuality, fertility and subjectivity emerge through deconstructing discourses of sexual difference as immutable and non-negotiable; exposing ‘premature ovarian failure’ as a discursive construction that censures early-menopausal women; and acknowledging the discourses of individual women as unique, diverse and dynamic. I looked to a method of exposing some of these individual discourses and in Chapter Four I describe a critical research process aimed at understanding early menopause as a lived experience. In the remaining chapters I align these ontological arguments with an analysis of the discourses of women who had experienced or were experiencing an early menopause. This section partly relieves the ‘cultural non-recognition’ of the discourses of early-menopausal women. I recorded the narratives of fifty early-menopausal women through in-depth interviews and used this empirical data to direct the study. This data provides the opportunity to understand early menopause as an assortment of embodied experiences. For instance women’s experiences of age at commencement of menopause spanned over three and half decades. They did not reflect the age specifications prescribed by medical discourses. Rather women interpreted their experiences within their own discourses and determined their menopause as early based upon the expectations of their cultural context. Many of the women experienced changes attributed to menopause at midlife. It was not these changes that were significant to early-menopausal women it was how each woman translated these changes that provided meanings of early menopause. In Chapter Five I introduce the women through a table that connects the varying experiences of each woman. This profile shows that, in the main, the women’s experiences of early menopause were unexpected. I suggest that this is due to the disparity between early-menopausal women’s experiences and the current age and social norms of menopause. By bracketing the women into cohorts patterns emerged displaying differences between women who had menopause in their teens, twenties, thirties and forties. Adolescent women had intense feelings of abnormality and despair. Women who were in their twenties were less devastated by menopause than the younger women but described their sexuality and self-identity as changing. And although some women in their thirties were shocked or dismayed to have an early menopause others were ambivalent or happy. These women also described their sexuality and self-identity through changing discourses. A number of the women who were in their forties said that they were ‘too young for the menopause’ but were far less despondent than the younger women. It seemed that the greater the distance between age norms and social norms the more negatively women responded. Age norms that determine the social norms of women's lives through a ‘biological clock’ are constructed to reflect social values. But age is a social construction that changes over time. Thus it would appear that women’s changing bodies and changing discourses of early menopause are in the process of recreating age and social norms around menopause. In Chapter Six I draw upon women’s narratives that describe a connection between early menopause and sexuality. Yet the respondents were not unified in their constructions of sexuality. For instance a number of the women rejected the containment of their sexuality as absolute and defined in terms of bi-lateral hetero-sexual opposition. The discourses of these women constructed their sexuality as continuously flexible. Some early-menopausal women described this sexual mobility as an equivocal relationship between their sexuality, reproductive capacity and female organs. Other women articulated their sexuality as vacillating, ambiguous and unrepresentative of the so-called ‘true woman’. Several felt that they were not meant to have female reproductive organs at all. Nearly one third of the women had had their uterus removed at hysterectomy and the reproductive organs of two women were rudimentary. Women’s narratives showed that the social value of fertility influences constructions of early menopause. In Chapter Seven I record the contrast between the poignant responses of women who wished to have a baby of their own and other women who resisted discourses that entwine reproductivity with being a woman. For instance some women negotiated fertility through economic discourses of consumerism with the expectation that they could purchase conception as a commodity. Other women welcomed their early menopause as freedom from contraceptive concerns and others had no interest in reproduction at all. Thus discord arose through discourses that problematize early-menopausal women as non-reproductive and discourses that value variability. In addition many of the women’s accounts constructed their subjectivity as mobile, challenging the notion that discourses of the self are immutable. Chapter Eight presents narratives which suggest that the subjectivity of many women was altered continuously by early menopause. Yet some of the women rejected the construction of their subjectivity as unfluctuating. These contradictions reflect the uncertainties of the contemporary world. Nevertheless most respondents found that the tethering of menopause to constructions of midlife was incongruous with their own experiences. Many women refused to accept the label of social redundancy attached to middle-aged women. They moved their subjectivity beyond the reproductive body to a shifting and tractable identity of the self. This thesis demonstrates that the medical construction of early menopause as a rare and natural female flaw varies from women's experiences which suggest that early menopause is common and discursively constructed. This disparity has occurred through the privilege placed upon the construction of bodies as immutable and sexually static. This privileging has obscured the multi-dimensional causes of early menopause and given preference to a mono-causal theory. By exposing the variety of causes of early menopause the medical construction of women through a universal and unalterable body of reproduction is challenged. Moreover, women's discourses of early menopause demonstrate that the medical reduction of early menopause to a spontaneous bio-chemical malfunction has ignored the volatility of women’s embodied experiences. Women experience early menopause variously and through mercurial discourses. I suggest here that women's discourses of their experiences of early menopause reflect recurring and restructuring philosophical quandaries of fertility, sexuality and subjectivity. While there can be no representative claims made from this thesis it contributes to an understanding of the embodied experiences of early menopause. It provides an understanding of the creation of early menopause through social practices and goes part way to redressing the problematics of what Fraser terms ‘cultural non-recognition’. But, more importantly, it acknowledges early menopause as a variety of experiences where women interpret their changing bodies through changing discourses.

Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references. Available also from UMI Company.

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

Menopausal symptoms are common causes for women to seek treatment. The severity of symptoms vary from patient to patient and reduces the quality of life for many women. Most women reach menopause between the ages of 45 and 55, some not until 60 and some at an early age in their thirties or forties (Stoppler, 2008). Aim This study aimed to offer an alternative form of treatment for women that are experiencing the unpleasant symptoms that are experienced with menopause, since hormone replacement therapy, may have adverse effects in some women (Wang-Cheng, 2007). This double-blind placebo controlled study investigated the efficacy of a complementary formulation of Folliculinum D6 and Five-Flower Formula™, (Folliculinum D6, Rock Rose, Impatiens, Clematis, Star of Bethlehem, Cherry Plum ) in the treatment of menopausal symptoms in terms of participants’ perception of the treatment. iii This formula is currently available commercially as an unregistered product trading under the name of Femme Rosa. This formula was developed by Dr Maharaj, and is prepared by Natura®. The formula consists of Folliculinum D6 and Five-Flower Formula™. Methodology A total of 60 female participants who were going through natural menopause and currently experiencing menopausal symptoms took part in the study. They were randomly assigned according to the randomization sheet drawn up by the supervisor, 29 participants to the treatment group and 31 to the placebo group. The study was conducted over a period of six weeks and participants were required to attend two consultations at the Homoeopathic Day Clinic at the Durban University of Technology. Participants were recruited according to the inclusion criteria set out. During the first consultation the participants completed the Greene Climacteric Scale questionnaire and a concise case history was taken, thereafter each patient was handed two hot flush diaries to be completed one week before treatment and during the sixth week of treatment. Each participant was required to take one tablet every morning and evening for 6 weeks. Six weeks after the first consultation participants attended the second consultation and the Greene Climacteric Scale was completed for the final time and the hot flush diaries collected. iv Results The results of the first questionnaire and hot flush diary were used as a baseline for statistical analyses. As each group consisted of 29 and 31 subjects, non-parametric tests were used for data analysis. All statistical analyses were carried out using SPSS version 15.0. Conclusion An improvement was demonstrated in both treatment and placebo groups after treatment yet this improvement was not statistically significant. The only symptoms that improved in the treatment group were the hot flushes and psychological symptoms however, there were no significant differences between the treatment and placebo group. It was concluded that the complementary formulation of Folliculinum D6 and Five-Flower Formula™ was not statistically effective in the treatment of menopausal symptoms in terms of the participants’ perception of the treatment.

Thesis (Ph. D.)--Dept. of Exercise and Sport Science, University of Utah, 2006. / Includes bibliographical references (leaves [58]-68).

Thesis (Ph. D.)--University of Utah, 2006. / Includes bibliographical references (leaves [58]-68). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

This study was prompted by the negative images of midlife women portrayed in the literature and popular culture. Apart from a few accounts of extraordinary feats, which counter the generalisations about midlife women, for example, a 76 year old grandmother going sky-diving, there is very little written about midlife women living enjoyable, independent lives. This work presents a detailed analyses of the way in which thirty women have been able to, or are in the process of, actively structuring an enjoyable midlife. Previous research has tended to view aspects of women's lives in isolation, such as leisure, body, health, or work. The artificial boundaries that have arisen because of this separation reinforce societal notions of fragmentation within social life. This research was designed to challenge these divisions and, by investigating women's enjoyable experiences, to develop concepts that are common across the composition of these women's lives. A feminist phenomenological methodology was used and semi-structured in-depth interviews were undertaken to access women's lived experience of enjoyment, their lifeworld, and also to determine participants understanding of the concept of leisure and their experience of menopause. All interviews were transcribed and subjected to a systematic content analysis, as advocated by phenomenological research practitioners. The findings contradict the predominantly negative popular images of midlife women and show that most of the women in the study are in the act of resisting the earlier views of women and ageing. Their responses also indicate they tend not to recognise the fragmentation of their lives into work, leisure and health issues, but rather regard their lives as 'all together and not separated out'. An enjoyable lifeworld means being regarded as an individual and independent person and having 'a sense of being in charge', over their own time and space, making opportunities for physical, social, creative and intellectual activity, as well as preparing for the future. The thesis concludes with a discussion of how midlife women are creating enjoyable lifestyles. The concept of enjoyment and enjoyable experiences appear to defy segmentation, and the women are in the act of composing their own lives.

No description available.

M.A. / In this study an attempt is made to understand the phenomenological experience of women in spontaneous premature menopause. There is very little literature available about spontaneous premature menopause and even less about the experiences of women in spontaneous premature menopause. Spontaneous premature menopause is viewed as a negative experience in the woman’s life and medical staff recommend that she should receive treatment for spontaneous premature menopause. In this study the woman, herself, was asked how she feels about spontaneous premature menopause and how it affects her life. Phenomenological research procedures are used in this study. Interviews were conducted with three participants. They were asked to tell the researcher about their experience of spontaneous premature menopause and how it affected their lives. Hermeneutic phenomenology is used to analyse the participants’ experience of spontaneous premature menopause. Themes and categories that stood out during analyses are discussed and interpreted. Results of the study show that spontaneous premature menopause can cause bodily changes in women; it can lead to several different menopausal symptoms and it can have a negative effect on her relationship with her family, friends and other people. Bodily changes that can occur, because of spontaneous premature menopause include weight gain, changes in the breasts, changes to the vagina, skin changes, bladder changes, itchy skin, heart palpitations and changes to the pelvic floor. Symptoms that can occur during spontaneous premature menopause include hot flushes, night sweats, headaches, sleep difficulties, tiredness, depression, forgetfulness, mixed emotions and pain in different areas of the body. Participants felt that their bodies, their doctors and their family and friends failed them. They had no one to turn to, because significant people in their lives did not believe that they are in spontaneous premature menopause. They were told that it must be something else like depression. The participants had shock reactions due to feelings of loss. They no longer had the body of a young woman. They had lost their youthful appearance, their sexuality, their abilty to bear children and to function satisfactorily in their daily duties. These women had to come to grips with the fact that their youthful days were over and that they were aging before their time. It is suggested that cross-cultural research be done in the future to establish how women in other cultures experience spontaneous premature menopause. Comparisions can be made and if there are any differences efforts can be made to establish what causes these differences. Cultures where spontaneous premature menopause is viewed as a positive event in a woman’s life can be researched to establish how this experience can be turned into a positive experience in cultures where it is viewed negatively.

Background: Anxiety is one of the mood symptoms experienced by menopausal women; however, anxiety symptoms during menopause have received little attention in the literature despite the potential impact on quality of life. Many of the tools used to evaluate and measure anxiety associated with menopause assume that menopausal anxiety shares similar criteria as anxiety disorders and this may not be entirely true. There are very few studies that have assessed anxiety in the context of menopause leaving the concept of menopausal anxiety not well defined and raising the question: Is menopausal anxiety a unique and distinctly different syndrome? The purpose of this study was to explore and gain an in-depth understanding of the experience of anxiety in menopausal women. Methods: Twenty menopausal women were recruited for this qualitative study to explore the experience of anxiety in menopause. Through the use of a semi-structured interview using open-ended questions, participants were asked to share their experience with anxiety that was new or different with the onset of menopause. Interviews were audio recorded by the researcher and lasted approximately 30 - 60 minutes. Participants described their experience with anxiety and discussed how the anxiety is different in menopause. Results: Emergent themes revealed that anxiety in menopause is a unique and individual experience. The substantial variation in the onset, timing and severity of the symptoms made it impossible to construct a uniform and consistent definition of the experience. Participants discussed their preferences for management which included non-pharmacologic, lifestyle, relaxation based interventions. Conclusions: This research supports the existence of a unique and individualized experience of anxiety in menopause. A better understanding of the experience and patient preferences will assist healthcare providers in developing individualized treatment options aimed at improving quality of life.