How is Menopause Managed in Different Cultures?

Last updated 12.08.2023 | by Sabrina Johnson | 13 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


As a woman, at some point in your life you will experience menopause, the time when your periods and fertile years come to an end. 

No matter what race, religion, culture, or background, our shared biology means we can all expect to experience this transition. But you might be surprised to learn that the way we experience it and the symptoms that happen to us vary greatly depending on our cultures and where we live. And learning about these variations can help us all to navigate the journey of menopause with greater ease and understanding.

I’ve supported women through menopause for many years, even before my own menopausal journey began. But even with my extensive medical knowledge about this phase of life, I have been amazed to learn how truly different this transitional  time can be in different parts of the world. 

So, are you curious about how different cultures manage menopause? Are you wondering what your own experience might have been like if you were born in another culture, or lived in a different country? Well, you’ve come to the right place. 

In this post, I’ll delve into the various ways that women view and manage menopause around the globe.

Does the Onset of Menopause Vary Among Different Cultures?

The onset of menopause varies from woman to woman. There are individual variations that are affected by medications, socioeconomic factors, diet, fitness, and age of onset of one’s period. There are also some striking differences in the age of onset in different parts of the world, as well as between women of differing ethnicities. 

In the US, the average woman reaches menopause at 51. But in India, the age is much lower, at just 46. Ethnicity also plays a large role in predicting when a woman may reach menopause. Black, Asian, and Latina women are all statistically more likely to experience premature menopause than Caucasian women[1]. The reason for this is not completely understood. 

How do Symptoms of Menopause Vary Around the World?

All women go through menopause. However, I was surprised to learn that not everyone experiences the symptoms in the same way.

Data gathered from around the world suggests that race, culture, and attitudes towards menopause all affect the type of symptoms women can expect to experience. These factors can also play a big role in how long the symptoms will last.

In the US, women are taught that menopause is something to dread. Symptoms such as hot flashes, mood swings, and insomnia are all expected to plague us for several years. And this transitional time is usually associated with loss rather than gain.

Sadly, I think this discouraging attitude can often hold us back and cause more problems than it solves. By preparing us for the worst, this cynical mindset teaches us to expect the worst. But thankfully, not every culture takes this pessimistic view of menopause.

Japan

In Japan, menopause, or “konenki,” is viewed as a time of rebirth. Even the word itself (“ko,” meaning renewal; “nen,” meaning years; and “ki,” meaning season) points to this optimistic stance.

This is very different from the attitudes found in many Western nations. For example, the English word “menopause” is derived from the Greek words “men,” meaning month, and pauses, meaning “to stop.”

And so, in the West, there’s a tendency to view menopause as simply the end of our monthly periods rather than an opportunity for spiritual, emotional, and physical renewal.

During menopause, our levels of estrogen go down. However, most Japanese women view any symptoms that come along with menopause as symptoms of an imbalance, not a depletion. This explains why medications such as hormone replacement therapy (HRT) are much less commonly prescribed in Japan. Instead, the focus is on rebalancing fluctuating hormones in a natural and holistic way.

Researchers think that these differences in cultural attitudes might explain, in part, why Japanese women tend to experience less discomfort during their menopausal transition.

Just a quarter of Japanese women report suffering from hot flashes. This figure is in stark contrast to the United States, where more than 80% of women notice this bothersome symptom.

The Japanese Diet

Cultural attitudes undoubtedly play a large role in how we experience menopause. But that’s not the only reason that Japanese women seem to fare better than their Western counterparts. The food consumed in Japan also has an influence.

Soy products, such as edamame, soy sauce, and tofu, are all a major part of the Japanese diet. These foods contain high concentrations of compounds known as phytoestrogens.

Phytoestrogens mimic the role of estrogen produced by the body. So, increasing your intake of these compounds has been shown to help rebalance hormones and make up for depleting estrogen in the ovaries.

I’ve personally noticed an improvement in my own symptoms since I began increasing my intake of phytoestrogens through my diet. My hot flashes have become less frequent and severe, and I also suffer from fewer episodes of night sweats.

It’s also important to note that the average Japanese woman tends to eat a more balanced and healthy diet overall and is more physically active compared with the average woman in the United States.

As a result, 2 out of 3 American women are either overweight or obese. However, in Japan, just 16% have a BMI (body mass index) above the normal threshold[2].

Excess body fat can severely increase the chances of developing undesirable symptoms during menopause. Hot flashes and night sweats are typically much more severe in women who are overweight, and symptoms also appear to last longer.

Being overweight also increases your risk factors for developing conditions such as diabetes, high blood pressure, and cancer. These diseases are rife in the United States; however, Japanese women experience far fewer of these chronic health problems.

Mayan Menopause

The Mayans were a sophisticated ancient culture, and while their civilization collapsed long ago, descendants of the Mayans still exist in parts of Central America and Mexico.

Recent research has shown that the female descendants of the Maya people report a surprising and fascinating lack of symptoms that otherwise plague menopausal women around the world[3].

Hot flashes, mood swings, and insomnia are significantly less prevalent in the rural Maya communities. And while not all Mayan women manage to avoid menopause symptoms entirely, the majority do.

Rates of osteoporosis in postmenopausal Mayan women are also much lower than women in other demographics. However, the reasons for these differences are unclear.

Some believe that Mayan women’s experience of menopause is helped by a predominantly natural diet, which is rich in vitamins and minerals. Plus, a typical Mayan woman leads a less stressful, more relaxed pace of life than many of us in other parts of the world. But while these factors no doubt play a large role, it seems that genetics are also a big influence.

Plus, just like Japanese women, Mayan women have a much more optimistic outlook when it comes to menopause. Most view menopause as an exciting milestone marked by freedom and newfound wisdom.

India

Many cultures in India also celebrate menopause as a positive stage of life.

And for some women, the transition comes with additional benefits. During an old study carried out in 1975, researchers Marcha Flint and Ratna Suprapti Samil visited the state of Rajasthan in North West India. There, they found that post-menopausal women who had spent their entire lives veiled from the male gaze could now socialize in mixed-sex environments and freely mingle with men.

And so, women tended to look forward to this time of transition and embrace the changes and new sense of freedom that came with it. As a result, they also experienced fewer symptoms compared with women in the West.

The Middle East

In some Middle Eastern cultures, such as the United Arab Emirates and Iran, words for menopause have a negative connotation[4]. In these cultures, a woman’s fertility is often considered to be her greatest asset. And so, when she stops having her periods and can no longer bear children, her social status depreciates.

Many women here consider the post-menopausal years as ‘the age of desperation.’ And so, perhaps unsurprisingly, women from this part of the world are more likely to experience bothersome menopause symptoms.

China

Chinese culture celebrates menopause as a time of rebirth. In ancient Chinese tradition, a woman loses energy each time she menstruates and with every child she gives birth to. And so, after menopause, women are considered more powerful, as they now hold onto the energy that was lost each month during their fertile years.

This positive attitude towards menopause means that women rely less on medicines to manage their symptoms. They also experience fewer hot flashes than women in the West.

But interestingly, this positive mindset and symptomatic relief isn’t universal across China [5]. Cultural and educational differences between city and rural women mean that those living in built-up areas are more likely to suffer from symptoms such as hot flashes, night sweats, and mood swings.

A Positive Mindset

Perhaps the secret to navigating menopause with ease is to cultivate a positive mindset?

In many traditional cultures, menopause isn’t considered to be a medical problem. So, women don’t place as much focus on the symptoms, and they spend less time in the doctor’s office.

It’s also important to note that in many parts of the world, aging is not considered something to fear but something to embrace. Menopause marks the transition into becoming a respected elder, an older woman who has power and status and is of great service to her community. After menopause, a woman becomes a leader who guides the younger generations with spiritual and practical wisdom.

This explains why women in many parts of the world look forward to this transitional time rather than dread it, as many women here in the West have been taught to do.

After discovering the powerful influence that mindset appears to have, I’ve decided to view my own menopausal transition with more positivity, and I encourage you to do the same.

Menopause Treatments Across the World

In the West, many women reach for prescription medications to tackle the undesirable symptoms of menopause.

But around the world, some natural foods, herbs, and supplements have been proven to have beneficial, hormone-balancing effects. In many cultures, these types of traditional treatments are preferred.

Soy

In Asia, night sweats and hot flashes are much less common because the soy-rich diets of countries like Japan, Korea, and China provide a great source of hormone-balancing phytoestrogens. Adding phytoestrogens to my own diet has certainly helped to alleviate many of my own symptoms.

Dong Quai

Dong quai, otherwise known as Chinese Angelica, is a popular herb prescribed by doctors, which also contains high amounts of phytoestrogens. It’s used in Chinese medicine to help stave off symptoms such as hot flashes, loss of libido, and mood swings.

Energy Balancing

Traditional Chinese medicine also dictates that menopause symptoms are triggered by an imbalance of yin and yang in the kidneys. And so to treat the symptoms, doctors will address a woman’s kidney health to treat the underlying cause.

Maca

In South America, many women swear by a natural supplement called maca root.

Maca has been shown to stave off the symptoms of menopause. But unlike soy and Dong quai, it doesn’t contain phytoestrogens. Instead, it works as an adaptogen to balance the hormones produced in the body.

Maca root also contains high amounts of healthy vitamins and minerals, such as magnesium, iron, calcium, and vitamins B, C, and E.

Thanks to maca’s hormone-balancing properties, it’s known to alleviate symptoms such as hot flashes and night sweats. But that’s not all. Maca is also renowned for its ability to increase libido and give a waning sex life a well-needed boost.

Red Clover

Like their American counterparts, modern European women are more likely to turn to prescription pharmaceuticals to manage the symptoms of menopause. But native plants, such as red clover, are still a popular form of alternative treatment.

Red clover grows abundantly across most of Europe, and it’s well known as a rich source of phytoestrogens, the same compounds found in soy.

Black Cohosh

In North America, another native herb, known as Black Cohosh, is also a popular phytoestrogen-rich remedy to treat symptoms such as hot flashes and mood swings.

FAQs

How popular is hormone replacement therapy (HRT) around the globe?

As of 2016, it was estimated that around 44 million women around the world were using HRT to combat the symptoms of menopause. And year after year, this number is steadily rising.
According to the Nation Health Interview Survey, 18% of US women over the age of 40 are taking HRT. However, HRT is significantly more popular in the US and other Western nations than it is in other parts of the world, where more natural and holistic solutions are preferred.

Does climate affect a woman’s experience during menopause?

While lifestyle factors, genetics, perceptions, and attitudes are the biggest factors that drive the menopause experience, the type of climate you live in can also have an effect. 
For example, women who live in hot and humid environments may experience increased discomfort due to hot flashes and night sweats.
Loss of bone density that accompanies menopause can also be made worse if you live in a climate with less sun exposure, leading to a lower uptake of vitamin D.

Which ethnicities experience the most severe symptoms of menopause?

While genetics and ethnicity can play a role in the way a woman experiences menopause, factors such as culture, socioeconomic status, and overall health play a much bigger role. So, there is no single ethnicity that universally experiences the worst symptoms.

Conclusion

Menopause is a universal experience for women, and all of us will go through this transitional time in our lives.

However, the experience of menopause looks very different in different parts of the world. The way menopause is viewed and treated, and even the symptoms you can expect, vary widely depending on where you live.

While race and genetics play a role in these differences, it seems that lifestyle, culture, and attitudes towards menopause have the biggest impact on the way we experience this transitional time.

I was fascinated to learn about the variations in approaches to menopause around the world, and how these variations can affect us on a physical level. And so now, I advise readers to change the way they think about their own menopausal journey. After all, if a simple shift in attitude leads to fewer hot flashes, less mood swings, and more sleep, it’s certainly worth a try.

So, let’s all remember that menopause can be an exciting milestone, instead of something to fear. It’s a time of spiritual change and a special opportunity to embrace the well earned wisdom that comes with age.

Author

  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.