Medicalization & Menopause: Women’s Health Beyond Reproduction

This past summer, I conducted an ethnography in Karachi, Pakistan where I explored questions related to menopause. I was interested in how perimenopausal and menopausal women acquire and understand health information. This idea started in undergrad when I was investigating how young, New York-based, South Asian women lacked access to information about reproductive health. I began thinking about how knowledge about the body and reproduction is acquired and how people’s narratives around their bodies are shaped. As I continued to explore these questions, I came across recent activism in the U.S. around menopause. It is a seldom discussed topic in both the Global North and the Global South, even though all reproductively able-bodied people will experience it if they live to that age or have it surgically induced.

Culture, environment, geography, and access all immensely shape how menopause is experienced. From thinking about menopause as a social experience, I began constructing this project to understand the embodied experience of menopause in Karachi, Pakistan. I conducted a 6-week ethnographic study during which I observed gynecological care settings, participated in care networks, and interviewed 25 women about their experiences with menopause. How do their ideas of health change as they move from the reproductive stage to menopause? What is the landscape of care on the ground, and how is that landscape composed by medical institutions on the one hand and non-medicalized aspects of care on the other? What social networks (kinship-based, age-based, etc.) do they rely upon for their health? What resonated with me most is that the women desired social support to aid them through their symptoms, perhaps even more so than they were seeking medical support. Social and familial support was held in as high regard as medical care, if not more so.

For contemporary care practices, I understand menopause on a spectrum between ignorance and medicalization, depending on the space. The two extremes are menopause being completely absent from any discussion, and clinical settings where it’s approached as an illness with an algorithmic treatment plan. While there is absolutely a need for more research, tools, and therapies to help women going through more difficult menopause transitions, menopause in and of itself should not become overmedicalized. As it is a subjective, culturally mediated experience, menopause care should have a much broader scope than just pharmacology and biomedical therapies