Menopause across cultures: A review of the evidence

Objective: To review the cross-cultural evidence on menopausal symptoms to assess the extent of variability in symptomatology and the relative weight of hormonal and social factors. Design: Literature review and critical summaries of available studies. Results: Symptoms related to menopause are found in all regions of the worl d, although everywhere large proportions of women go through menopause unev entfully. The evidence does not support that women in developing countries report fewer symptoms than in industrialized countries, There is a great di versity in symptom frequencies across countries, and the association of sym p toms with menopausal status is weak. A number of symptoms thought to be p art of menopause are in fact not specific to it, although the evidence does support the narrow estrogen hypothesis of a core of symptoms associated wi th estrogen decline, namely vasomotor and vaginal symptoms. Conclusions: The association between hormonal changes and menopause symptom atology is complex and mediated by sociocultural factors. (Menopause 2000;7 :184-192, (C) 2000, The North American Menopause Society.).