The medicalization of menopause: Implications for recruitment of study participants

Objective: Early studies of menopause recruited sample populations from cli nical settings; however, in the 1970s, populations drawn from health care s ettings were characterized as nonrepresentative because of symptom overrepo rting. This pilot study was carried out to test whether this characterizati on still holds true: that women who are: drawn from clinical settings repor t more symptoms compared with women who are recruited from community and wo rk sites. Design: Open-ended interviews were carried out with patients aged 40-60 yea rs in a physician's office (n = 50), in a chiropractor's office (n = 24), a t two Breast Health Project sites (n = 50), and ill several non-health care sites in the community (n = 81). Interviews were supplemented by anthropom etrics and standardized return-by-mail questionnaires. Results: Women who experienced hot flashes and sweating were more likely to report having spoken with a physician about menopause. However, women who were drawn from the clinical setting were not significantly more likely to describe hot flashes, sweats, or mood changes and were significantly less l ikely to report headaches in relation to menopause compared with a communit y sample. Women who were drawn from the physician's office were more likely to use hormone replacement therapy and to have had a hysterectomy. Conclusions: This study suggests that because of the medicalization of meno pause, we need to rethink our assumptions about the characteristics of popu lations drawn from health care settings, In western Massachusetts, place of recruitment did not predict symptom frequency. (Menopause 2000;7:193-199. (C) 2000, The North American Menopause Society.).