Life change: what do women want?

Life change: What do women want?

Ask them. Two epidemiologists did just that in a study of healthy middle-aged women to determine how major life transitions affect the well-being of women between 45 and 60. Sonja M. McKinlay and John B. McKinlay of the New England Research Institute in Watertown, Mass., examined the role of menopause and other events, such as children leaving home and then returning, employment, becoming parental caretakers and a husband's illness or death. In an initial analysis of results, the McKinlays report that depression in menopausal women, long regarded as a fact of life, is due not to the physiological change but to other causes.

Data from the five-year study of more than 2,300 women show that only 3 percent expressed regret during or after menopause about their physical changes, including normal hot flashes, cold sweats and menstrual irregularities. Rather than lamenting the loss of reproductive ability, the majority were neutral or expressed relief from the concerns of pregnancy, contraception and menstruation.

A survey of more than 8,000 women born between 1926 and 1936, from rural and urban areas of Massachusetts, produced the pool of 2,353 initially pre-menopausal women whom the McKinlays interviewed six times between 1982 and 1987. Standard measures of social and psychological status were used.

"In fact, it's overwhelming," says Sonja McKinlay of the women's upbeat response, which she attributes in part to basing the survey on healthy women.

"A bit over 50 percent of the women we interviewed don't even see a physician once a year," she told SCIENCE NEWS, elaborating on findings initially reported at the recent Society of Behavioral Medicine meeting in Boston. "Physicians assume that they see most women, when actually they're seeing a very biased, unrepresentative group. The majority of women, we found, go through menopause without ever consulting a physician." McKinlay also suggests that because oral contraceptives were not available to this age group when they were younger, their feelings reflect relief from a great concern, but that "it may be different if we surveyed a younger group."

Analyzing the data for the relationship between menopause and depression, John McKinlay discovered that many women who reported menopausal symptoms to doctors were already depressed, and that depressed women reported symptoms at twice the rate the non-depressed did. Chief among the underlying causes of depression were children (41 percent), followed by parents (23 percent), relatives (22 percent) and husbands (11 percent), the McKinlays found.

The McKinlays call their study the largest prospective study yet on non-institutionalized women of this age. Most research into menopause has been in clinical populations, and, observes Robert Wallace of the Department of Preventive Medicine at the University of Iowa, "that makes it difficult to get a sense of what's going on in the community. What's new here is taking a population with a relatively low disease risk and asking a different set of scientific questions."