LAUSR

In Bangladesh, a South Asian country of 162 million people, M enopause, the cessation of menses and ovarian function, is a physiologic, endocrinologic, and normal consequence of aging. Yet, as with all female reproductive functions, menopause is also seen and interpreted socio-culturally by the values placed by a particular society on a woman’s status and worth based on her reproductive potential. The experience and interpretation of menopause is nuanced internally by each woman who goes through this transition and externally by the perceptions of her family and community. The interpretations of these experiences vary cross-culturally from a normal biological process, to transformative liberation from menses, to a state of identity loss and shame. In this issue of Menopause, Harun et al summarize the experience of menopause in a cohort of urban and rural women in Bangladesh. To understand the knowledge and attitudes of menopausal Bangladeshi women, they performed a 28-question interview of 160 women. They conclude that although women in Bangladesh had little understanding of the process of menopause, increased knowledge was associated with education, profession, and urban dwelling. They also identify shame and stigma associated with menopause in Bangladesh. In particular, a substantial proportion of both rural and urban women felt humiliated and 61% and 39%, respectively, of rural and urban women did not consider themselves ‘‘real women’’ once they lost their reproductive capacity. Additionally, 91% of women reported a deterioration of their relationships with their husbands. Their study brings up many interesting questions. Why is there stigma to menopause in Bangladesh? Is this a universal phenomenon faced by aging women in all countries? Or does Bangladeshi society, specifically, have a negative outlook on the condition of menopause?