The role of the menopause in women's experiences of the 'change of life'

Over the course of the 20th century, the menopause came to be viewed amongst the medical profession as a hormone deficiency state. This formulation of the menopause as a physiological and biochemical change, whilst in some ways appropriate, understates the importance of the social context in which the menopause is experienced. Drawing on women's accounts of the menopause, as described in the comments section of a longitudinal national survey, this paper describes the experience of the menopause transition as a status passage (Glaser and Strauss 1971), where women move through a series of five stages: (1) expectation of symptoms; (2) experience of symptoms and loss of control; (3) confirmation of the menopause; (4) regaining control and (5) freedom from menstruation. The social changes experienced by women during this time are then considered as parallel status passages, often competing for attention with the menopause transition. These free comments made by women emphasise the importance of changing social relationships with partners, children and parents, and changes at work. We show that, whilst women conceive the menopause to be a medical event, they themselves place importance on the social context in which the menopause is experienced. We argue therefore that the predominantly lay term, the 'change of life', is appropriate to capture the multiplicity of biological and social changes that occur during midlife, of which menopause is only one part.