Menopause: A Biocultural Perspective (Studies in Medical Anthropology)

243 Pages·2006·0.91 MB·English

by  Lynnette Leidy Sievert

Menopause
Studies in Medical Anthropology
Edited by Alan Harwood
Advisory Board
William Dressler
Mary Jo Good
Peter Guarnaccia
Sharon Kaufman
Shirley Lindenbaum
Lynn Morgan
Catherine Panter-Brick
Stacy Leigh Pigg
Lorna Rhodes
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Menopause
A Biocultural Perspective
LYNNETTE LEIDY SIEVERT
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RUTGERS UNIVERSITY PRESS
NEW BRUNSWICK, NEW JERSEY, AND LONDON
LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA
Sievert, Lynnette Leidy, 1960–
Menopause : a biocultural perspective / Lynnette Leidy Sievert.
p. cm.—(Studies in medical anthropology)
Includes bibliographical references and index.
ISBN-13: 978-0-8135-3855-6 (hardcover : alk. paper)
ISBN-13: 978-0-8135-3856-3 (pbk. : alk. paper)
1. Menopause. I. Title. II. Series: Studies in medical anthropology.
RG.S
.'—dc 
A British Cataloging-in-Publication record for this book is available
from the British Library.
Copyright © by Lynnette Leidy Sievert
All rights reserved
No part of this book may be reproduced or utilized in any form or by any means,
electronic or mechanical, or by any information storage and retrieval system, without
written permission from the publisher. Please contact Rutgers University Press, 
Joyce Kilmer Avenue, Piscataway, NJ –. The only exception to this
prohibition is “fair use” as defined by U.S. copyright law.
Manufactured in the United States of America
In memory of
Marina Sánchez Conde de Paz

CONTENTS
List of Figures ix
List of Tables xi
Preface xiii
Acknowledgments xvii
1 Introduction 1
2 The Biological Basis of Menopause 32
3 Methods of Study 49
4 Age at Menopause 82
5 The Discomforts of Menopause 111
6 Hot Flashes 127
7 Conclusions and Future Directions 162
Notes 171
References 177
Index 217

FIGURES
1.1. Life stages of the macaque, chimpanzee, and human 3
1.2. Growth and development of an ovarian follicle 11
1.3. The most often cited model of follicular depletion 12
1.4. The true decline in numbers of ovarian follicles across the lifespan 13
1.5. Evolutionary relationships 17
1.6. A biocultural model for examining human variation 19
1.7. Cultural and biological boundaries on female reproduction 25
1.8. Ages at tubal ligation, hysterectomy, and natural menopause
in Puebla, Mexico 31
2.1. Neurotransmitters and GnRH release 33
2.2. Levels of LH, FSH, total estrogens, and progesterone across
the menstrual cycle 34
2.3. A model of the production of estradiol within ovarian follicles 36
2.4. Changes in FSH, LH, estradiol, and estrone levels among women
followed longitudinally through the menopausal transition 39
2.5. Recalled ages at natural menopause, Puebla, Mexico 40
2.6. Nineteenth-century example of uterine displacement 42
3.1. Variability of menstrual cycle length 52
3.2. Probit analysis to compute median age at menopause in
Puebla, Mexico 54
3.3. BMI among women of menopausal age, Puebla, Mexico 66
4.1. Recalled ages at natural menopause, Asunción, Paraguay 91
4.2. Kaplan-Meier analysis to compute median age at menopause
in Puebla, Mexico 99
5.1. Mood swings, irritability, or weepiness in relation to
menopausal status 121
6.1. Body diagram 131
6.2. Biocultural model for the study of hot flashes 141
6.3. The thermoneutral zone 144
6.4. Variation in hot flash frequency in relation to temperature
of the coldest month 146
ix