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By Y. Beyene

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This book attempts to provide a holistic view of peasant women and the cultural significance and physiological manifestation of menopause in two nonindustrialized cultures. A holistic approach means studying a culture totally: the economic, religious, political, and social dimensions of a particular culture as it affects its people. Cross-cultural studies of menopause should consider the social and economic status of the women as well as their personal lives, reproductive histories, health beliefs, and practices in order to present a complete picture of these women.

MacPherson (1981) states that physicians extended the boundaries of their roles beyond diagnosis and treatment of the usual diseases to include the definition and management of the normal female condition. Western medicine also extended its power as an agent of social control by stating that physicians should care for all women in menopause. During the 1960s, Robert A. Wilson, a New York gynecologist, led the crusade to redefine menopause as a physical disease. In his book, Feminine Forever (1966), Wilson stated that in the course of his work, spanning four decades and involving hundreds of carefully documented clinical cases, it became evident that menopause is, in fact, a deficiency disease.

The changes that occur in the ovaries influence the hypothalamic-pituitary unit and its hormone production and the functions of the ovary itself (Peters, 1978). Menopause is believed to occur when there are fewer primordial follicles (oocytes) in the ovary and the remaining follicles are unresponsive, showing no signs of development despite large amounts of circulating gonadotropins (follicle stimulating hormone and luteotrophic hormone). As a result, lower levels of circulating estrogen and progestrone are found because the follicles do not mature (Carroll, 1983).

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