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Menopausal Discomfort? No Sweat! A New Theory on the Cause and Prevention of Hot Flashes

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Women in Fiji have it easy, at least when it comes to menopause.

We were in Fiji to study bra wearing and breast cancer, but took advantage of the opportunity of being with these non-western people to ask about the way local women experienced menopause. Margaret Mead, the famous cultural anthropologist, discovered that the discomforts young western women often associate with the "coming of age" were mostly absent for Samoan women. As medical anthropologists, we wondered if the coming "out of age" was any different for Fijian women than for those in the west who complain of various symptoms, such as hot flashes and profuse sweating.

So we asked some post-menopausal women how they experienced their menopause. The response was pretty similar from each.

"What's that?" they asked, perplexed.

We soon discovered that there is no equivalent word in Fijian for "menopause". In Fiji, when a women lives long enough to stop menstruating, she simply goes to the doctor to make sure she is not pregnant. Once she is assured this is not the case, she is happy and carefree. The lack of negative physiological and psychological effects, so troublesome for some western women, has resulted in the absence of a term to describe this time in a Fijian woman's life.

The hot flashes and profuse sweating of menopause is therefore not universal among all cultures. And in western cultures, it is not even universal among all women. While the medical literature has harped on lack of estrogen and excessive gonadotropic hormones as the most likely causes of this "pathology", the fact that most women who pass through menopause have little or no problem at all suggests that the mechanism for the reported problems must be something other than altered endocrinology post-menopause. In other words, since all women have reduced estrogen and elevated gonadotropins as they enter menopause, why do some women have troubling hot flashes and sweats, while others do not? Could there be another mechanism that has been overlooked?

Perhaps the solution lies in the way we are conceptualizing menopausal "symptoms".

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