FIRST NATIONS WOMEN AND MENOPAUSE
Breaking down barriers
Menopause is traditionally not a subject discussed among First Nations women, which can lead to discomfort when discussing the subject with healthcare professionals. However, every woman has the right to be informed about what is happening to her body and to have access to helpful resources.
Menopausal Experience in Australian first nations Women
Documentation of the experience of menopause in Australian First Nations women is scarce, making their menopausal experience relatively unknown. In one study of more than 200 First Nations participants, it was found that the average age of onset for menopause was five years earlier than non-First Nations Australian women. Additionally, only 36% of rural First Nations women reported symptoms¹. This indicates a potential underreporting or different perception of symptoms among First Nations women compared to their non-First Nations counterparts.
Several factors appear to influence the menopausal experience among women:
- Mother’s age at menopause: A hereditary factor impacting the age of onset.
- Age at menarche: Early menarche has been linked to earlier menopause.
- High BMI: Associated with increased menopausal symptoms and earlier onset.
- Lack of physical activity: Can exacerbate symptoms.
- Smoking: Known to advance the age of menopause and increase symptoms.
- Diet rich in phytoestrogens: May reduce symptoms.
- High parity and long duration of breastfeeding: Associated with fewer symptoms.
- Use of oral contraceptives: Linked to lower reporting of menopausal symptoms.
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Terms like 'The Change' or 'Change of Life' are more commonly used than menopause.
The experience of menopause is subjective and can be interpreted in many ways, both socially and culturally. There is no clear consensus on how First Nations women view menopause or what influences this view. It is uncertain whether menopause is influenced by poor health, what coping mechanisms are used, and whether this transition is a highly private experience⁴.
In a study of 25 First Nations women over a year using interviews and focus group discussions to explore how First Nations women view menopause, these major themes emerged³.
Cultural Influences on Menopause
Considerable research shows significant variation across cultures in the menopause experience, influenced by biological, psychological, social, and cultural factors². In many Indigenous cultures, menopause can lead to an increased role in the family and religion, often elevating a woman's status in her community and leading to a more positive experience².
In Indigenous Australian cultures, menopausal women often gain increased respect and authority within their communities. This elevation in status can contribute to a more positive experience of menopause, contrasting with the often negative connotations associated with menopause in Western cultures⁴. The holistic view of health in Indigenous cultures, which integrates physical, emotional, and spiritual wellbeing, also plays a significant role in shaping the menopausal experience⁴.
Health Implications and
Access to Care
Cardiovascular disease (CVD) is the leading cause of death in women around the world. Among First Nations women, cardiovascular disease is more prevalent and often occurs 10-20 years earlier than non-First Nations women⁵.
The intersection of cultural beliefs and access to healthcare services significantly impacts the menopausal experience for First Nations women. Many First Nations women face barriers to accessing healthcare, including geographical isolation, socioeconomic disadvantage and cultural differences between patients and healthcare providers⁴. These barriers can lead to delayed diagnosis and treatment of menopausal symptoms, exacerbating health inequalities.
There is a pressing need for culturally competent healthcare that acknowledges and respects the unique experiences and perspectives of First Nations women. Healthcare providers should be trained to understand the cultural context of menopause in Indigenous communities and to provide information and support in a way that is respectful and relevant to these women⁴.
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Symptoms vary widely among individuals.
Research and Future Directions
Despite the insights gained from existing studies, there remains a significant gap in the literature regarding the menopausal experiences of First Nations women. More comprehensive and culturally sensitive research is needed to fully understand the diverse experiences of menopause⁴. Such research should be co-designed and collaboratively implemented to ensure that First Nations women’s voices are heard and their perspectives accurately represented⁴.
Future studies should also explore the effectiveness of different interventions, both traditional and modern, in managing menopausal symptoms among First Nations women. By building a robust evidence base, healthcare providers can develop better strategies to support First Nations women through menopause, improving their health and wellbeing.
In summary, the menopausal experience among First Nations women is influenced by a variety of factors, including cultural beliefs, social status, and access to healthcare. There is a need for more research to fully understand this experience and to provide appropriate support and resources. By recognising and addressing these unique experiences, First Nations women in Australia can be better supported through this significant life transition.
References
1. Jurgenson, J. R., et al. (2014). “Exploring Australian Aboriginal women’s experiences of menopause: a descriptive study.” BMC Women’s Health 14(1). This study references McKenna EM. Masters Thesis - Masters of Medical Science. Cairns: The University of Queensland; 2001. The experience, knowledge and relevance of menopause to aboriginal and Caucasian women in Far North Queensland.
2. Barthelus, E. D., et al. (2022). “Culture: An Influence on the menopausal experience.” Menopause 29(12).
3. Jurgenson, J. R., et al. (2014). “Exploring Australian Aboriginal women’s experiences of menopause: a descriptive study.” BMC Women’s Health 14(1).
4. Jones, E. K., et al. (2012). “Menopause and the influence of culture: another gap for Indigenous Australian women?” BMC Women’s Health 12(1).
5. Marschner, S., et al. (2022). “Randomised clinical trial using Coronary Artery Calcium Scoring in Australian Women with Novel Cardiovascular Risk Factors (CAC-WOMEN Trial): Study protocol.” BMJ Open 12(12).