title: Attitudes toward menopause in relation to symptom experience in Puebla, Mexico.
abstract: OBJECTIVE
  To examine how attitudes toward menopause were associated with symptom frequencies after controlling for menopause status and level of education.
  
  
  METHODS
  Women aged 28-70 (n = 755) were interviewed from May, 1999 through August, 2000 in the city of Puebla, Mexico. Over 90% of the sample were aged 40-60. Participants were asked to select from a set of dichotomies to describe "how a woman feels during menopause." Symptom frequencies were assessed by a checklist of everyday complaints experienced during the two weeks before interview. Symptom presence or absence was examined in relation to attitudes while controlling for menopause status and level of education using binary logistic regression analyses.
  
  
  RESULTS
  The majority of respondents said that a menopausal woman feels "insecure" and "unattractive" yet "complete," "necessary," and "successful." Pre-menopausal women and respondents who had undergone a hysterectomy were more likely to express negative attitudes. Post-menopausal women and women with fewer years of education were significantly more likely to report symptoms such as hot flashes, joint aches, and nervous tension. A range of negative attitudes were associated with nervous tension, feeling blue, and head aches; however, only a few negative attitudes were significantly predictive of estrogen-related symptoms (e.g., hot flashes).
  
  
  CONCLUSIONS
  There is a high value placed on both external appearance and familial responsibility among menopausal women in Puebla, Mexico, and negative characterizations of menopause reflect these values. Negative attitudes were associated with more frequently reported symptoms compared with positive attitudes. The challenge remains to separate factors related to the hormonal changes of menopause from those not associated with hormonal changes to better understand symptom experience.
authors.affiliation: Department of Anthropology, University of Massachusetts at Amherst, 01003-9278, USA. leidy@anthro.umass.edu
authors.forename: Lynnette Leidy
authors.initials: LL
authors.lastname: Sievert
authors.forename: Graciela
authors.initials: G
authors.lastname: Espinosa-Hernandez
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D004522:Educational Status; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008593:Menopause / Q000208:ethnology / Q000523:psychology*; D008800:Mexico; D008875:Middle Aged; D012649:Self Concept