Women's attitude and perceptions towards menopause in different cultures. Cross-cultural and intra-cultural comparison of pre-menopausal and post-menopausal women in Germany and in Papua New Guinea.
OBJECTIVE
To study cross-cultural and intra-cultural differences between the perception and the experience of menopause in pre-menopausal and post-menopausal German and Papua New Guineas women.


METHODS
Concepts concerning menopause and the experience of the menopause were assessed by the symptom categories (i.e. hot flashes, cardiac or sleeping disorders, depression, irritability, lack of drive, vaginal dryness, painful joints or muscles) according to the Menopause Rating Scale (MRS). In addition to the translated English version, a questionnaire in Pidgin-English was offered. Questions about positive and negative expectations of menopause and the acceptance of hormonal replacement therapy were included. Statistical analysis was performed using Chi-square test and the Mann-Whitney U-test as indicated.


RESULTS
One hundred and one pre-menopausal and 40 post-menopausal women in Germany as well as 36 pre-menopausal and 41 post-menopausal women in Papua New Guinea were questioned. The expectations regarding the menopause differed significantly in favor of a higher trait intensity concerning the item of hot flashes in Germany and a significantly higher trait intensity in the items cardiac trouble, lack of drive, urological symptoms, vaginal dryness, joint and muscle symptoms in Papua New Guinea. In the menopause experience, significant differences between the cultures are confirmed in favor of a higher trait intensity in Papua New Guinea concerning experienced depression, drop in performance, sexual disturbances and vaginal dryness. The intra-cultural comparison between the concepts concerning menopause and the menopause experience in Germany shows a significantly higher trait intensity with regard to the expected disturbance from hot flashes, depression, agitation, lack of drive and sexual problems as compared to the experienced disturbances. In Papua New Guinea, the survey showed a difference in expected and experienced vaginal dryness.


CONCLUSIONS
Perception and concepts concerning illness and health are based on culturally produced patterns.
Department of Obstetrics and Gynecology, Medical University of Schleswig Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany. kowalcek@t-online.de
Ingrid
I
Kowalcek
Doerte
D
Rotte
Constanze
C
Banz
Klaus
K
Diedrich
D001294:Attitude to Health; D016009:Chi-Square Distribution; D003431:Cross-Cultural Comparison; D003469:Culture; D005260:Female; D005858:Germany; D006801:Humans; D008019:Life Style; D008593:Menopause / Q000523:psychology*; D010219:Papua New Guinea; D017698:Postmenopause / Q000523:psychology; D017697:Premenopause / Q000523:psychology; D011795:Surveys and Questionnaires