experience of menopause in the developing countries indian

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EXPERIENCE OF MENOPAUSE IN THE DEVELOPING
COUNTRIES Indian cultural perspective

• DR. AMIT SENGUPTA
• MBBS, MD, Ph.D.
• CONSULTING GYNECOLOGIST BIOMEDICAL SCIENTIST
• MUMBAI-INDIA

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CULTURE

• The system of shared beliefs, values, customs,
  behaviors, and artifacts that the members of
  society use to cope with their world and with
• one another, and that are transmitted from
  generation to generation through learning.
• We adapt to our environment through cultural
  strategies rather than genetic predispositions
• Std. definitions

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SOCIO- CULTURAL BIOLOGICAL EFFECTS

• Menopause like menarche elicits
• physiological psychological response
• 
  
  
  
• Menopause elicit wide spectrum of socio-
  cultural response in any society

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ROLE OF CULTURAL STUDY ?

• How is menopause perceived ? In Indian
  sub-continent
• Can it define short or long term health issues ?
• Can it suggests remedial measures and improve our
  understanding ?

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INFLUENCING FACTORS

• Gender equality
• Cultural/religious belief
• Issues related to marriage/ reproductive status /
  widow-hood / divorce IN INDIA

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INDIA A DIVERSE MULTILINGUAL-MULTIETHINIC
MULTIRELIGIOUS NATION CONCURRENTLY COEXSITING IN
ANCIENT-MEDIAVAL-MODERN TIMES - Unity in diversity
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STRONG BRAHMINIC AGE-EPIC AGE-AYURVEDA (A MIX OF
SMALL INDUS MAJOR ARYAN CIVILIZATION) DECLINE
OF BRAHMINISM EMERGENCE OF BUDDHISM/JAINISM/SIKHIS
M REMERGENCE OF BRAHMINISM STRONG EVEN NOW ENTRY
OF CHRISTIANITY/JEWS/ISLAM/ZOROSTIANS CONTRADICTI
ONS CONTINUED WOMEN EXPLOITATION AND WOMEN
WORSHIP CONTINUED
STRONG WOMEN POWER - GENDER EQUALITY FEMALE
WORSHIP
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Mother Goddess East West
Growth Prosperity Power
Women symbolized Fertility
2000BC - Harappa
1600BC- Minoan Crete
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Gender equality
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INDUS VALLEY ( Pre-Vedic urban
civilization) ( b4 1500BC
)

• Gender equality strong No Purdah, Worships women
  as mother OR fertility and power
• ( Dravidian, non-Brahmins, aborigines, eastern
  people)

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BRAHAMINICAL AGE ( complex spiritualism)
( 1500BC-1500AD )

• FOUR STAGES WERE PRESCRIBED ( early Vedic age)
• AGING IS NOT DECAY BUT ENRICHMENT OF SOUL AND
  MIND WITH TIME
• BRAHMACHARYA (25yrs) Student/Learning
• GRIHASTHA (25-48) Marriage is an important
  institution, men without a wife a son is
  powerless and incomplete.
• VANPRASTHA ( 48- 70) detached from family
  responsibility-to be respected by the society,
  and looked after by the younger ones. more so by
  the eldest son
• SANYASA - beyond that LIVE AN ASCETIC LIFE

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A SOCIAL EVENT until now rural India

• 
  
• MENSES ,LABOUR-PUEPERIUM, WIDOW IMPURE STATE
• Bengal - Widow live alone as wonderers, goes for
  pilgrimage
• - Menopause women goes for
  pilgrimage
• Punjab widows to marry even younger
  brother-in-laws
• ( women is family prestige/possession should
  be kept unexposed)
• MENOPAUSE IS EMPOWERMENT
• Kerala couples ceremony at 50
• Rajasthan - removes purdah to become highly
  empowered but conferred by the men

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Demographic change women status

• Before 1947- Women hood-marriage and child
  birthbegins at 16 average 6 live children and
  many abortionslife span-35 yrs, So no concept of
  middle age for women
• Now - ( 200167yrs, 2025-80 yrs )
• Survives beyond 50 60 widow

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ROLE OF WOMEN

• Rural India (75)
• TO follow the mens dictates
• Inter-spouse dialogue is strong and decision
  making of women poor
• Complete lack of awareness as far as female
  middle age is concerned other than a social event
• Urban India (25)
• Medicalized and Aware, hysterectomy high

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TRADITIONAL-MODERN CONCEPT

• TRADITIONAL aging is not a DECAY but passage of
  time with enrichment of soul and mind - Social
  and psychological event- social standing improves
  with parity (male child), and on reaching
  menopause
• MODERN Middle age concept- dualism-
  Psychological and physiological event, low
  parity-more life time cycles and
  irregularities-Hysterectomy
• FUSION a reality in the developing world
  Future answer to manage menopause

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Present debate evolving in India

• Post modernism
• SPIRITUAL - MEDICINE
• Harmonious combination of both for the future
  welfare of the mankind
• A blend of traditional practice (ethics,
  spiritualism, mind supremacy) and scientific
  materialism (evidence based arguments, physical
  health assumes priority)

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Available Options

• If we decide menopause as a temporary state of
  transition, positive attitude and acceptance will
  suffice
• If mild physical symptoms- diet and life style
  modification may help
• If severe- may need intervention

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Available Options -II

• If clubbed with co-morbidity then screen for
  DM,CAD,HT, osteoporosis etcand develop
  preventive, promotive and curative therapy
• Rehabilitative or regenerative therapy may help
• List advantages disadvantages of each
• State cost of each option

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Thank You