Beyond Hot Flashes: How Culture Shapes Our Menopause Journey
For women refusing to disappear, understanding the full spectrum of menopausal experiences is like stepping through a looking glass into a world where everything you thought you knew is wonderfully, surprisingly different.
The medical establishment would have us believe menopause is a one-size-fits-all story: hot flashes, mood swings, sleep disturbances—the end. Like a deck of cards arranged in perfect order, each woman's experience supposedly follows the same predictable pattern.
But what if we've fallen down a rabbit hole of limited understanding? What if our bodies are writing stories as unique as we are, influenced not just by hormones but by heritage, community, and the cultural-looking glasses through which we view this transition?
The Menopause We Don't Hear About
When I first noticed perimenopause symptoms, I followed the white rabbit of information through every book and article I could find. The curious thing? They all seemed written about—and for—one very specific type of woman, as if all others had somehow disappeared.
What I've discovered since then has been nothing short of magical. The symptoms we experience, their intensity, how we interpret them, and how we're treated when seeking help—all vary dramatically depending on our cultural background, like different rooms in a curious mansion where each door opens to entirely new possibilities.
Symptom Variations: Curiouser and Curiouser
The research reveals a wonderland of differences in menopausal symptoms across populations. And yet, when was the last time your doctor mentioned this curious reality?
Hot Flashes: Not So Universal After All
While up to 80% of North American women report hot flashes, the numbers shift mysteriously when we travel elsewhere:
Japanese women report hot flashes at rates as low as 10-15% as if they've found a "drink me" potion that changes the experience
Indigenous Mayan women often don't report hot flashes at all—they've apparently taken a different path through the woods entirely
South Asian women frequently describe not the sudden flush we're told to expect, but a sensation of heat crawling up from their feet, like following a different set of rules in this strange game
This isn't just a curiosity—it's a looking glass that reveals a truth: if your experience doesn't match the "typical" descriptions, you're not losing your mind. Your body is telling its own unique story.
Joint Pain: The Overlooked Chapter
While Western medical literature obsesses over hot flashes like a Queen of Hearts shouting "Off with their heads!" to all other symptoms, many Black and Latina women report joint pain as their most troublesome companion on this journey:
Black women were 50% more likely to report joint pain than white women
Latina women often described joint pain as more disruptive than vasomotor symptoms
East Asian women reported lower rates of joint pain but higher rates of shoulder stiffness
When I shared this information at one of our Alice in Menopause circles, the room erupted like a pack of cards flying into the air. "Why didn't my doctor tell me this was related to menopause?" one woman demanded. "I've been told it was just aging," another added.
This is what happens when the story we're told doesn't match the story our bodies are living. We question ourselves instead of questioning the incomplete map we've been given.
Sleep Patterns and Mental Health
The variations continue when we look at sleep disruption and mood changes—each culture seemingly serving a different tea at this strange party:
African American women report more severe sleep disruption than other groups
Japanese women frequently report more shoulder stiffness and headaches but fewer mood disturbances
Indian women often describe a sensation of "internal heat" rather than external sweating
White European women report higher rates of depression and anxiety during the transition
These differences aren't just biological curiosities—they're evidence that our bodies exist in conversation with our environments, like Alice adapting to each new situation in Wonderland.
Cultural Attitudes: The Invisible Queen
Perhaps even more powerful than biological variations are the cultural frameworks we use to understand and navigate menopause—the invisible queens ruling different territories of this experience.
The Power of Positive Transitions
In cultures where menopause is viewed as a magical doorway to a better place—one that brings wisdom, respect, and even new freedoms—women report fewer negative symptoms:
In Rajput communities in India, menopause brings release from restrictive practices and often correlates with an elevation in family status—like finding a key that opens new doors
Many Native American traditions honor elder women as wisdom keepers, with menopause marking entry into a highly respected role—a transformation as profound as Alice growing taller
In parts of Greece, particularly in rural areas, the end of menstruation is celebrated as freedom from the burden of fertility—like putting down a too-heavy burden you've carried for decades
The curious truth becomes clear: when a culture expects menopause to be miserable, women often experience more suffering. When a culture expects it to be liberating, women often experience more freedom. The expectation itself seems to cast a spell.
The Language We Inherit
The very words we use to describe menopause reveal powerful cultural attitudes, like secret messages encoded in seemingly simple terms:
In Japan, the term for menopause (konenki) translates to "renewal years" or "energy-change years"—an invitation to transformation rather than decline
In France, the popular phrase "la ménopause" is clinically matter-of-fact, treating it as a normal life phase
In many English-speaking countries, terms like "the change" or "women's problems" shroud menopause in vague euphemisms, as if speaking its true name might summon something unpleasant
In some Indigenous cultures, there's no specific term for menopause at all—it's simply seen as part of the natural aging process, no more remarkable than growing taller or shorter
When I began asking women about the words their mothers and grandmothers used, their answers revealed hidden pathways through this experience. Women whose families used positive or neutral language reported feeling less anxiety than those who grew up hearing menopause described as "the end" or "withering."
Access to Support and Treatment
Cultural variations in healthcare systems and family structures dramatically impact how women navigate menopause—some finding themselves in wonderlands of support, others in mazes with no apparent exit:
Latina women often benefit from extended family networks where knowledge is shared across generations—like having many guides for the journey
East Asian women in countries with traditional medicine may access a broader range of options beyond hormone therapy—more keys to try in more locks
Black women in the U.S. face documented disparities in healthcare access, including less likelihood of having their symptoms taken seriously—as if speaking a language their doctors don't understand
Indigenous women often combine traditional healing practices with modern medicine—creating their own unique paths through the woods
These differences don't just affect treatments—they shape whether women seek help at all and how supported they feel throughout their curious journey.
Reclaiming Our Diverse Menopausal Stories
So what do we do with this looking-glass knowledge? How do we use these insights to transform our own adventures?
Listen to Our Bodies, Not Just the Storybooks
If you're experiencing symptoms that don't match the "classic" descriptions, trust yourself. Your experience is real, even if it doesn't fit neatly into Western medical categories, like a story veering off the expected path into more interesting territory.
When Maria, a participant in our Mexican-American women's circle, described a sensation of "electricity running under my skin" rather than traditional hot flashes, other women nodded in recognition. They'd been experiencing the same thing but didn't have the words for it because it didn't match what the official storytellers had described.
Seek Out Diverse Voices and Communities
One of the most powerful things we can do is connect with women from different backgrounds who are navigating the same curious landscape. Their maps might reveal pathways you never knew existed.
In our cross-cultural menopause circles, I've watched women exchange remedies, coping strategies, and perspectives that transformed each other's journeys. A cooling breathwork technique shared by a Korean American woman brought relief to others who hadn't found help through conventional approaches—like discovering a hidden door in what seemed to be a solid wall.
Question the Cultural Spells We've Internalized
What did your culture teach you about aging women? About the value of fertility? About the wisdom that comes with age? These messages have cast their spell on your expectations and experiences more than you might realize.
I invite you to sit with these questions: What if menopause isn't a medical condition to be treated but a transformation to be honored? What if the discomfort of this transition is not just hormonal but the growing pains of becoming a more powerful version of yourself, like Alice adjusting to her new size and capabilities?
Advocate for More Inclusive Research and Healthcare
The medical establishment is slowly—too slowly—recognizing the need for more diverse research on menopause. But change will come faster if we demand it, like Alice finally learning to stand up to the Queen of Hearts.
Ask your healthcare providers about research specific to your background. Question treatments that were developed based on studies of women who don't share your heritage. And consider participating in research studies that are working to broaden our understanding of menopause across cultures.
The Power of Cultural Reclamation
Perhaps the most revolutionary act is to reclaim the positive aspects of menopause from cultures around the world, creating new traditions that honor this transition—writing our own stories when the existing ones don't serve us.
In our Alice in Menopause community, we've developed rituals that draw inspiration from diverse cultural practices—wisdom circles inspired by indigenous traditions, cooling foods adapted from East Asian approaches, and celebration ceremonies that honor the passage into this new life stage.
These aren't acts of cultural appropriation but of appreciation and adaptation, drawing on the collective wisdom of women across time and place to create new pathways through this universal transition, like creating a new map when the old ones prove insufficient.
We Are Not Invisible
The diversity of menopausal experiences across cultures teaches us one undeniable truth: there is no single "right way" to experience this transition. Our bodies, minds, and spirits are responding not just to changing hormones but to the complex interplay of biology, culture, environment, and personal history.
Understanding this diversity doesn't just validate our individual experiences—it opens doors to new possibilities for navigation and healing. When we recognize that our symptoms and struggles are shaped by cultural factors, we gain the power to choose which cultural messages we accept and which we reject.
We can refuse the Western narrative of decline and disappearance. We can embrace traditions that honor the wisdom of age. We can create new cultural contexts that celebrate rather than stigmatize this transformation.
For women refusing to disappear, this knowledge isn't just interesting—it's liberating. It reminds us that while menopause is universal, how we experience it is uniquely our own. And that gives us the power to write our own stories, create our own traditions, and define this transition on our own terms.
Like Alice, we can question the rules of the game, challenge the authority of those who would define our experience for us, and ultimately find our way through the looking glass to a place where we are not diminished, but magnificently, powerfully ourselves.
Dive further down the rabbit hole, get How To Thrive Before, During, After and Menopause.
