Contextual influences on women's health concerns and attitudes toward menopause.

The purpose of this study was to better understand the ways in which the social context of midlife affects women's attitudes toward menopausal aging. This study builds on prior research that identifies contextual factors. Adaptation to menopause has many facets, including adjustment to the loss of fertility as well as concerns about physical attractiveness and health (Rossi, 2004). What is not clear is whether women's adjustment to menopause reflects a single underlying dimension that has a common set of antecedents or if it is more meaningful to differentiate between adjustment to the loss of fertility on the one hand and women's concerns regarding health and attractiveness on the other. One contextual factor--having multiple roles--has the potential to enhance women's adaptation to menopause. According to role-enhancement theory (Thoits, 1983), multiple roles can promote women's development by increasing self-esteem, providing purpose and meaning in life, increasing one's ability to develop deep connections with others, and buffering against strain or difficulties experienced in one role. The perspective of role accumulation theory has received support from numerous studies of women's well-being (Barnett & Hyde, 2001; Chrouser-Ahrens & Ryff, 2006; Crosby, 1991). Although little attention has been given to the potential contribution of multiple roles to women's adjustment to menopause, some initial studies suggest that adaptation is better among women who occupy multiple roles. For example, paid work outside of the home may have a positive impact on women's experience of menopausal symptoms (Polit & Larocco, 1980; Prill, 1977). Paid work may be particularly important as a buffer against loss of fertility during menopause, as work can provide women with a meaningful identity that is not rooted in their capacity to carry children. Other contextual factors that have been found to be related to women's adjustment to menopause include age, education, financial security, and symptom levels. Younger women may be more fearful of the impending experience of menopause than older women (Eisner & Kelly, 1980; Kresovich, 1980; Neugarten, Wood, Kraines, & Loomis, 1963) and, therefore, have more negative attitudes toward menopause (Dege & Gretzinger, 1982; Perlmutter & Bart, 1982; Wilbur, Miller, & Montgomery, 1995). Women with lower levels of education and income have been found to report more intense menopausal symptoms (Hunter, 1990; Hunter, Battersey, & Whitehead, 1986; Jaszmann, Van Lith, & Zatt, 1969; Leiblum & Swartzman, 1986; McKinlay, McKinlay, & Brambilla, 1987; Polit & Laracco, 1980) and tend to show greater increases in depression during menopause (McKinlay et al., 1987). Women who perceive menopause as a medical problem, rather than as a part of normative aging, tend to show lower levels of psychological well-being (Avis & McKinlay, 1991). Although these studies suggest that women's adjustment to menopause can be shaped by the social context in which this life transition occurs, it is not clear whether multiple contextual antecedents have the same adaptational significance for all facets of adjustment to menopause (for example, loss of fertility, concerns about attractiveness and health). The present study examined the influence of contextual factors in a sample of women who were born in to the baby boom generation and who experienced menopause at the turn of the century. The present study may therefore provide a more contemporary perspective on the contributions of potential protective factors on adjustment to menopause. Many of the major menopause studies cited previously were conducted during the 1960s, 1970s, and 1980s. The women in these earlier studies were born before the postwar baby boom generation. The experiences of women born during the postwar baby boom may not be represented in these earlier studies. For the generation born after 1945, opportunities for women to expand their repertoire of multiple roles have increased greatly due to the steadily increasing participation of mothers in fulltime career employment. …