Author: Sharon Lee

There is little support for widely-held beliefs about depression and sexual decay. The National Institute for MentalHealth in the USA declared that it’s tougher for postmenopausal women because they expect their own climacteric to display the negative aspects they have come to believe it will have, which in some cases has the effect of a self-fulfilling prophecy. There seems to be three groups of climacteric symptoms: those associated with reduced estrogen-production, those which are in connection with socio-cultural factors and finally those which arise from personality characteristics. No doubt the most relevant factors influencing a woman’s quality of life during the menopausal transition are her previous emotional and physical health, her social situation, her experiences of stressful life events (particularly bereavements and separation) as well as her beliefs about menopause.

Menopause is a natural process. Yet, as early as the 1930s, the hot flashes and irritability that accompanied menopause was seen as a threat to the happiness of families and stability of marriages. Blame in a couple’s conflict often shifted entirely onto a middle-aged wife’s changing physiology and her emotional reactions to it. There are various treatments available that focus on symptomatic relief. Vaginal dryness is treated with topical lubricants or estrogens. Medications aimed at reducing the severity and frequencies of hot flashes include venlafaxine and gabapentin. In special circumstances, oral hormone therapy may be prescribed. A case study was done on a total of 71,076 patients with a diagnosis of menopause symptoms or a prescription claim for hormone therapy that were matched to control patients. Healthcare resource utilization and costs during the 6-month follow-up period were compared. In the study published in the Aug. 27 online issue of the journal Menopause, it was found that moderate to severe hot flashes- also known as vasomotor symptoms (VMS) are not treated in most women. It was found that women who experienced hot flashes had 1.5 million more health care visits than women without VMS. Costs for additional health care were $339,559,458. The cost of work lost was another $27,668,410.

Menopausal symptoms have a significant negative impact on a patient’s quality of life and increase health costs among women. In other research, significant correlations between socioeconomic factors and the severity of climacteric symptoms have also been found. Patients with menopausal symptoms were most likely to have depression and anxiety and incurred significantly higher follow-up healthcare costs than those without menopausal symptoms.

While awareness of menopause and women’s health has increased, there are still stigmas toward those who receive mental health treatment. For example, in Korea, the Ministry of Health and Welfare announced the ‘Comprehensive Plan for Mental Health Improvement’ for the purpose of redefining mental patients and conducting regular checkups of mental health across one’s lifespan. However, the rate of utilizing mental health services in South Korea is still significantly low. According to a survey by the Ministry of Health and Welfare in 2012, only 15.3 percent of potential people with mental health concerns sought professional help. The lower rate of people seeking mental health services implied that mental health and counseling fields still face enormous challenges in Korea, including a stigma towards those who receive mental health treatment. The Korean public may still consider he concept of a person being mentally ill and seeking relevant treatment as being taboo.

Hwabyung is one particular Korean mental illness that arises when people are unable to confront their anger as a result of conditions which they perceive to be unfair. The term ‘Han’ is a Korean culture-related sad sentiment related to hard life and social unfairness resulting not only from the tragic collective national history, but also from a traumatic personal life. As a culture-bound syndrome, Hwabyung is a unique affliction which can be triggered by various external events, particularly intra-familiar stressors such as spousal infidelity and conflict with in-laws. Because of the cultural emphasis on familial harmony and peace, expressing anger is not acceptable. Prevalence of Hwabyung exhibits gender differences in that the majority of individuals who experience Hwabyung are middle-aged, menopausal women. These individuals usually are women of low socioeconomic status, live in rural areas, and are among the divorced or separated, smokers and drinkers. They typically typically live in traditional families which stress the value of males while devaluing women. In these families, a woman’s virtue is to quietly bear misfortune and unhappiness while maintaining harmony.

I used the concept of Hwabyung to point out an interesting lexical gap in America. To my understanding, there is no term in the English language that accurately matches this illness. While Hwabyung may not necessarily be a cultural norm in this country, it cannot be denied that American women face a unique menopausal experience marked by its own stigma and oppression. Analyzing different situations menopausal women of varying cultures are placed in brings light to a deeper understanding to the disparities in treatment of women and my own experience as an Asian American who will one day experience menopause.

Women are held to maintain domestic tranquility and sex appeal while fulfilling sexual obligations. To border the dangers of sexual excess would be unthinkable. The social stigma surrounding menopause and the unavailability of treatments to those of the lower class points out that there needs to be an adequate understanding and fulfillment of women’s health care and not merely a matter of individual assistance. The psychological aspects concerned are relevant not only to women themselves, but also because an adequate or inadequate approach to them has consequences on women’s perception of their health needs, their access to health services provided, and their compliance to the treatments prescribed. This is a problem which involves public health policies and strategies designed to take into account the needs of women domestically and internationally.