HEALTH-ASIA: Governments Do Little for Ageing Women

By Suvendrini Kakuchi Reprint | | Print |

Suvendrini Kakuchi

YOKOHAMA, Japan, Oct 30 1999 (IPS) - No woman is eager to reach menopause, but those in Asia may be justified to add worry to their feelings about getting to that stage in their lives.

According to health activists, many women in this region do not have access either to complete information about menopause or to the proper treatment for the changes most of them undergo because of it.

This situation, say the activists, puts a significant portion of the region’s population at risk — and only because governments and many medical practitioners have been slow in realising the health needs of older women.

Indeed, health activist Midori Ashida may well be speaking of most menopausal women in Asia when she describes what it has been like for Japanese women who have reached that stage.

“Middle-aged Japanese women get little advice from their doctors when they seek treatment for symptoms of menopause,” said the head of the Professional Women’s Coalition for Sexuality and Health during a conference on menopause that was held here recently.

“(This reflects) a severe situation for them because many of them are responsible for looking after their elderly parents and husband,” Ashida added.

Women usually reach menopause — or when they stop having menstrual cycles — between the ages of 45 and 55. Although some feel only a bit of discomfort during its onset, many experience hot flashes, insomnia, memory loss or even depression.

At the same time, studies have also found linkages between the loss of estrogen, which a woman’s body stops producing during menopause, and osteoporosis, heart blockages and Alzheimer’s disease.

But despite these serious consequences, health activists say many menopausal women in Asia are going with neither help nor understanding from their doctors. This is also in spite of the fact that an estimated 285 million women in the region today have already reached menopause – a number that will grow by almost 40 percent in 2010.

Rieko Yasui, for instance, recalls how she was sent from pillar to post when she began to feel all sorts of things that were later attributed to menopause.

“I was given anti-depressants, antibiotics – everything, instead of being counselled on menopause by my doctor,” says Yasui, who has since become a member of the Group to Study Menopause. “This is because menopause is not considered important.”

Thus, at the Ninth International Menopause Society (IMS) Conference that was held here last week, health experts and activists called for awareness campaigns on menopause targetted at both doctors and their female patients.

As Dr Tasmeen Aslam-Tariq pointed out, low awareness is among the major reasons why there has yet to be a “proper treatment system” for menopausal Asian women.

As it is, the experts and activists noted that there is scarcely any research focusing specifically on Asian women whose experiences during menopause may differ from those of their Western counterparts.

Here in Japan alone, telephone surveys conducted by volunteer groups showed depression as the most common complaint of menopausal women, in contrast to the West where hot flashes usually top the list of “menopausal experiences”.

According to Dr Hideo Honjo, an expert on hormone replacement therapy (HRT) that is widely used in the West to treat women undergoing menopause, Asian women are less likely to experience hot flashes because of their diet, which is rich in vegetables and beans.

He also said that because Asian women have smaller frames than their Western counterparts, they would need lower dosages of estrogen should they go through HRT.

Honjo told participants at the conference, though, that the busy schedule of many doctors might be to blame for the lack of counselling of menopausal women in the region. He added that the fear of the possible side effects of HRT, such as breast cancer, is another obstacle to the effective treatment of these women.

Aslam-Tariq, for her part, said poverty may be to blame as well for the scores of menopausal women in Asia who are going without treatment.

“Poverty in many Asian countries is another reason why women cannot benefit from menopause treatment that will definitely add quality to their middle-aged years,” she said. “Women in Pakistan, for instance, would prefer to buy ‘roti’ (bread) instead of spending (money) on hormone replacement therapy, even if it means suffering physically and mentally.”

This, however, makes it all the more necessary for governments to do more for their ageing women, said Aslam-Tariq.

Meanwhile, Ashida observed that Tokyo at least seems to be finally waking up to the need to maintain the health of older women. She said that in the past, the Ministry of Health and Welfare had focused mainly on maternity health when it came to women, largely because of the traditional view of females primarily as child-bearers.

But now that Japan has a greying population, Ashida said the government is realising that keeping the older women as healthy as their younger counterparts was as important not only because of their caregiver roles in the family but also because doing so is cost-effective.

Said Ashida: “Government officials are recognising, for the first time, that having healthy middle-aged women makes up an important part of national policy for it helps lessen the public welfare budget and even reduces medical spending by reducing heart disease and all the other illnesses associated with menopause.”