The medicalization of menopause: implications for recruitment of study participants

Early studies of menopause recruited sample populations from clinical settings; however, in the 1970s, populations drawn from health care settings were characterized as nonrepresentative because of symptom overreporting. This pilot study was carried out to test whether this characterization still holds true: that women who are drawn from clinical settings report more symptoms compared with women who are recruited from community and work sites.

Open-ended interviews were carried out with patients aged 40-60 years in a physician's office (n = 50), in a chiropractor's office (n = 24), at two Breast Health Project sites (n = 50), and in several non-health care sites in the community (n = 81). Interviews were supplemented by anthropometrics and standardized return-by-mail questionnaires.

Women who experienced hot flashes and sweating were more likely to report having spoken with a physician about menopause. However, women who were drawn from the clinical setting were not significantly more likely to describe hot flashes, sweats, or mood changes and were significantly less likely to report headaches in relation to menopause compared with a community sample. Women who were drawn from the physician's office were more likely to use hormone replacement therapy and to have had a hysterectomy.

This study suggests that because of the medicalization of menopause, we need to rethink our assumptions about the characteristics of populations drawn from health care settings. In western Massachusetts, place of recruitment did not predict symptom frequency.