Managing menopause: a qualitative analysis of self-help literature for women at midlife

This article reports on a qualitative social constructionist analysis that aims to examine the ways in which menopause and women's bodies are represented in self-help texts. In particular, we aim to compare texts with a more traditional 'medical' approach and others taking a more 'woman-centred' perspective. Four diverse self-help books on menopause and HRT available in England were analysed to examine the ways in which women, menopause and midlife were portrayed, and to investigate the construction of notions of knowledge, expertise and responsibility. The selected texts were published between 1992 and 1996 and covered a range of perspectives, including medical, alternative and feminist. Results showed that menopause was constructed as a 'deficiency disease' in all four texts, although in three of the texts this 'disease' discourse was counterposed by the simultaneous use of a 'menopause as natural' discourse. Menopause was also constructed as inherently complex and confusing, as were women's bodies. A discourse of 'change' was drawn upon in which menopause was portrayed as only one of the stressful events women must cope with at midlife. Finally, most of the texts drew on a discourse of 'management' rather than one of 'treatment' or 'cure' when discussing how menopause, and women's relationship to menopause should be handled. The medical profession was constructed as the primary source of expertise on menopause and women's bodies, although responsibility for the 'management' of menopause as a chronic condition lay solely with individual women. Although there were a number of differences in representations of menopause in medically oriented self-help texts and those adopting a more woman-centred perspective, our analysis also revealed several areas of similarity and overlap with regard to the construction of menopause and its 'management'. The implications of these findings for the construction of menopause in self-help texts for women are discussed.