Menopause with the in-laws: Why living with your husband’s family may make your menopause worse

Blog written by Megan Arnot. Read the full paper here.

The menopause generally occurs in women at around the age of 50 (Laisk et al., 2019), and for many, this process is accompanied by many negative symptoms, such as brain fog, hot flashes, and anxiety. In Western societies, it is often taken as read that these symptoms are a normal part of the menopausal transition; however, cross-cultural research is beginning to demonstrate an unpleasant experience is not an inevitability (Avis et al., 2001).

For example, Japanese women are less likely to report hot flashes compared to Western women (Thurston et al., 2008). Similarly, women who smoke are at a greater risk of a turbulent menopausal transition and an earlier menopause than non-smokers (Gold et al., 2006). As a result, researchers have begun to focus on what behavioural and lifestyle factors might influence the severity of symptoms throughout the menopausal transition.

In our new paper, we consider whether living arrangements influence menopause symptoms, and our results were surprising: women living with their genetic family reported less severe menopause symptoms than those who lived with their husband’s family.

Family matters?

As anthropologists, we are interested in how different levels of relatedness within households can have behavioural and physiological implications.  In the case of the menopause, we were interested to see whether these varying levels of relatedness had any bearing on the symptoms experienced throughout the menopausal transition. To do so, we travelled to south-west China to collect data. 

In this region of China, there are different ethnic groups with distinct living arrangements, which lends itself to easy comparison of different levels of relatedness between households. Firstly, the Han and Yi are ‘patrilocal’, which means women typically leave their family following marriage to live with that of her husbands. Secondly, the Mosuo and Zhaba display a more uncommon ‘duolocal’ residence pattern. This means that even when married the husband and wife live separately, each residing in their family households, partaking in the practice of zou hun (‘walking marriage’), in which they only visit one another at night (Wu et al., 2013).

It turned out that the duolocal women who lived with their own families reported significantly less symptoms than the patrilocal women who lived with their husband’s family following marriage.

Living arrangements and conflict

While this results was initially slightly perplexing, we think that this may be due to the differing levels of conflict and support within the households, which is contingent upon the post-marital residence pattern of the group.

If a woman moves to live with her husband’s family (i.e. is patrilocal), then until she has children, she is not biologically related to anyone in the household. This lack of relatedness may cause tension between the new wife and her husband’s relatives, as they have little genetic interest in her (Danielsbacka et al., 2018).  Additionally, it has been observed elsewhere that women who live with their husband’s family argue with their partners more and are more likely to get divorced. More extremely, rates of domestic violence are higher for women who live away from their family (Borgerhoff Mulder & Rauch, 2009). 

In the context of menopause symptom severity, increased levels of household conflict would likely make the woman more stressed, and stress has been observed in previous research to worsen pain perception (Ahmad & Zakaria, 2015). Therefore, household conflict may exacerbate any menopause symptoms the woman is experiencing.

In addition to there being decreased levels of household conflict when women reside with their own family following marriage; these households may also provide higher levels of social support. A household in which there are plenty of people willing to help you out – both in terms of emotional and physical support – would contribute to a less stressful environment, which may soften the physiological and psychological burden of the menopausal transition. 

Within the study sample, the Mosuo are widely regarded to be an extremely peaceful group, with arguments between family members being consciously avoided and rarely observed. On the other hand, in in ethnographic literature there is a greater number of reports of social conflict within the Han and the Yi, lending support for our hypothesis that conflict and support are influential in determining how symptomatic the menopausal transition is.  

Global perspectives

While our research was conducted in China, globally, we see a wide range of living arrangements which would provide various levels of conflict and social support. In the West, women typically live away from their families, which may mean they have decreased levels of social support, perhaps contributing to more turbulent menopause symptoms.

These results aren’t an excuse to visit your in-laws less! However, they do demonstrate that menopause symptoms are not simply the inevitable result of hormonal irregularities. To an extent, they are the product of your social environment, which should be worth bearing in mind when approaching and going through the menopause.

References

AHMAD, A. H. & ZAKARIA, R. 2015. Pain in Times of Stress. The Malaysian Journal of Medical Sciences, 22(Special Issue), 52-61.

AVIS, N. E., STELLATO, R., CRAWFORD, S., BROMBERGER, J., GANZ, P., CAIN, V. & KAGAWA-SINGER, M. 2001. Is there a menopausal syndrome? Menopausal status and symptoms across racial/ethnic groups. Social Science & Medicine, 52(3), 345-356.

BORGERHOFF MULDER, M. & RAUCH, K. L. 2009. Sexual conflict in humans: Variations and solutions. Evolutionary Anthropology, 18201-214.

DANIELSBACKA, M., TANSKANEN, A. O. & ROTKIRCH, A. 2018. The “Kinship Penalty”: Parenthood and In-Law Conflict in Contemporary Finland. Evolutionary Psychological Science, 4(1), 71-82.

GOLD, E. B., COLVIN, A., AVIS, N. E., BROMBERGER, J., GREENDALE, G. A., POWELL, L., STERNFELD, B. & MATTHEWS, K. A. 2006. Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: Study of Women’s Health Across the Nation. American Journal of Public Health, 96(7), 1226-1236.

LAISK, T., TŠUIKO, O., JATSENKO, T., HÕRAK, P., OTALA, M., LAHDENPERÄ, M., LUMMAA, V., TUURI, T., SALUMETS, A. & TAPANAINEN, J. S. 2019. Demographic and evolutionary trends in ovarian function and aging. Human Reproduction Update, (dmy031), 1-17.

THURSTON, R. C., BROMBERGER, J. T., JOFFE, H., AVIS, N. E., HESS, R., CRANDALL, C. J., CHANG, Y., GREEN, R. & MATTHEWS, K. A. 2008. Beyond frequency: who is most bothered by vasomotor symptoms. Menopause, 15(5), 841-847.

WU, J. J., HE, Q. Q., DENG, L. L., WANG, S. C., MACE, R., JI, T. & TAO, Y. 2013. Communal breeding promotes a matrilineal social system where husband and wife life apart. Proceedings of the Royal Society B: Biological Sciences, 280(1758).

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