Harris, MTC Harris 2013, 'Menopause : the need for a paradigm shift from disease to women's health', PhD thesis, Southern Cross University, Lismore, NSW.
Copyright MTC Harris 2013
Through a multimethodology, this research revealed menopause and women’s menopausal and postmenopausal ageing life cycle journey as a women’s positive adult developmental process. Utilizing multi-methods I argue that emerging from women’s narratives, the phenomenon of menopause is limited by a reductionist paradigm. Further exploration revealed that a paradigm underpinned by a wholistic philosophy is more appropriate for women as they negotiate this significant ageing life cycle process to postmenopausal status.
The positive conceptualisation of menopause is set against a backdrop of a discourse analysis of seminal and pivotal biomedical texts, which revealed the marginalization of women’s adult developmental processes. Menopause, a normal life cycle process has been diagnosed by Western scientific reductionist methods as a deficiency disease and an endocrinopathy. This reductionist biomedical diagnosis, underpinned by Descartes’ philosophy of separation is the dominant paradigm in our Western culture. The discourse analysis also revealed the power of biomedicine to define menopause as a pathological process highlighting losses only, thereby marginalizing other aspects of the phenomenon such as the interactions of body, mind, soul and spirit, and the acknowledgement of context.
The research revealed the necessity for policy development on menopause and menopausal women to be designed by postmenopausal women informed by their embodied experiences, perspectives, and theories. This is a gender equity issue. I propose that the Social Model of Health enables a fuller understanding of this women’s health issue as it is underpinned by the social determinants of health. Particularly the determinants of social justice, gender equity and sustainability inform the proposed redesign and development of women’s health: policy and practices, educational and health promotion programmes for menopause, menopausal and postmenopausal women. In addition, this social model of health forms the framework for a proposed paradigm shift to a wholistic model. The research supports an urgent call for the employment of a social model of health as directed by the World Health Organisation.
Finally, positive evidence presented from multidisciplinary research supports the increased status of ageing postmenopausal women. This, together with the evidence from the texts of postmenopausal women’s wholistic experiences, an argument emerges for a shift from an alternative to the biomedical paradigm, to an integrated wholistic paradigm that raises the value and status of ageing women. Finally recommendations and strategies are proposed for menopause health promotion including complementary and alternative medicine, multidisciplinary conferences, and an enhanced multidisciplinary health care programme accompanied by local group follow up.