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The roles of biologic and nonbiologic factors in cultural differences in vasomotor symptoms measured by surveys

Crawford, Sybil L. PhD

Menopause:
doi: 10.1097/gme.0b013e31802efbb2
Articles from the Workshop on "Cross-cultural Comparisons of Midlife and Aging"
Abstract

Objective: To review evidence of cultural differences in both biologic and nonbiologic factors as possible explanations for variation across cultures in self-reported vasomotor symptoms from surveys.

Design: Literature review and cross-sectional and longitudinal comparisons of ethnic groups with respect to patterns of symptom reporting from the Study of Women's Health Across the Nation (SWAN).

Results: The evidence to date indicates that cultural differences in vasomotor symptom reporting on surveys reflect both differences in the underlying biology, which are likely to influence vasomotor symptom occurrence, and differences in nonbiologic sociocultural factors such as attitudes toward menopause, which are likely to be related to vasomotor symptom perception and reporting.

Conclusions: It is important to consider interactions of culture and biology in studies of vasomotor symptoms. Recommendations for future studies include using both open- and closed-ended questions, providing concrete definitions of relevant symptoms and response choices for closed-ended questions, including measurements of objective indicators such as reproductive hormone concentrations, measuring both culturally related biologic and nonbiologic factors related to vasomotor symptom occurrence or reporting, and using the same general study protocol for multiple cultural groups being compared.

In Brief

Cultural differences in vasomotor symptom reporting on surveys reflect both differences in the underlying biology, which are likely to influence vasomotor symptom occurrence, and differences in nonbiologic sociocultural factors such as attitudes toward menopause, which are likely to be related to vasomotor symptom perception and reporting. Consequently, it is important to consider interactions of culture and biology in studies of vasomotor symptoms.

Author Information

From the University of Massachusetts Medical School, Worcester, MA.

Received September 20, 2006; revised and accepted November 9, 2006.

Funding/support: The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health, Department of Health and Human Services, through the National Institute on Aging, the National Institute of Nursing Research, and the Office of Research on Women's Health (grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, and AG012495). Supplemental funding was received from the Fetzer Institute.

Financial disclosure: None reported.

Address correspondence to: Sybil L. Crawford, PhD, Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Shaw Building, Room 228, Worcester, MA 01655. E-mail: Sybil.Crawford@umassmed.edu.

©2007The North American Menopause Society