Even though hormonal changes after menopause produce similar symptoms in many women, cultural differences can still shape how people experience this stage of life, a study suggests.

Researchers reviewed results from an online survey asking 8,200 older men and women in North America and Europe how menopause impacted their sex lives and relationships and found similar complaints in different countries. But the magnitude of suffering for typical symptoms such as vaginal dryness, hot flashes and weight gain varied by nationality.

“In societies where age is more revered and the older woman is the wiser and better woman, menopausal symptoms are significantly less bothersome,” lead study author Dr. Mary Jane Minkin, a professor in obstetrics, gynecology and reproductive health at Yale Medical School, said by email. “Where older is not better, many women equate menopause with old age, and symptoms can be much more devastating.”

Women go through menopause when they stop menstruating, which typically happens between ages 45 and 55. As the ovaries curb production of the hormones estrogen and progesterone in the years leading up to menopause, women can experience symptoms ranging from irregular periods and vaginal dryness to mood swings and insomnia.

Minkin and colleagues focused their analysis on postmenopausal women aged 55 to 65, and men in relationships with women this age, in the United Kingdom, United States, Canada, Sweden, Denmark, Finland, Norway, France and Italy.

The survey was primarily designed to assess how vaginal atrophy, which may include dryness, irritation, itching or pain, impacted participants’ relationships. But the web-based questionnaire also explored other menopause symptoms and examined whether the severity of these difficulties matched what people had expected to experience.

Perhaps not surprisingly, given the main goal of the study, vaginal dryness was the top complaint both men and women reported, regardless of nationality, the researchers report in the journal Menopause.

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