Postmenopausal Health and Disease from the Perspective of Evolutionary Medicine

Anthropology & Aging Quarterly Volume 34, issue 3 (September 2013) pp.61-86

Postmenopausal Health and Disease from the Perspective of Evolutionary Medicine

Andrew W. Froehle

Department of Community Health, Boonshoft School of Medicine Wright State University

Download PDF version here: AAQ34(3)FROEHLE

Abstract

Menopause normally occurs between 45-55 years of age, marks the end of a woman’s reproductive lifespan, and is accompanied by a reduction in estrogen that has substantial physiological effects. The standard medical view is that these changes underlie high postmenopausal disease rates, defining menopause as an estrogen deficiency condition needing treatment. This view stems from the idea that extended postmenopausal longevity is a consequence of recent technological developments, such that women now outlive their evolutionarily-programmed physiological functional lifespan.Increasingly, however, researchers employing an evolutionary medicine framework have used data from comparative demography, comparative biology, and human behavioral ecology to challenge the mainstream medical view. Instead, these data suggest that a two-decade human postmenopausal lifespan is an evolved, species-typical trait that distinguishes humans from other primates, and has deep roots in our evolutionary past. This view rejects the inevitability of high rates of postmenopausal disease and the concept of menopause as pathology. Rather, high postmenopausal disease risk likely stems from specific lifestyle differences between industrialized societies and foraging societies of the type that dominated human evolutionary history. Women in industrialized societies tend to have higher estrogen levels during premenopausal life, and experience a greater reduction in estrogen across menopause than do women living in foraging societies, with potentially important physiological consequences. The anthropological approach to understanding postmenopausal disease risk reframes the postmenopausal lifespan as an integral period in the human life cycle, and offers alternative avenues for disease prevention by highlighting the importance of lifestyle effects on health.

Keywords: menopause, estrogen, evolution, human lifespan, aging

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About Jason Danely

Jason Danely is Senior Lecturer of Anthropology and an affiliate of the Centre for Medical Humanities at Oxford Brookes University. He has been conducting fieldwork-based ethnographic research looking at aging, caring, grief, and ritual in Japan since 2005. His book, Aging and Loss: Mourning and Maturity in Contemporary Japanwas published in 2014 by Rutgers University Press. He is also editor of Transitions and Transformations: Cultural Perspectives on Aging and the Life Course (Berghahn 2013). From 2011-2015, he served as Editor-in-Chief of Anthropology & Aging, the journal of AAGE. He has received awards from the Fulbright Foundation, the Japan Society for the Promotion of Science, the Center on Age & Community, University of Wisconsin Milwaukee, and the University of California Pacific Rim Research Program. His current research is supported by the Enhancing Life award from the John Templeton Foundation, and is a cross-cultural comparison of the lived experiences of family caregivers of older adults in Japan and the UK. He received his PhD in Anthropology from the University of California, San Diego.

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