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Based on longitudinal mixed methods ethnographic research conducted in China from the mid-1990s to 2018, this article argues that Chinese lay language use divides what Americans and Canadians refer to as "menopause" into two distinct though overlapping concepts of the narrow juejing or end of menstruation and the broader non-gender-specific gengnianqi or "transition between middle and old age." While comparison with research done by Lock in Japan shows that Japanese language uses a similar set of two overlapping yet distinct terms called heikei and könenki, there are important differences between Chinese and Japanese views and experiences of female midlife amidst the similarities. While views and experiences of juejing in China are very similar to notions of heikei in Japan, gengnianqi is quite different from könenki. Like in Japan, the end of menstruation tends to be welcomed by women in China. Also like in Japan, midlife women in China had a lower prevalence of hot flashes than that found in the US and Canada. Also similar to Japan, Chinese women rarely associate hot flashes with embarrassment. However, unlike in the Japanese sample, the Chinese women reported a higher rate of irritability than even the American and Canadian samples. Contrasting with könenki, which is primarly associated with bodily aches and self-restraint in Japan, gengnianqi is commonly viewed as a time of vulnerability to irritable outbursts which must be allowed, though managed carefully. Overall, I show how menopause and midlife aging as concepts and as lived experiences are subject to variation related to differences in language, cultural ideas and practices, local biologies, and culturally-mediated generational experiences of historical change.

Drawing on ethnographic and survey research conducted by the author in a general population sample in mainland China, this article presents findings on Chinese women's midlife symptom reporting in comparison with pivotal studies conducted by Lock, Kaufert, and McKinlay in Japan, Canada, and the U.S. Analysis of the China survey data (N = 156 women, age 45-55) reveals for sixteen core symptoms a reporting frequency that is much lower than depicted in classic biomedical models of menopause. At the same time, however, the China data indicates problems with the popular extrapolation that midlife Asian women are virtually symptom-free compared to their North American peers. Finding the Chinese level of symptom-reporting low to moderate depending on the symptom, the article reveals important differences between Chinese and Japanese women in their level and pattern of symptom reporting, as well as substantial overlap with North American women in this regard. Referencing ethnographic materials on Chinese women and the cross-cultural literature on menopause, the article assesses potential explanations for the cross-cultural variation observed, including: local reproductive endocrinology, phytoestrogen consumption, aspects of East Asian culture, the nature of social change, the cultural acceptability of monitoring and voicing symptoms, and differences in dominant conceptions of midlife.

Objectives: It has become popular to assert that Asian women in general have low midlife rates of reporting a wide variety of symptoms and that these rates are much lower than those found among women in western countries. Comparable data from mainland China remains sparse, however. This study aimed to uncover the symptom reporting frequency for a general population sample of women in mainland China and to compare these results with rates from similar studies conducted in Japan and North America., Methods: The author conducted a community-based survey of over 400 Chinese women aged 40-65 years living in a rural village and an urban neighborhood in northern China. The cross-cultural analysis was conducted on the 156 Chinese women within that sample who were between the ages of 45 and 55 years. Their rates of reporting 16 core symptoms in the previous 2 weeks were compared with those of women in the same age range in studies conducted in Japan [Lock M. Encounters with aging: mythologies of menopause in Japan and North America. Berkeley: University of California Press; 1993], Canada [Kaufert P, Lock M, McKinlay S, et al. Menopause research: the Korpilampi workshop. Soc Sci Med 1986;22(11):1285-9], and the U.S. [McKinlay SM, McKinlay JB. Research note: aging in a 'healthy' population. Soc Sci Med 1986;23(5):531-5]., Results: The Chinese women had a low to moderate rate (below 50%) of reporting each of the 16 core symptoms. On most symptoms, the Chinese rates were higher than the Japanese and more similar to the North American. The only exceptions were hot flashes and headaches., Conclusions: Data from the China Study of Midlife Women showed that women's rates of midlife core symptom reporting in mainland China differ from the extremely low levels found in Japan. It is important to avoid generalizations about East Asian women relative to North American women in this regard.

This report draws on data from the author's China Study of Midlife Women (CSMW) to test the popular notion that East Asian women have a low level of midlife symptom reporting compared with North American women. Symptom-reporting frequencies from a general population sample of 156 Chinese women of age 45-55 in China are compared with rates from published studies on midlife women in Japan, Canada, and the U.S. While the Japanese women's rates of reporting 16 core symptoms are uniformly low, the Chinese women's frequencies range from low to moderate. Except on hot flashes and headaches, the Chinese women's symptom-reporting rates tend to be more similar to the North American than to the Japanese sample. This analysis demonstrates that women's midlife symptom reporting in China cannot be equated with findings on women in Japan. Sources should be more cautious in making generalizations about East Asian women in this regard., (Am. J. Hum. Biol. 18:219-222, 2006. (c) 2006 Wiley-Liss, Inc.)