Menopause is not a single biological event but a life stage shaped by evolution, culture, and social inequality—and this project builds a framework to understand it across all three dimensions at once. The problem is that clinical guidelines for menopause are largely based on Western, medicalised models that treat it as a universal hormonal deficiency. This ignores how a woman’s ancestry, migration history, race, diet, and cultural beliefs about ageing all influence her experience and her risk of conditions like osteoporosis. The network of anthropologists, evolutionary biologists, sociologists, and clinicians aims to fill that gap by integrating three perspectives: evolutionary medicine (what is “normal” compared to our hunter-gatherer past), life-course intersectionality (how sex, race, and class combine), and biocultural competence (how culture shapes symptoms and treatment-seeking). If successful, the framework will inform clinical guidelines for diverse, unequal societies. Health professionals will be able to offer more targeted and inclusive support—not just for hot flushes, but for long-term wellbeing in later life. This is not fundamental science; it is applied interdisciplinary work with a direct practical aim: reducing health inequalities at menopause and beyond.
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This project brings together a network of experts in anthropology, medicine, evolutionary biology and feminist sociology to improve clinical support for menopause in a cross-cultural context, addressing sustainable development goals in terms of reducing women’s health inequalities/inequities in later life. Through this collaboration we will view menopause via an innovative multi-disciplinary framework comprising three dimensions: (i) evolutionary medicine which brings a new perspective to what medicine considers ‘normal’ for the reproductive life course in comparison to our hunter gatherer ancestors. It also enables us to identify evolutionary factors making certain populations at increased risk of conditions like osteoporosis; (ii) life course intersectionality, namely the understanding that sex, race, socio-demographics, migration history and other factors combine in complex ways to shape health inequalities including at menopause; (iii) (bio)cultural competence, which brings an understanding of how cultural factors shape the lived experience of menopause, including cultural beliefs about menopause and attitudes towards age and gender, combined with environment and diet. In combination, these dimensions highlight that there are multiple ways of both understanding and experiencing menopause. Constructing an integrated interdisciplinary framework enables us to map differences in lived experience as well as identify patterns in large data sets. This mapping will then inform clinical guidelines on supporting the menopause in increasingly diverse societies which are furthermore characterised by health inequalities within and between communities. It will facilitate health professionals in their interactions with mid-life women, enabling more targeted and inclusive support for health and wellbeing aimed both at menopause and later life
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