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CHANGING BODIES, CHANGING LIVES: URBAN MIDDLE CLASS MALAY WOMEN‟S EXPERIENCES of MENOPAUSE Nurazzura Mohamad Diah B. Hsc. (Hon

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CHANGING BODIES, CHANGING LIVES: URBAN MIDDLE CLASS MALAY WOMEN‟S EXPERIENCES of MENOPAUSE Nurazzura Mohamad Diah B. Hsc. (Hon CHANGING BODIES, CHANGING LIVES: URBAN MIDDLE CLASS MALAY WOMEN‟S EXPERIENCES OF MENOPAUSE Nurazzura Mohamad Diah B. HSc. (Honours) & M. HSc in Sociology and Anthropology International Islamic University Malaysia This thesis is presented for the degree of Doctor of Philosophy of The University of Western Australia School of Social and Cultural Studies Discipline of Anthropology & Sociology 2010 Dedication I dedicate my noble work to Mbah, Nyai and Mak who have undergone the ‘silent passage’ with audacity Abstract Menopause is a time of life where women make the transition from a reproductive stage to a non-reproductive stage. Although it is biologically universal, menopausal experiences are not homogeneous in nature and there have been significant differences reported by women within and across cultures. The study of menopause is pertinent in anthropology because as Lock (1998) contended, how menopause is seen, experienced and managed, rests upon social and cultural factors. The purpose of this thesis is to gain an in-depth understanding of the menopausal experiences of urban middle class Malay women who, for the most part, are formally educated and work in professional paid jobs. The research addresses how these women manage their changing bodies and attribute meaning to the experience of menopause. By considering how families respond to the women during this time, as well as how menopause is cast within an increasingly medicalised and media oriented discourse, the thesis proposes that menopause in Malay society today creates specific challenges for ageing women. Using an ethnographic approach, the thesis investigates the various factors that contribute to Malay women‟s understanding of menopause. In-depth interviews and participant observation helped to unravel the complexity of this topic, which in Malay society is considered private and dealt with in silence. I argue that the increasingly pervasive influence of Western perceptions of youth, femininity and sexuality among urban Malay women, together with the increasing adoption of biomedical treatments have altered cultural understandings of menopause. It is apparent that medicalisation and the ageing female body have been discussed extensively in the Western academic community but to a lesser extent in non-Western settings so the thesis adds substantially to this discussion. My research shows that menopause is a problematic and chaotic life stage for most of the urban middle class Malay women in my study. In Malaysia today educated Malay women are most likely to stay in the paid workforce until their mid to late fifties so they experience menopause while still working full time. Their dual obligations to both family and work complicate their experience, particularly if they have typical menopausal symptoms such as „hot flushes‟ and fatigue. Pressures from work, as well as the desire to portray a youthful and attractive appearance, contribute to their acceptance of biomedical interventions. In order to maintain the social order, these women should transition easily and silently from one status to another. However, while those around them know little of the challenges faced by women undergoing i menopause, the situation is not at all easy for them. There is no celebration to mark the coming of menopause as women move from middle to older age. By contrast to other life stage transitions, this experience is embarrassing, sometimes challenging to personal identity and generally unimportant to all, other than the women experiencing it. The Critical-Interpretive medical anthropological perspective provides the framework for this investigation as well as the personal narratives of the women. The study is implicitly linked to the experience of ageing in a contemporary Asian society which has taken up many of the values associated with Western lifestyles. The thesis highlights the encroachment of hegemonic Western attitudes upon traditional Malay perceptions of ageing and femininity. Although youth, beauty and sexual attractiveness are more often associated with Western values, they have increasingly influenced urban middle class educated Malay women. However, the picture is not straightforward as traditional Malay values are still abundantly evident in the women‟s daily lives, in their culture, religion and lifestyle. There are clearly competing values at play that create challenges for ageing women in urban Malay society as they navigate between traditional and Western approaches to femininity, ageing and health. ii Table of Contents Abstract .............................................................................................................................. i Table of Contents ............................................................................................................. iii Acknowledgements .......................................................................................................... vi Statement of Candidate Contribution ............................................................................. viii Translation Note ............................................................................................................... ix List of Abbreviations......................................................................................................... x List of Figures .................................................................................................................. xi List of Tables................................................................................................................... xii List of Plates ................................................................................................................... xiii List of Appendices ......................................................................................................... xiv Glossary of Malay Terms ................................................................................................ xv CHAPTER ONE ............................................................................................................... 1 INTRODUCTION ............................................................................................................ 1 Background of the study ................................................................................................... 1 An introduction to the researcher: the ethnographer as insider......................................... 3 Research questions .......................................................................................................... 11 Significance of the research ............................................................................................ 12 Study setting .................................................................................................................... 14 Theoretical approach: combining the insights of interpretive and critical medical anthropology ................................................................................................................... 27 Connecting women and their bodies ............................................................................... 34 Organisation of the thesis ................................................................................................ 36 Chapter Two ................................................................................................................ 36 Chapter Three .............................................................................................................. 37 Chapter Four ............................................................................................................... 37 Chapter Five ................................................................................................................ 38 Chapter Six .................................................................................................................. 38 Chapter Seven ............................................................................................................. 39 Chapter Eight .............................................................................................................. 39 CHAPTER TWO ............................................................................................................ 40 RESEARCHING A SENSITIVE ISSUE: METHODOLOGICAL ISSUES ................. 40 Introduction ..................................................................................................................... 40 Researching a sensitive issue .......................................................................................... 40 Methodological issues ..................................................................................................... 43 a) Research participants: urban middle class Malay women ...................................... 43 b) Research site ........................................................................................................... 49 Klinik Harapan: the menopause clinic ........................................................................... 50 Methodology ................................................................................................................... 53 Challenges in the research and strategies used ............................................................... 65 Gaining access into the field ........................................................................................... 66 Managing relationships in the field ................................................................................
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