Menopause: Invisible and Unmarked in Punjab, Pakistan

During my fieldwork on menopause in Punjab, Pakistan for PhD in 2019, I have interviewed 25 women with natural and surgical menopause. I have also interviewed 4 traditional healers and 6 biomedical practitioners including general practitioners, gynaecologists and physicians. My data suggests that menopause remains unmarked in women’s lives in Punjab. Middle aged women in Punjab are socially engaged with family issues like looking for suitor for their children, looking after elderly relative or financial burden that when they experience menopause they don’t find time to pay attentions to changes occurring inside their own body. It is not a cause of concern for healthcare providers because there are other health issues that need more attention such as anaemia, tuberculosis and pneumonia. The Punjab government is highly focused on population control in order to meet the millennium goals of population growth given by international funders. There are massive campaigns to spread awareness on contraceptive methods arranged by government but next to nothing has ever happened on issues related to menopause. All these factors combined has resulted in invisibility of menopause in Punjab. on the contrary, women are offered oophorectomy and total hysterectomy (that causes surgically induced menopause) for medical conditions that can be cured with less invasive treatments. The data collected for my thesis suggests that patients and doctors consider non-medical issues while deciding to perform these live changing surgeries. These non-medical reasons includes financial and social reasons where patient may not be able to afford regular treatments for financial reasons or patient may want a swift solution to their condition because they cannot look after their families. All these factors contribute to invisibility and strategic ignorance of surgical menopause in Punjab, Pakistan.