Anthropology and the study of menopause: evolutionary, developmental, and comparative perspectives.

OBJECTIVE This work aims to consider how the discipline of anthropology contributes to the study of menopause through evolutionary, developmental, and comparative perspectives. METHODS This study was a review of skeletal and ethnographic evidence for menopause and postreproductive life in humans' distant past, hypotheses for the evolution of menopause and long postreproductive life, variation in age at menopause with focus on childhood environments, and the study of variation in symptom experience across populations. RESULTS Longevity, rather than capacity for menopause, sets humans apart from other primates. Skeletal evidence demonstrates that some Neanderthals and archaic Homo sapiens lived to the age at menopause and that at least one third of women in traditional foraging populations live beyond menopause. The evolutionary reasons for why women experience a long postreproductive life continue to be debated. A developmental perspective suggests that early childhood may be a critical time for the environment to irreversibly influence the number of oocytes or rate of follicular atresia and, ultimately, age at menopause. A comparative perspective examines symptom experience at midlife through participant observation, qualitative interviews, and quantitative instruments to gain a holistic understanding of the meaning, experience, and sociocultural context of menopause. CONCLUSIONS An evolutionary perspective suggests that menopause is not a recent phenomenon among humans. A developmental perspective focuses on the influence of early childhood on ovarian function. A comparative perspective expands clinical norms and provides knowledge about the range of human variations.