Traditional views of women at are often inaccurate and may be deleterious to the emotional and physical well-being of women. The author reviews quantitative and qualitative research that may help guide counselors in their work with women. ********** Stories of the midlife man have saturated our culture and include images of balding men purchasing sexy red sports cars and abandoning their wives for youthful replacements. Female markers of include menopausal symptoms, targeted ads for reconstructive surgeries, and empty nests. There is a stark contrast between the very active and positive choices of men and the very reactive and negative markers of women. Although balding men may now seek treatment for this condition through chemical or surgical means, they are proving their enduring value by winning the young admirer, climbing the corporate ladder, and purchasing the new two-seater. Women, however, are seen as victims of the process. With the end of fertility often comes the departure of children from the home, and women are left to fight the natural shifting of their bodies in order to fight for their spouses. Because I view this as a very negative, sterile view of women at midlife, in this article I address the physical and psychological changes that herald transitions for women and provide recommendations for counselors who work with women who are moving through this passage. BACKGROUND Menopause, defined as the cessation of menses for a period of 12 consecutive months, generally occurs between the ages of 40 and 58, with an average age of about 51 (North American Menopause Society, 2001). Because information about menopause is often poorly communicated from doctor to patient or from one woman to another, perimenopause, the 4- to 10-year period that occurs before menopause, often takes women by surprise with the upset in a normally regular menstrual cycle, increased premenstrual syndrome symptoms, and hot flashes (Gregory, 1999). This passage, and prelude to menopause, is mythic in our culture and, typical of myths, fabrications and omissions are prevalent in the telling of the story. Women who are 40 years old or older accounted for about 45% of the total U.S. female population in the year 2000, and those from 40 to 59 years make up about 27% of the population (U.S. Bureau of the Census, 2001). These women are standing on the threshold of menopause or have already passed through this transi tion (Kunz & Finkel, 1987). With the mean age of U.S. women calculated to be 37.8 years (U.S. Bureau of the Census), it is apparent that menopause and hold immediacy for a substantial portion of the female population. However, Gergen (1990) noted that if the academic research and developmental theories were our only measure of reality, it might appear that only men survive past age 40. Perhaps the preponderance of theories built to explain men's developmental transitions reflects the absence of biological transition points that exist for women, including menarche, childbearing, and menopause. The belief that biology is destiny, which is generally attributed to Sigmund Freud, is a concept that is used to preserve the difference between genders and their respective opportunities. Science and industry seek to medicalize and pathologize the changes that women experience. Pregnancy tests, ovulation predictors, and now menopause tests (Flaws, Langenberg, Babus, Hirshfield, & Sharara, 2001) are available that allow women to divorce themselves from self-knowledge and rely on hard science to get in touch with their bodies. Plastic surgery has provided relief for wrinkles, crow's feet, and sagging breasts, and now a woman in may choose to firm up an aging pubis if she dislikes the descent of her pubic hair and labia (Alter, 2001). Another physician advertises on his Web site a procedure called vaginal rejuvenation (Matlock, 2001). …
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