Biological and Cultural Influences on Menopause (Koonenki) in Japan

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Margaret Lock's pioneering research on konenki (menopause) in Japan showed that menopausal symptoms (i.e., hot flushes, night sweats) may not be universal. Lock and others have proposed that phytoestrogens (estrogenic plant chemicals) in soy, consumed in great quantities by Japanese, ameliorate midlife symptoms. This study aims to identify whether and how soy consumption affects the menopausal transition. The project will test the following hypotheses:1A. The menopausal transition will be characterized by highly variable levels of estradiol (E2) and the pituitary gonadotropins follicle stimulating hormone (FSH) and luteinizing hormone (LH), reflecting dysfunction in the neural regulation of gonadal hormones.1B. Women with higher phytoestrogen exposure will have less variation in FSH and LH.2A. Women with more variable E2, FSH, and LH will have more frequent or severe midlife symptoms.2B. Women with higher phytoestrogen exposure will have less frequent or severe midlife symptoms.These hypotheses will be tested in two populations of Japanese women, aged 45-55, from Tohoku and Kinki, regions of Japan with the highest and lowest soy consumption. In Year 1, women will be sampled longitudinally for E2, FSH, LH, and the phytoestrogens genistein and daidzein using finger prick blood spot methods. Dietary frequency questionnaires, symptom checklists, surveys, and interviews will be administered. Years 2-3 will be devoted to analysis and write-up of blood samples, surveys, and ethnographic data. These data will contribute to our understanding of cross-cultural variation in aging by enabling modeling of environmental influences on endocrinology and experience of the menopausal transition.