Kōnenki: What the Japanese Concept of Menopause Can Teach Us About Midlife

Menopause is having something of a moment. After generations of women quietly getting on with it, we're finally talking about hot flushes, sleep, brain fog, mood changes, HRT and the very real effects hormonal changes can have on women's lives.

But what if there is another part of menopause worth talking about too? Not only what is happening to our hormones, but what this stage of life means.

In Japan, there is a word often used when talking about this period: kōnenki. It broadly describes the climacteric period surrounding menopause, rather than simply the moment menstruation ends. Today it is commonly understood medically as approximately the five years before and five years after menopause.

Online, you will sometimes see kōnenki translated rather poetically as the ‘renewal years’. The literal meaning is more nuanced than that, and it would be misleading to suggest that Japanese women universally experience menopause as a wonderful period of reinvention. But the concept does offer us an interesting way of thinking about female midlife. Because menopause is not simply something that happens to the ovaries. It happens in the middle of a life.

Menopause or kōnenki?

Medical anthropologist Margaret Lock explored this idea extensively in her influential research comparing women's experiences of menopause in Japan and North America. In Encounters with Aging (1993), Lock argued that what we understand as ‘menopause’ is shaped not only by biology but by culture, language and the meaning societies attach to ageing.

In interviews with Japanese women, she found that kōnenki was often understood as part of a broader transition through midlife. The end of menstruation mattered, but it wasn't necessarily the defining event. Women also talked about ageing, changing family roles, relationships, responsibilities and their place within society.

That distinction feels important.

In Western medicine, menopause has historically been strongly associated with the decline of ovarian hormones. That biological process is real and can have significant physical and psychological consequences. But biology isn't the only thing happening to a woman in her forties and fifties.

Children may be becoming more independent. Parents may be ageing. Relationships may be changing. Careers can reach a point of reassessment. Bodies change. Friendships shift. Years spent looking after other people can leave women wondering where they fit within their own lives.

Sometimes the question isn't only ‘What's happening to my hormones?’ It's also: ‘What's happening to me?’

The psychology of transition

Psychology has long recognised that identity isn't something we establish in early adulthood and then simply carry unchanged for the rest of our lives.

Midlife can involve reassessing roles, priorities and the assumptions we've made about who we are supposed to be. For women in particular, this period can coincide with changes across several domains at once: work, caring responsibilities, relationships, motherhood, ageing and physical health.

That doesn't mean midlife is inevitably a crisis. Nor does it mean we should romanticise menopause as some magical awakening. For some women, menopausal symptoms are disruptive and debilitating. Contemporary research in Japan itself shows that women can experience significant vasomotor and other symptoms, and kōnenki disorder is a recognised medical diagnosis when symptoms interfere with everyday life.

A more expansive psychological view shouldn't replace medical treatment. It can sit alongside it.

Perhaps the interesting thing about kōnenki is simply that it gives us language for thinking about this period as a passage rather than a single biological event.

Does culture change how menopause feels?

This is where the research becomes particularly fascinating.

Cross-cultural studies have found differences in how menopausal symptoms are described and experienced. Research involving Japanese women has historically reported lower rates of hot flushes than those found in many Western populations, although reported prevalence in Japan has changed over time (Melby, 2005).

Japanese women have also used a broader vocabulary for bodily experiences associated with kōnenki. Research has identified symptoms such as shoulder stiffness, memory difficulties, stress and hieshō - a sensation of chilliness - as salient experiences alongside more familiar vasomotor symptoms (Melby, 2005; Melby, 2007).

We need to be careful about what we conclude from this. It doesn't mean Japanese women have discovered a mindset that prevents menopause symptoms. Genetics, diet, environment, healthcare, language, reporting practices and cultural expectations may all contribute to differences between populations.

But it does remind us that the way we understand bodily experiences is partly shaped by the language available to describe them. If menopause is presented only as decline, loss and deficiency, that becomes part of the cultural story women inherit. If it is understood as a period of change within a much longer life course, the story becomes slightly different.

The biology hasn't disappeared. But the meaning surrounding it has changed.

Perhaps midlife asks different questions

There is something else about this stage of women's lives that interests me. By our fourties and fifties, many of us have spent decades accumulating roles. Partner. Mother. Daughter. Friend. Employee. Carer. Organiser. The person who remembers the birthdays, books the appointments, notices when somebody isn't quite themselves and keeps everything moving.

And then, somewhere in the middle of all that competence, another question can appear: What do I want now? Not what should I want. Not what does everybody need from me. What do I want?

For some women, menopause coincides with an uncomfortable awareness that parts of life no longer fit quite as well as they once did. A relationship may need attention. Work that once felt fulfilling may feel different. Boundaries may suddenly matter more. The willingness to keep accommodating everybody else may begin to diminish.

We shouldn't attribute every midlife feeling to hormones. But perhaps we shouldn't dismiss every midlife questioning as a hormonal symptom either. Sometimes dissatisfaction contains information.

Not an ending, but not necessarily a reinvention

There is a tendency in modern wellbeing culture to turn every difficult transition into an opportunity for transformation. Menopause doesn't need that pressure either. You don't have to emerge from it with a new career, a new body, a meditation practice and an entirely reinvented sense of self. Perhaps the gentler idea we can take from kōnenki is simply this: change is happening.

Some of it is biological. Some psychological. Some social. Some may be uncomfortable. Some may eventually feel liberating. And perhaps we don't need to decide immediately what all of it means. The end of menstruation is one event within a much bigger story about becoming older. That story can contain loss and relief, uncertainty and confidence, grief and possibility at the same time.

The renewal years?

I still rather like the poetic interpretation of kōnenki as the ‘renewal years’, even if it isn't a perfect translation. Not because menopause necessarily renews us. But because renewal doesn't have to mean becoming somebody completely different. Sometimes it means noticing what is no longer working. Reconsidering what we want to carry forward. Being a little less willing to disappear inside the roles we've spent years performing. And perhaps recognising that getting older isn't simply a process of losing younger versions of ourselves.

It can also be the process of becoming more fully acquainted with the woman who remains.

References

Lock, M. (1993). Encounters with Aging: Mythologies of Menopause in Japan and North America. University of California Press.

Melby, M. K. (2005). Vasomotor symptom prevalence and language of menopause in Japan. Menopause, 12(3), 250–257.

Melby, M. K. (2007). Chilliness: A vasomotor symptom in Japan. Menopause, 14(4), 752–759.

Melby, M. K., Lock, M., & Kaufert, P. (2005). Culture and symptom reporting at menopause. Human Reproduction Update, 11(5), 495–512.