Margaret Lock explicitly compares Japanese and North American medical and political accounts of female middle age to challenge Western assumptions about menopause. She uses ethnography, interviews, statistics, historical and popular culture materials, and medical publications to produce a richly detailed account of Japanese women's lives. The result offers irrefutable evidence that the experience and meanings--even the endocrinological changes--associated with female midlife are far from universal. Rather, Lock argues, they are the product of an ongoing dialectic between culture and local biologies. Japanese focus on middle-aged women as family members, and particularly as caretakers of elderly relatives. They attach relatively little importance to the end of menstruation, seeing it as a natural part of the aging process and not a diseaselike state heralding physical decline and emotional instability. Even the symptoms of midlife are different: Japanese women report few hot flashes,