One of the great privileges of guest editing this special volume of Culture, Language, and Representation, entitled «Women and Metaphors: Terminology, Lexis, and Representations on Women’s Health Issues in Biomedical Discourse» has been encountering the widerange of scholarly perspectives that critically examine the language and metaphors that shape our understanding of women’s health. This volume bringstogether a diverse selection of studies that focus on topics such as menopause, menstruation, eating disorders, hysterectomy, and chronic illnesses. A common thread running through these contributions is a critical exploration of how linguistic choices, particularly metaphors, influence communication and perception within biomedical discourse.

These articles illustrate how metaphorical language can either facilitate or hinder effective communication in the context of women’s health. The authors investigate specific terminologies and conceptual frameworks used to describe and address these health issues, applying both qualitative and quantitative analyses. Collectively, the yunderscore the importance of reflecting on the metaphors and cognitive elements that arise in biomedical and societal discourse. By adopting a more nuanced and informed approach to such language, we hope to foster more accurate and empathetic representations of women’s health.

The volume is organized into five distinctyet interconnected sections, each one addressing crucial aspects of how women’s health issues are conceptualized, communicated, and understood within biomedical discourse.

The first section considers the metaphorical and discursive representations of menopause and menstruation. These natural processes, often framed within a biomedical context, are exploredthrough the lens of language, which can reinforce or challenge societal norms.The studies here reveal the power of metaphor in influencing how women experience and understand significant life transitions such as menopause and menstruation. From the negative emotional language associated with menopause to the cross-cultural examination of climacteric-related discrimination, these articles provide a comprehensive account of the impact that metaphorical language can have on women’s health and perceptions of it.

«Framing Menopause from Negative Emotional Language: A Study of Metaphors in Medical Discourse», by C. Vargas-Sierra, examines how medical language often employs negative metaphors, shaping societal perceptions of menopause in ways that may contribute to stigma. The author uses corpus linguistics as a methodology and Conceptual Metaphor Theory as a theoretical framework. The central aim of her study is to identify themost common metaphors associated with menopause and to analyze how these influence the social perception of this stage of women’s lives. Four dominant metaphors are identified: a) Menopause asemotional turbulence, in which menopause is associated with a state of significant emotional instability; b) Menopauseas disruptive change, in which menopause is a significant period ofchange and upheaval; c) Menopause as hormonal conflict, in which the role of hormones in menopausal symptomsis emphasized; and d) Menopause as a challenge to identity. The study suggests that menopause challenges women’s societal and personal identity, and Vargas-Sierra concludes that these metaphors in medical discourse reinforce negative stereotypes about women, presenting menopause as a stage marked by loss of identity and emotional suffering. This in turn contributes to a simplified and negative social perception of this natural transition in women’s lives.

Orts’ contribution, «The Right to Menopause: A Cross-Cultural Analysis of Judicial Discourse on Climacteric-Related Discrimination in English and Spanish Courts», looks at how legal systems address menopause-related discrimination, revealing cross-cultural differences in the recognition and treatment of climacteric rights. The article addresses the issue of age and gender discrimination as experienced by many women during the menopause. In particular, the often-underestimated side effects of menopause lead many women to leave their jobs because of discrimination or the physical and psychological difficulties they experience. The study focuses on how employment tribunals in England and Spain perceive and deal with menopause as a disability that affects women’swell-being and self-esteem. Specifically, three judgments from each country are analyzed discursively. Orts presents two specific findings: a) An absence ofdirect references in the Spanish legal discourse: Although indications ofmenopause-related difficulties were referred to in the Spanish cases, no direct references to the term ‘menopause’ were found; and b) A legislative asymmetry:The comparison between the two countries reveals a difference in recognizing menopause as a cause of disability. The article underlines the fundamental role of linguistic analysis in understanding the experiences of menopausal women and suggests raising awareness of this issue among those professionals involved (translators, terminologists, journalists).

Also in this section is «Metaphorical Conceptualization of the Big M,» by Pérez-Hernández, which considers metaphors used to discuss menopause, highlighting how these influence both personal and public understandings of the experience. Pérez-Hernández’s article approachesthe analysis of metaphors from a different perspective to that of Vargas-Sierra. In this case, the focus is on the narrative of women themselves, not doctors, by means of a study of the testimonies of women in recounting in English their own experiences of and perspectives on menopause. The author’s goal is to investigate contemporary women’s conceptualizations of menopause through the metaphors that they use. Unlike metaphors in biomedical discourse, which frame menopause as an illness or health condition, women tend to emphasize positive aspects, seeing menopause as a force for liberation andnon-conformism. Through the framework of Critical Metaphor Analysis, Pérez-Hernández reports that women in the UK primarily use four metaphors to conceptualize menopause: Journey, Force, Divided Person, and Struggle/Fight.This study opens up a fascinating area of enquiry, with further research now needed in order to compare the metaphors used by women in different cultures and languages.

The final contribution to this first section, «Exploring the Metaphorical Language of Menstruation: Health, Hygiene,or Camouflage?» by Llorens-Simón, investigates how menstruation is metaphorically framed within the specialized medical discourse in Spanish, using corpus linguistics tools. Again, many metaphors, even those related to medical science, have negative connotations and thus perpetuate stereotypes. Menstruation is often seen as an adverse or taboo event, despite being a natural part of women’s lives. The detailed linguistic analysis reported by Llorens-Simón reveals that, from a medical perspective, there is a ‘pathologisation of menstruation’, often portrayed as a disease or something to be avoided. This is seen in the conceptual references relating to dirt, hygiene and negative emotions. The study argues for the use of more inclusive and empathetic language surrounding women’s health as a means of avoiding the perpetuation of stereotypes.

Together, these four articles contribute to a deeper understanding of how menopause and menstruation are linguistically and culturally constructed, and hence how they impact women’s health and identity.

The volume then moves on to address the intersection of gender and health, focusing on how reproductive health issues are linguistically framed. The exploration of cognitive bases for terminology related to sexually transmitted infections (STIs), and variations in the denominative representation of women’s health, highlight the role of languagein both reflecting and shaping gendered experiences in medical contexts.

The article «Género y Salud Reproductiva: Base Cognitiva de la Terminología Relativa a las Infecciones de Transmisión Sexual», by Sánchez Manzanares and Santamaría-Pérez, considers the cognitive foundations of the terminology used to discuss sexually transmitted infections (STIs), revealing how gender influences the way in which these health issuesare conceptualized and communicated. The study shows that although the technical language of STIs is relatively neutral, the discourse surrounding itstill reflects some gender biases. However, a positive trend towards more inclusive and respectful language is also reported.

In the following paper, «Denominative Variation in the Terminological Representation of Women’s Health», Candel-Mora examines terminological variation in the discourse on women’s health, with the aim of improving communication and information management here. The starting point is that although medical language is known for its characteristic precision, there is significant variation in terminology relating to women’s health. The methodology, once again, is corpus-based, drawing on academic texts in English to identify patterns and trends in terminology. Articles from three journals specializing in women’s health with high impact factors (between 5.14 and 2.4) were compiled from an initial corpus of 403 articles amounting to almost 2 million words, all recently published (between January 2021 and April2023). Candel-Mora focuses specifically on lexical change, observing that changes were found in the terms used, but not as frequently as expected, except in the case of the term ‘women’. Likewise, variations in morphology, spelling, ellipsis, spelling, and permutation were observed. Two conclusions arise from the analysis. First, terminological variation in women’s health can make communication and information management difficult. Second, a careful approach to the choice of appropriate terms is necessary to ensure accuracy and comprehension. Based on the data analyzed, the author argues for standardizing and managing synonyms in this field, towards providing clear and consistent language in women’s health and thus improving communication and medical care.

Together, these two studies highlight the critical role of gendered language in women’s health discourse, as it significantly influences the framing, perception, and treatment of health-related issues, with implications for both medical practice and societal attitudes.

The volume then turns its attention to the metaphorical language surrounding eating disorders (ED), a critical issue affecting women’s health. In the article «Biting into the Bitter Reality: A Metaphorical Exploration of Food Disorders,» Gozalo and Moreno-Sandoval describe how metaphors like ED is a journey and ED is a war significantly influence the emotional and psychological experiences of those affected by EDs, impacting both their personal recoveries and societal perceptions of the disorder. The authors find that Spanish speakers often emphasize hardship and powerlessness, while their English counterparts tend to focus on recovery and empowerment, reflecting cultural differences here. It is concluded that these variations underscore the need for culturally sensitive and empathetic communication in medical and therapeutic discourse, suggesting that language and culture profoundly shape how individuals perceive and manage their disorders.

In the next section, the focus shifts to the discursive construction of hysterectomy, a medical procedure with profound implications for women’s health and identity, as Ramirez-Polo explores in her article «From Evictions to Shame: Exploring Hysterectomy Through Metaphor.» The metaphors examined in this study, such as the uterus as a ‘tenant’ or a ‘kidnapper’ and the procedure itself as an ‘eviction’ or ‘robbery,’ provide deep insights into how these linguistic choices shape women’s perceptions of their bodies and the procedure itself. Ramirez-Polo concludes that these metaphors do not merely reflect the experiences of women undergoing hysterectomy, but actively influence their emotional and psychological responses to the procedure. The article underscores the need for sensitive and accurate communication in supporting women through this medical process, advocating for language that respects and validates their experiences, ultimately ensuring that their stories are told with the dignity that they deserve.

In the final section, the volume broadensits scope, presenting a series of insightful articles that consider various chronic illnesses, including Multiple Sclerosis, Osteoporosis, Breast Cancer,and Endometriosis.

In «From Beasts to Faulty Wiring: Metaphorical Images of Multiple Sclerosis as described by women,» Campos-Pardillos explores how women with Multiple Sclerosis use metaphors todescribe their symptoms, revealing that these metaphors profoundly influence their understanding and communication of the disease. The study concludes that metaphorical language is crucial to how women with Multiple Sclerosis express their symptoms, shape their identity, and manage their experience of the disease. An effective use of metaphors can enhance understanding and social support, which are essential for patient well-being, while also emphasizing the need for further research into the cultural and linguistic factors thatinfluence such expressions.

On similar lines, Balteiro’s article, «‘I have ants in my pants’: Metaphorical Framing in Female’s Conversational Narratives of Osteoporosis,» examines how metaphors shape the narratives of women with osteoporosis, concluding that such language significantly affects how these women perceive their condition and communicate their experiences. The study finds that women often use conventional metaphors relating to impact, journey, and war, which serve to highlight both the challenges posed by osteoporosis and the strength and resilience with which they confront these challenges. Metaphors like these allow women to portray themselves as empowered individuals, capable of overcoming obstacles and maintaining autonomy in theirlives, despite the stigmas and stereotypes associated with the disease.

In the following study, which extends thegeographical scope of the volume, «Cáncer de mama, discurso y cognición: metáfora y esquemas de imagen de la enfermedad y sus participantes en el Perú,» Domínguez and Conchacalle explore the metaphorical and cognitive frameworks used by Peruvian women in conceptualizing their experiences with breast cancer. Drawing from a corpus of personal testimonies, the authors analyze howmetaphors like war and personification, along with image schemas such ascontainment, force, and locomotion, shape the perception of the illness. Their research highlights how these cognitive structures not only influence patient narratives but also contribute to the broader cultural understanding of breast cancer in Peru, emphasizing the emotional and psychological dimensions of thedisease in addition to its medical aspects.

Continuing with research from South American, «Relatos de dolor: las metáforas conceptuales en la construcción del padecimiento crónico de mujeres chilenas,» by Pascual and Vásquez, investigates how Chilean women with chronic pain, particularly those suffering from endometriosis, use metaphors to construct their narratives. The study concludes that conceptual metaphors are crucial in expressing the complex and individual experience of chronic pain by women with endometriosis, with a significantfocus on how these metaphors reflect the intensity and social repercussions ofthe condition. The findings also highlight the role of cultural biases in diminishing women’s agency here, leading to the underestimation of their pain and delays in diagnosis and treatment, which in turn negatively impacts their emotional well-being and personality.

The last four articles above illustrate the significant role that metaphorical language plays in shaping the lived experiences and public perceptions of chronic illnesses, highlighting the need for careful consideration of language in both medical and social contexts.

In short, by examining these diverse topics, the volume provides a comprehensive exploration of how metaphorical language shapes the understanding of women’s health issues in both biomedical and general discourse. It invites readers to critically reflect on the implications of language in medical contexts, arguing for more nuanced and informed approaches to communicating women’s health.

Chelo Vargas-Sierra and Antonio Moreno-Sandoval

Acknowledgment

This special issue is part of the research project «Digitisation, processing and online publication of open, multilingual and gender-sensitive terminology resources in the digital society (DIGITENDER)» (TED2021-130040B-C21), funded by Ministerio de Ciencia e Innovación, Agencia Estatal de Investigación (10.13039/501100011033) and by the European Union «NextGenerationEU»/ Plan de Recuperación, Transformación y Resiliencia.