1. INTRODUCTION

A woman’s life journey is marked by key biological milestones, including the onset of menstruation, the beginning of reproductive capacity, pregnancy, childbirth, and the transition through menopause, each with its own positive and negative connotations. In Western cultures, menopause is often seen as a sign of aging and the end of fertility, a perspective not universally shared across societies around the globe (Niland, 2010: 6). Currently, a common biomedical perspective on menopause is that it constitutes disease-like condition arising from estrogen deficiency (Martin, 1994, 1997; Lyons and Griffin, 2003: 1630). Such a disease concept of menopause began to take shape in 1870, when the Irish physician Edward J. Tilt published The Change of Life in Health and Disease: A Practical Treatise on the Nervous and other Affections Incidental to Women at the Decline of Life. Tilt refers to menopause as a stage in a woman’s life that brings with it a multiplicity of symptoms and afflictions and presents a bleak and pessimistic view of the issue, indeed asserting that his book will reveal «the evil effects of this time of life» (Tilt, 1870: 212²). His work goes on to detail various physical and mental problems which are claimed to occur in women due to menopause. Such a negative medicalized view of menopause was reiterated by many other medical professionals over the years (see Greer, 1993; Vélez and Figueredo, 2016). Framing menopause as a disease illustrates how medical ideology shapes our conceptualization of this natural phenomenon and ultimately impacts the lives of women.

Metaphors work both conceptually and cognitively by creating new meanings and helping us to understand the world. This process involves comparing and projecting knowledge onto mental mappings, akin to creating a mental diagram that links abstract concepts with more familiar experiences for easier understanding. This essential function of metaphor is itself described metaphorically as ‘framing’ by Semino et al. (2018), who highlight its ability to shape our perception and interpretation of specific aspects of our lives. According to Entman, in order to create a frame, we need to «select some aspects of a perceived reality and make them more salient in a communicating text, in such a way as to promote a particular problem definition, causal interpretation, moral evaluation, and/or treatment recommendation for the item described» (1993: 53). Framing explains the mechanisms by which language and selected images in the construction of a specific kind of discourse promote a particular interpretation of the presented events (Entman, 1993; Bogetić, 2018; Porto, 2023). These frames go beyond mere reasoning and have the power to influence or shape our understanding, realities, and beliefs. This is so because metaphor involves a «highlighting and hiding» facet (Lakoff & Johnson, 1980), selectively emphasizing certain aspects while downplaying others, and thus contributing significantly to the ideological relevance of metaphors. Research by Thibodeau (2016) and Jiménez et al. (2021) underlines the profound impact of metaphorical framing on perceptions in the field of public policy. Thibodeau showed that framing crime as a virus rather than a beast influenced a shift to the favoring of social reforms over punitive measures, whereas Jiménez et al. found that depicting immigration as a flood, as in «a wave of refugees», could lead to increased support for barriers on the US-Mexico border. Both studies illustrate how language shapes not only our understanding of societal issues but also our responses to them.

Menopause can be defined by highlighting its positive and/or its negative aspects. Any description will be influenced by particular points of view or ideologies, in that variation in any description is likely to reflect the individual or collective perspectives that come into play. On the positive side, for example, we can find examples where menopause is framed as a second puberty, suggesting a parallel with the hormonal fluctuations of adolescence and implying, among many things, that it can bring about positive changes and mark the beginning of a new chapter in life. In addition, the metaphorical frame of the hormonal dance emphasizes the dynamic and rhythmic nature of hormonal changes, depicting the ups and downs as graceful movement, thus evoking a sense of vitality and happiness. On the negative side, menopause is sometimes referred to as planned obsolescence –carrying with it the metaphor a woman is a product with built-in obsolescence– associated with the loss of ovarian function; it suggests that, just as manufactured products reach a point at which they are no longer useful or effective, women lose value or relevance after this stage.

In addition, describing hormonal changes as hormonal chaos implies a perception of disorder and confusion, emphasizing instability and unpredictability during menopause. As these examples illustrate, and as other studies on menopause have shown (Martin, 1993, 1994; Niland, 2010; Vargas-Sierra, 2024), negative frames may contribute to a view that this stage is a period of decline or even an illness, potentially overshadowing some of its positive aspects, such as the end of menstrual discomfort and freedom from reproductive concerns.

In the analysis of metaphor, the use of corpora and digital tools has marked a significant and well-documented methodological shift (Charteris-Black, 2004; Deignan, 2005; Koller et al 2008; Stefanowitsch, 2008; Deignan and Semino 2010; Sardinha, 2012; Vargas-Sierra and Moreno-Sandoval, 2021; Zeng and Ahrens, 2023, among many others). This not only enhances our ability to analyze linguistic patterns more effectively through the adoption of an empirical approach, but also expands the potential scope of research, as shown by Ho and Cheng (2016) in their work on analyzing a corpus for frequent words in a specific semantic category: emotion. Within this evolving framework, the study of emotions, particularly in relation to metaphor, has become increasingly significant. Thus, Kövecses notes that «the most conspicuous feature of emotion language in English is its metaphorical and metonymic nature» (2003: 191). Indeed, our present corpus analysis has revealed a predominance of negative emotions, and as such provides a compelling point of departure for an exploration of the predominant metaphorical frames in discourse on menopause, one in which we seek to highlight the intricate relationship between emotional language and metaphorical conceptualization.

In what follows, we first outline the theoretical assumptions underpinning the study, focusing in particular on Conceptual Metaphor Theory and associated concepts with particular relevance to our research, along with Critical Metaphor Analysis. We then describe the corpus and methodological framework adopted, before presenting the findings of our analysis and offering some conclusions.

2. THEORETICAL FRAMEWORK: CONCEPTUAL METAPHOR THEORY AND FRAMING

Conceptual Metaphor Theory (CMT), pioneered by Lakoff and Johnson (1980), has been a dominant approach to metaphor research since its inception. A conceptual metaphor (CM) is a cognitive mechanism in which a source domain (the domain from which the metaphor is derived) is conceptually represented in a target domain (the domain being described metaphorically). During this process, knowledge from a familiar conceptual domain (such as war, health, journey or machine) is used to structure and understand another domain that is more abstract or distant (Barcelona, 2003; Kövecses, 2010). This ‘conceptual mapping’ manifests itself in language as metaphorical expressions, taking the form of A is B. For example, in the metaphor menopause is a disease, expressions that are often mapped are those relating to the concepts of ‘symptoms’, ‘treatment’, ‘discomfort’ and ‘diagnosis’. Here, the target domain menopause uses the source domain disease to emphasize the concept of ‘pathology’ or ‘medical condition’. The mapping principle for the menopause is a disease metaphor is that menopause is understood as a disease in that, just as diseases involve symptoms and require treatment and medical management, menopause is often perceived as a phase requiring medical intervention and characterized by a variety of physical and emotional symptoms.

In this way Lakoff’s frames (2000: 24) serve as indicators that guide us in understanding events or situations. As such, frames not only offer a perspective on a specific issue but also actively influence our alignment to it, thereby shaping our understanding and judgment. Lakoff (2006) goes on to argue that «every word evokes a frame» and that «frames trigger meaning», which underlines the significance of framing in both general comprehension and the specific context of linguistic interpretation. Within the context of menopause discourse, the framing function of CMT becomes particularly relevant, since it helps us to understand how metaphors shape perceptions and representations about this life stage. It is also pertinent to critically assess these metaphorical frames, in the sense that they can influence societal attitudes towards menopause, sometimes reinforcing stereotypes or oversimplifying complex experiences.

Critical Metaphor Analysis (CMA), as proposed by Charteris-Black (2004: 34), draws on cognitive linguistics to establish a relationship between linguistic expressions and the cognitive system; it uses pragmatics as a means of understanding how metaphors function within specific contexts; and it uses the empirical methods of corpus linguistics, based its analysis on real linguistic data, for the detection of patterns in language. CMA focuses on the correspondence between linguistic expressions and ideology to reveal the evaluative and cultural implications of metaphors and how they can influence the perception of reality.

Metaphors, as a linguistic resource, are fundamental in the formation and transmission of ideologies, which in turn are manifested and reinforced through language and thought in specific social contexts, such as the biomedical one. As such, metaphor has ideological dimensions at the conceptual, cognitive and pragmatic levels (Maalej, 2011: 97). Conceptually, it represents a source domain in a target domain, stabilizing meaning within discourse. Cognitively, it can both highlight and conceal aspects of meaning and understanding (Lakoff and Johnson, 1980), affecting their ideological relevance, and can be classified as either conventional or creative (Charteris-Black, 2004: 21-22). Conventional metaphors, rooted in our culture, go unnoticed (Lakoff & Johnson, 1980: 140; Kövecses, 2010: 33) and establish social and ideological realities, whereas creative ones tend to be somewhat more prominent or noticeable in the discourse. Pragmatically, metaphors have an impact on listeners or readers, depending on the connection between source and target concepts and the context in which they are used.

From a critical linguistic perspective, ideology involves the interaction between language, thought and social context (Simpson, 2005: 5). It is based on beliefs and values shared by social groups, with dominant ideologies typically arising from powerful or otherwise influential groups. Ideological discourse often uses conventional metaphors to transmit ideologies and construct social realities. According to Simpson (ibid), ideology emerges from group beliefs and values and is linked to society through language and thought. Dominant ideologies, influenced by political and social institutions, including medicine, have linguistic, cognitive and social dimensions. Metaphor is crucial in the construction and shaping of medical discourse, exerting control over the debate and establishing power relations therein (Segal, 1997: 220). A critical analysis of metaphors in medical discourse, then, is essential in understanding their valuational and cultural implications and their impact on perception and decision-making in the context of health.

To gain deeper insights into the role of metaphors in constructing the social reality of our subject field, a brief examination of the imagery associated with women during menopause is necessary. Images in picture banks, for example, tend to depict women at this life stage in a state of suffering, characterized by symptoms such as headaches, anxiety, sweating and fanning themselves, or taking medication. Such portrayals, along with metaphors like menopause is a disease, menopause is suffering and menopause is physical affliction, align with the ideological narratives prevalent in biomedical discourse and in popular media. Such metaphors, often chosen for commercial purposes, as noted by Segal (1997: 221), contribute to the promotion of treatments like hormone replacement therapy (HRT), metaphorically framed as an elixir of youth (Vargas-Sierra, 2024: 196). This framing can also be seen in the use of contrasting images on medical websites, for example, by depicting a woman’s face in two halves: one appearing younger (due to HRT) and the other showing the natural aging process³. Such representations, portraying menopause as a decline in physical and mental health, reflect societal biases against the aging process in women. Consequently, women experiencing menopause often face negative sociocultural attitudes and feel pressure to conform to unrealistic standards of youth and beauty.

3. CORPUS AND METHODOLOGICAL FRAMEWORK

The use of corpora in metaphor research is a fairly recent method, dating back to around 1999 (Sardinha, 2011: 330), and having gained popularity among scholars, not least those who have used corpus techniques to examine and validate hypotheses in conceptual metaphor theory. The analysis of corpora in metaphor research has a great many benefits, and as Tissari (2017: 117) notes, a corpus is now considered essential here, much like it is in a wide range of other linguistic fields. The present study used a specific approach for characterizing the corpus, following the principles initially proposed by Vargas-Sierra (2006).

The DIGITENDER project has involved the compilation of several corpora of specialized texts, including medical literature and webpages, which deal with a number of topics relating to women’s health (see Vargas-Sierra, 2024). The corpus on menopause comprises a range of biomedical texts, including research articles, monograph chapters and specialized web pages in English, which were carefully selected to provide a comprehensive view of menopause discourse. The selection criteria include relevance to the topic of menopause, the credibility of sources, and diversity of content. The table below presents a details breakdown of the corpus data:

This study employs a hybrid approach, integrating quantitative semi-automated corpus methods with detailed manual qualitative analysis, to explore the dominant metaphorical framings of menopause. We analyze a corpus of some 2,675,672 million words (Table 1), encompassing a diverse range of biomedical texts with varying degrees of specialization. One challenge in metaphor research arises due to the current limitations in fully automating the identification of metaphorical expressions in texts, and in this case we used Wmatrix5 for this purpose. Developed by Paul Rayson’s team at UCREL, University of Lancaster, and available online, Wmatrix shares common features with other corpus tools, such as generating concordances, collocations, keyword lists, and frequency lists. A notable aspect of Wmatrix is its integration of the UCREL Semantic Annotation System (USAS) (Archer et al., 2002), which enables the automatic semantic tagging of words, compound words, and multiword expressions in a corpus. In the present study, we used Wmatrix5’s semantic tagging function to examine the use of metaphor (Demmen et al., 2015). From 21 USAS semantic domains, we focused on the Emotion (E) semantic tag (E-semtag) (Figure 1).

Figure 1. Complete list for Emotion

We examined the specific words that each E-semtag contained and then considered the concordances of these to identify examples of metaphorical segments. It was often not the seed word itself that was used metaphorically, but rather the surrounding words and phrases. The use of USAS semantic tagging for finding metaphors provided valuable insights, in that it allowed us to quickly elicit emotions, but it is also important to note the challenges inherent in this approach, especially given the huge volume of data involved. The size of our corpus meant that exhaustive metaphor extraction was a considerable task, and this was reflected in the high frequency of certain emotional tags in the corpus. For example, the tag E4.1- (Sadness) had 6,657 occurrences (Figure 2). Consequently, our analysis does not cover every instance of the use of metaphor related to these emotions, but only those that represent a repeated pattern. This limitation highlights the difficulties of balancing the depth of qualitative analysis with the breadth of data available in a large corpus. Moreover, it underscores the need to conduct a selective examination of metaphorical expressions, especially in the context of very specific pathologized topics like menopause.

Figure 2. Occurrences for E4.1- (Sadness)

For the identification of metaphorical expressions, we used the Metaphor Identification Procedure (MIP), developed by the Pragglejaz Group (2007) and further refined by Steen et al. (2010). In the next phase of the analysis, the metaphorical expressions identified in the concordance were incorporated into a Microsoft Excel spreadsheet, where an additional manual analysis was carried out to determine the source and target domain, plus the mappings and metaphorical frames that each expression suggested. To assign source and target domains we used MetaNet Metaphor Wiki, a comprehensive repository of conceptual metaphors (Dodge et al. 2013) in which these two domains are conceptualized as frames, essentially schematic representations that encompass a variety of experiences, objects, and events. The procedure involved examining each metaphorical phrase to identify applicable domains and to categorize them using the predefined classifications available from this repository⁴. The unique nature of our target domain, menopause, demanded a tailored approach to labelling, so we created new tags that could comprehensively capture the various aspects of menopause that arose. Selected examples from these segments will be used to describe our findings in the subsequent analysis.

Charteris-Black (2004: 34-41) outlines a three-step process for conducting CMA analysis: first, identification, which entails deciding if specific words or phrases are used metaphorically; second, interpretation, which includes both establishing a connection between metaphors and their cognitive and pragmatic features, and identifying conceptual metaphors and keys; and third, explanation, which involves determining the social agents responsible for producing the metaphors and understanding their role and function in the discourse. Our analysis follows Charteris-Black’s three-step model of metaphor examination.

In the following section, we will present the quantitative data obtained from the corpus, focusing specifically on the semantic tags of emotions and citing a selection of words from each emotional category. This corpus data will then be used to conduct a qualitative analysis of the metaphors identified. Our focus here will be on the most dominant metaphorical frames, detailing their source (SD) and target domains (TD) and exploring their meaning in the discourse. Due to space constraints, our presentation will be limited to the most illustrative examples of each frame. In addition, we will interpret the domains and metaphorical framings and how they shape our perception and interpretation of menopause.

4. ANALYSIS AND RESULTS

4.1. E-tags

Table 2 below sets out the relevant alphanumeric tags (with one or more ‘pluses’ or ‘minuses’ to indicate a positive or negative position on a semantic scale) and the frequencies of these, thus providing a general overview of the emotional categories extracted from the menopause corpus:

A quantitative analysis of the emotion words in the corpus indicates a significant disparity in their prevalence. Words tagged as positive emotions (Happy, Like, Confident, Contentment, Bravery, Calm) account for only 21.86% of the total, with 3,610 occurrences. By contrast, negative words dominate, with 78.14% (12,902 occurrences). Such a disparity indicates that the discourse within the corpus is heavily framed by negative emotional language, suggesting that experiences and states related to menopause are often conceptualized negatively. Table 3 below sets out the negative emotional tags that will be the focus of our study:

As can be seen here, the most frequent Emotion tag is Sad, with more than half the cases (51%), with Worry the second most frequent (29%). Violent/Angry emotions also have a notable presence (14%), followed by Fear/Shock (4%) and Discontent (1%), indicating that although these latter emotional frames are less frequent, they are still present. Dislike (E2-) also has 1%, indicating a lower presence of more overtly negative language. Indeed, a particularly intense form of sadness, tagged as Sad (E4.1--), appears to be infrequent, with only 3 occurrences, which could indicate that while sadness is frequently mentioned, extremely high degrees of this emotion are not usually expressed or are not the focus of attention in the texts contained in our corpus. These frequencies suggest that menopause is depicted largely through a lens of negative emotions, with a significant emphasis on sadness and worry. The presence of anger and fear, although less frequent, adds to the complexity of the emotional experiences conveyed.

Next, a selection of our seed words⁵ as automatically classified under specific emotional tags by Wmatrix5 is presented, together with the frequency of their occurrence in the corpus:

• Sad_E4.1-, e.g. depression (3,644), depressive (1,731), depressed (427), suffer (173), suffering (119), suffered (58), sad (53), sadness (45), trauma (42), miserable (32).
• Worry_E6-, e.g. anxiety (1,317), stress (675), concerns (264), distress (214), concern (150), trouble (146), tension (102), stressful (94), anxious (69), care (64), distressing (54), worry (53), bother (50), concerned (49), nervous (46), disturbed (42), bothered (40), worried (37), nervousness (35), caring (28), concerning (16), stress-related (15), worrying (12), disturbing (11), unbalanced (11).
• Violent_Angry_E3-, e.g. disturbances (346), disturbance (320), irritability (229), bothersome (173), irritation (72), abuse (55), anger (53), irritable (43), hit (37), attacks (30), rage (29), toxic (24), aggressive (21), attack (20), angry (20), force (18), irritated (16), agitation (16), threat (14), annoying (14), violence (10).
• Fear_E5-, e.g. fear (84), inhibition (56), panic (51), cold_sweats (25), afraid (22), scary (20), fears (18), scared (18), shock (15), dread (12), alarming (12), fearful (8), terrified (8), scare (7), shocks (7), angst (6), frightening (6), inhibited (6), dreaded (5), panicky (5), panicked (4), terrifying (4), fearing (4), freaked_out (4), shocked (3)
• Discontent_E4.2-, e.g. frustrating (34), frustration (20), dissatisfaction (9), dissatisfied (4), disappointing (3), disappointed (3), disappointment (3), frustrations (2).
• Dislike_E2-, e.g. hate (18), antagonism (10), self-criticism (9), antagonizes (6), antagonistic (6), antagonize (3), can_not_stand (3), resentful (2), disapprove (1), averse (1), dislike (1), is_against (1), leave_cold (1), disliked (1).
• Sad_E4.1--: mourn (3)

It should be noted that while frequency played a role in selecting emotion-related words and expressions for analysis, our approach was not solely quantitative. We also conducted a qualitative review of concordances to discern metaphorical patterns, including less frequent but semantically rich terms such as ‘mayhem’ and ‘mourn’. This nuanced approach allowed us to identify authentic metaphorical usage distinct from technical jargon. For example, terms that superficially seemed metaphorical due to their emotional connotations, such as ‘antagonism’, ‘poisoning’, and ‘toxic’, were in fact not emotional or metaphorical, since they were used in their technical sense.

4.2. Metaphor framings

Next, we introduce the main metaphorical framings identified in our study, with the emotional seed words that led to each metaphor’s identification provided in brackets. We then present an example of each one, accompanied by a detailed analysis of the specific domains and framing involved. This approach seeks to explore in detail how menopause is shaped and conceptualized. The frames we discuss primarily reveal the intricate interplay between physiological and psychological experiences of menopause, often portrayed pathologically, as evidenced by ‘symptom’ (11,412 occurrences), this being the second most frequent word in our corpus, after ‘woman’. The target domains most frequently encountered were brain function, emotional intensity, hormonal change/function, menopause experience/transition, and mental health, among others. Correspondingly, the source domains paint a narrative of menopause through lenses of chaos, loss, burden, downward/non-linear motion, imbalance, instability, obstacle/impediment to motion, machine/functionality, mechanism, turbulence, physical challenge/combat, upheaval and disruption, each underscoring the challenging and often negative depicting of this life stage.

(I) Menopause as emotional turbulence (seed words: ‘mood swings’, ‘depression’, ‘anxiety’, ‘disturb’, ‘embarrassment’, ‘discomfort’, ‘disturbance’):

The focus in example (1) is on the experience of mood swings, particularly their unpredictable and fluctuating nature. The source domain is roller coaster (non-linear movement), used metaphorically to describe the dynamic and unpredictable nature of mood swings. The ups and downs of a roller coaster ride symbolize rapid and extreme changes in mood, so the metaphorical mapping in this context is drawing a parallel between the unpredictable and rapid changes in direction of a roller coaster ride and the similarly unpredictable and extreme changes in a woman’s mood during mood swings. Thus, metaphorical framing of a woman’s mood swings represents someone who is unpredictable, variable, with ups and downs, and as such does not contribute to a positive image of women in general or at this stage of life, instead highlighting emotional turmoil and the difficulty of achieving stability, with mood swings portrayed as a tumultuous (negative) experience. This sentence also carries implications of helplessness, in that riders on a roller coaster cannot control the experience («get off the ride that easily»), and this can also influence how mood swings are perceived by others, potentially minimizing women’s perceived agency here. The description of «periods of intense elevation are suddenly followed by severe depression» emphasizes the intensity of these mood changes and its framing highlights the extreme and often sudden shifts in emotional states, akin to the rapid transitions experienced on a roller coaster. This metaphorical language suggests that the woman’s emotional fluctuations are like a journey which is difficult to escape from or control.

Example (2) focuses on the levels of anxiety and the changes in these that women experience before, during, and after menopause. Anxiety is portrayed as a fluctuating condition due to the description of varying levels of anxiety («high anxiety at premenopause», «low anxiety at pre-menopausal transition», etc.). This framing suggests variability and changeability in the experience of anxiety, and the use of terms like risk and susceptibility metaphorically frames the experience of anxiety as something that can be measured in terms of vulnerability. The framing here stresses the variability and unpredictability of menopause-related anxiety as part of a complex transitional phase which has notable in mental health implications.

The source domain in example (3) involves the concepts of non-linear motion or interference («disturb the sleep») and reduction (in energy). These expressions and the underlying domains are used to describe how menopause-related symptoms can disrupt normal function and well-being. The interruption of the natural sleep cycle is mapped onto the disruption of emotional well-being. The expression «lower down energy» is used to describe the energy-draining effect that emotional symptoms can have on a woman’s overall vitality. Here, the concept of an object descending is mapped onto the notion of reducing energy levels, illustrating the transition from a state of vitality to one of fatigue. Describing symptoms as things that «disturb the sleep» and «lower down energy» uses a framing that suggests interference and reduction, implying that the symptoms of menopause disrupt normal sleep patterns and deplete energy levels, much like an external disturbance or a draining force.

The expression «emotional lability» frames the emotional effects of hot flashes in terms of instability or variability. It involves the source domain instability, referring here to rapid and often unexpected fluctuations in emotions. The unpredictability and inconsistent nature of instability is mapped onto the fluctuating emotional states caused by hot flashes during menopause. Just as something unstable is prone to sudden changes or lacks a consistent pattern, emotional lability here is characterized by rapid, unpredictable shifts in mood and feelings. The metaphorical framing serves to position such emotional experiences as inherently unstable and unpredictable, suggesting that just as one cannot predict or control an unstable situation, the emotional responses triggered by hot flashes are also beyond a woman’s control and can change swiftly and unexpectedly.

(II) Menopause as disruptive change (seed emotions: depression, anxiety, embarrassed, anxious, disruptive; misery)

This sentence (5) relates brain function during menopause to that of a machine. Such a comparison likens the brain to a complex mechanism, in which menopause affects its operational efficiency and overall functionality. Thus, the woman’s brain is compared to a machine that is malfunctioning. Such a framing suggests that the brain’s usual functioning capacity is impaired or reduced, implying that menopause may lead to a diminished mental state, one in which cognitive abilities are compromised, and thus reinforcing notions of mental decline associated with this stage of life.

The target domain here is the impact of menopause on daily life, both physically and emotionally. The source domain is obstacle/impediment to motion, suggesting that menopause is a significant barrier to the natural flow of a woman’s life, and symbolically represents the transition as a disruptive force that can interrupt or alter her normal patterns of behavior. This framing portrays menopause as a disruptive event, as an unpredictable force that can derail a woman’s usual existence, and also emphasizes the notion that menopause has a challenging and often unanticipated impact on daily life.

In the first part of this sentence (7), the target domain is the menopause transition, especially concerning its impact on women who are otherwise accomplished and capable. The source domain obstacle/impediment to motion is consistently used, as in the phrase «simply stumble into menopause», which frames menopause as an unexpected obstacle or hurdle in life. It conveys the notion of a sudden and unprepared encounter which brings with it difficulties, akin to encountering a physical stumbling block that unexpectedly disrupts one’s path. In the second part of the sentence, we again see the term ‘disruptive’, already noted in (3) where it was applied to sleep, and now mapped onto the menopause transition, likening it to a significant disturbance in a woman’s life. Such a framing portrays menopause as a period of substantial change and upheaval, one characterized by hormonal imbalances that disrupt the normal flow of life, and again emphasizing the challenging nature of this transition.

In the analysis of metaphorical language surrounding menopause, one striking pattern emerges in which menopause is framed through the lens of conflict and adversity. This is exemplified in the previous sentence (8) with the expression «safeguard against menopause misery» which implies a defensive course of action against potential harm or danger. The metaphor, then, draws on the source domain threat and enemy to describe the target domain emotional intensity, in which «menopause misery» is perceived as a hostile force or adversary that could impact women’s emotional state. The term «menopause misery» frames this life stage extremely negatively as a time of great discomfort and unhappiness, assuming without nuance that menopause is per se a state of extreme sadness and emotional distress. The phrase «safeguard against menopause misery» coordinated with «long-term health problems» frames menopause as a risk or threat to long-term health.

These metaphors present menopause not only as a biological transition, but as a formidable challenge or opponent, infusing the experience with a sense of struggle or confrontation. Such a metaphorical pattern highlights the intense emotional experiences often associated with menopause, portraying these as battles to be fought or dangers to be defended against. This framing can significantly shape perceptions and attitudes towards menopause by highlighting a number of issues that can cause disruption and distress.

The source domain chaos evokes a sense of disorder, confusion and lack of control in the fluctuation of hormone levels which impact on women’s emotional and psychological well-being. The target domain here is that of the hormonal changes, particularly changes in gonadal hormones, with the sentence «hormones are chaotic or unpredictable» mapping the characteristics of chaos and uncertainty (commonly associated with unpredictable and disorderly states) onto the hormonal changes that occur during menopause.

Through this metaphor, the sentence frames menopausal hormonal changes as inherently disordered and unpredictable, contributing to a perception of menopause as a period marked by instability and uncertainty, and as such potentially influences how menopause is perceived and discussed.

(III) Menopause as hormonal conflict (seed emotions: depression, irritability, sadness, mayhem, throw_off_balance)

The target domain in (10) is hormonal change, focusing on those biochemical substances in the body that influence psychological states. The notion of estrogen becoming the «dominant» hormone suggests a power or dominance dynamic, where one hormone assumes a controlling role over others, leading to certain effects. This concept aligns with source domains competition and conflict, where the increasing influence of estrogen compared to other hormones is seen as a form of competition or struggle for dominance. This metaphorical framing illustrates the relationship between hormone levels and symptoms as a cause-and-effect dynamic. The decrease in progesterone and the dominance of estrogens are presented as direct causes of irritability and depression, suggesting a chemical imbalance. Thus, the role of hormones is metaphorically conceptualized as a controlling force significantly impacting a woman’s emotional state during hormonal changes.

In (11) we can observe the intricate interplay between the source domain of a trigger mechanism and the target domain hormonal change. The concept of a trigger mechanism, typically associated with the initiation of a precise and immediate action in machinery or weaponry, is used to conceptualize the initiation of hormonal changes. In the biomedical narrative, hormonal changes, particularly the decrease in levels of progesterone, are often presented as central to the understanding of the menopause experience. This metaphorical framing carries with it notions of the immediacy and impact of hormonal changes, framing them as critical triggers of emotional and physical reactions. Just as a trigger elicits an immediate and predictable reaction in a mechanism or weapon, a decrease in progesterone levels is presented as having a direct and almost inevitable impact on emotional states, emphasizing the power and influence of hormonal fluctuations on mental and emotional well-being, and thus implying a lack of control over such reactions.

Hormonal change is the target domain in (12), where the term «mayhem», a typically negative and chaotic state, is used to imply the source domain chaos, disorder, or confusion. It is used metaphorically to characterize the nature and impact of hormonal fluctuations during perimenopause. In this way, the sense of chaos experienced during a state of mayhem is mapped onto the emotional distress and disruption caused by hormonal fluctuations during perimenopause, and the destructive and disruptive nature of mayhem is mapped onto the negative impact of hormonal changes on women’s emotional well-being. This metaphorically frames the perimenopausal hormonal changes as disruptive and undesirable.

The underlined phrases in (13) are used metaphorically to describe the state of hormonal equilibrium and its potential disruption, and hence the source domain involves the concepts non-linear dynamics and imbalance. The discussion of how hormones work in the context of balance and imbalance frames the endocrine system metaphorically as a balanced scale or a finely-tuned mechanism, implying that hormones need to maintain a certain equilibrium for optimal functioning. The phrase «throw them off balance» suggests an action or condition that can disrupt this equilibrium. Such framing implies the action of a carefully balanced object being knocked over or destabilized, thus emphasizing the sensitivity of the hormonal system to external or internal changes. The metaphorical framing of menopause in biomedical discourse often casts it in a light of imbalance and instability, portraying this natural life stage as a period of disequilibrium and disorder, rather than a normal physiological transition.

The «misfiring of neurons» here represents the brain’s electrical activity (TD: brain function), which when not functioning properly can lead to symptoms that are likened to receiving «electric shocks», a concept commonly associated with electrical systems. When neurons «misfire» it implies a disruption or error in this process, akin to the malfunction of a complex machine. So, the mapping in (14) associates the electrical nature of neurons with the unexpected and unpleasant experience of an electric shock. It implies a failure in the normal functioning of the brain’s neurological pathways, similar to a short circuit in an electrical system. By describing hormonal changes as causing neurons to misfire, it implies a loss of the regular, healthy brain function, contributing to a perception of menopause as a period of decline or deterioration. The framing emphasizes uncomfortable or distressing symptoms («electric shocks») as a direct consequence of menopause, potentially heightening fear and anxiety about this transition. «Misfiring of neurons» also suggests a lack of predictability and control over bodily functions, reinforcing a narrative that views this stage of life negatively.

This narrative suggests a heightened sensitivity to hormonal disruptions, depicting menopausal women as fragile and vulnerable to various internal influences that could further destabilize their condition. Such a conceptualization contributes to a «loss of control narrative», where menopausal women are seen as struggling to maintain hormonal balance, thus reducing their agency over their own bodies. Furthermore, the emphasis on the negative symptoms associated with hormone imbalance pathologizes menopause, framing it as an abnormal or undesirable condition rather than a natural phase of aging.

(IV) Menopause as a societal and identity challenge (seed emotions: mourn, stress, brutal, overwhelming):

In a literal sense, mourning is the act of grieving the loss of a loved one. In the metaphorical sense, it can also refer to the grief associated with the loss (SD) of a significant role or identity, as in examples (15) and (16), where the target domain is menopause experience/transition. The focus here is on the emotional experience of women transitioning from an active caregiving role in motherhood to a post-caregiving stage, coinciding with menopause or later life stages. Framing the end of the active caregiving stage as something to be mourned implies that this transition is not a smooth and natural chronological change but a extremely sad process. The expressions «didn’t know who she was» and «mourned the woman she used to be» in (16) offer a poignant reflection on the profound experience that some women might go through during this period. Such metaphors highlight a deep sense of loss, confusion, and grief, one that transcends mere physical symptoms to include the psychological and emotional realms. The idea of having a distinct and recognizable sense of self is mapped onto the experience of feeling lost and confused during menopause; at the same time, the state of being unsure of one’s identity is mapped onto the state of feeling disconnected from one’s past self and unsure of who one is in the present. In the second part of the sentence, the act of mourning the loss of a loved one is mapped onto the act of grieving the loss of a part of oneself, such as one’s youth, health, or sense of identity. Thus, the feeling of sadness, grief, and regret associated with mourning is mapped onto the feeling of loss and sadness associated with the physical and emotional changes of menopause; the metaphor of «not knowing oneself» suggests a disruption or fragmentation of identity brought about by menopause. In western societies, where youth and physical vitality are highly valued, menopause is often viewed as a departure from these ideals. Furthermore, the act of mourning one’s prior self conveys a particularly profound sense of grief and loss. As a metaphor it extends beyond the physical aspects of menopause to encompass a mourning process for the loss of certain aspects of one’s life, such as fertility or a particular phase of existence; hence, menopause is presented as an emotional burden similar to the process of mourning.

In the metaphorical analysis of menopause-related discourse, we often find the use of the source domains overwhelm and burden to articulate the experiences involved in the menopause transition and the changes in a woman’s body. These domains, rooted in the notion of being heavily laden or inundated, serve to convey a sense of the intensity and impact of menopause, the notion that this period can be especially taxing, both physically and emotionally. The metaphorical framing in (17) presents the menopause transition and bodily changes as significant challenges, emphasizing their considerable weight and difficulty, portraying this life stage as a time of substantial strain and readjustment, focusing on the struggle to adapt to and cope with the myriad changes occurring during this phase.

The source domain in (18) involves the concept of a burden and various challenges such as «psychosocial stressors», «role changes», «losses», and «aging». These terms are used metaphorically to describe the weight of the experiences faced by women during this phase. This framing implies that the transition is not just a natural process but also that it adds to the challenges a woman faces in life, akin to carrying a extra, heavier load. The inclusion of «losses» and «the experience of aging» in the framing points to these elements as inherent components of the menopausal transition, and metaphor here conveys the idea that such aspects are notably impactful parts of the process. «Losses», we might add, also implies a more definitive sense of the end of certain life stage or role.

The metaphorical framework used in the above analysis has sought to situate menopause as a multifaceted transition that affects women biologically, psychologically, socially, and existentially. The language explored has been seen to present menopause as extremely complex, going beyond the physical changes that occur and including a wide range of emotional and social readjustments.

5. CONCLUSIONS

The present study took as its starting point the representation of menopause as a disease, focusing on a set of emotions detected and automatically tagged using Wmatrix5 in a corpus of texts on menopause. As highlighted, negative words predominated (78.14%), and such a disparity clearly indicated that the corpus studied is heavily framed by negative emotional language.

The prevalence of this discourse in the four metaphorical frames discussed has underlined the difficulty of overcoming negative representations at this stage of life. More specifically, the analysis of the framing of menopause as emotional turbulence has shown how profoundly it shapes our understanding of menopause as a period marked by intense and unpredictable emotional fluctuations. This framing is vividly illustrated in the metaphor of roller-coaster-like mood swings, highlighting as it does the supposedly erratic and extreme nature of women’s emotional changes, and thus drawing on a social stereotype and suggesting a lack of control and stability that casts women in a light of helplessness and vulnerability.

The second category of framing was menopause as a disruptive change, which influences the perception of menopause by highlighting its complexity and the series of challenges it presents, as if changes are not constant facts of life and that women suddenly find that they are someone else physically and mentally. Indeed, menopause is portrayed as detrimental to mental acuity, the brain compared to a malfunctioning machine, suggesting cognitive impairment and reinforcing stereotypes of mental deficiency. Hot flashes, mood swings, plus hormonal and physical changes are framed as obstacles, hence describing menopause as a disruptive force in daily life, emphasizing its unpredictability and the physical and emotional challenges that accompany it. Menopause is thus metaphorically described as an unexpected obstacle, even for successful women, placing those who experience it at a dead end, somewhere from which they are unable to escape. In fact, this framing also employs metaphors of threat and enemy to describe the «menopause misery» –a highly negative connotation to collocate with «menopause»– as an adversarial force, negatively presenting this stage of life as a period of discomfort and sadness, one which also poses a health risk. Indeed, «risk» is also one of the most frequent words in the corpus (3,796.87 per million tokens).

The framing of menopause as hormone conflict highlights the loss of estrogen production as central and emphasizes the negative changes of this biological change, one capable of provoking various pathologies. In this sense, it conveys the notion that hormones are our number one enemy. Indeed, this framing presents menopause as a period of hormonal imbalance, leading to emotional disorders such as irritability and depression, and draws on ideas of internal strife and discord. Hormonal changes are metaphorically described as a triggering mechanism, highlighting their immediate and significant impact on emotional and physical well-being. The use of the term «chaos» to describe hormonal changes during menopause conveys the disruptive and challenging nature of this stage in a woman’s life. The framing of the disruption of hormonal balance using non-linear dynamics and imbalance suggests a lack of verticality and a vulnerability in menopausal women, pathologizing menopause as an abnormal condition; it is depicted as full of ups and downs, as if the course of life were otherwise a journey in a straight line and this stage were something radically different. There is no doubt that even in our 21^st-century world, we can still find in this kind of discourse a reliance on the kind of approach to menopause that Tilt referred to as «the evil effects of this time of life» (Tilt, 1870).

The framing of menopause as a societal and identity challenge presents this stage as an important point of emotional and identity transition for women. This perspective serves to articulate a profound sense of loss and the upheaval associated with the end of maternal functions (as if you suddenly cease to be a mother), changes in bodily and sexual functions, and the broader experience of aging. It touches on the emotional experiences of women, highlighting grief, confusion, and a sense of disconnection from one’s past self, suggesting a departure from societal ideals of youth and vitality, and intensifying the sense of loss and re-evaluation of self-identity. The emotional complexity and struggle of women is highlighted, in that they are seen as having to adjust to these changes, with menopause described as a period of considerable stress and involving the reassessment of one’s identity. Such an approach, in that it focuses on how menopause can have a profound impact on women, also runs the risk of reinforcing stereotypes that view the stage in life predominantly in terms of loss and decline, potentially overshadowing women’s diverse and individual experiences. As such, we believe it has the power to contribute significantly to social narratives that frame menopause as a predominantly negative transition, thus influencing how women’s experiences during this phase are understood, discussed, and managed in both personal and broader social contexts.

Taken together, these dominant metaphorical frames contribute to the reinforcing of several stereotypes about menopausal women, shaping societal perceptions in ways that often oversimplify and negatively color this life stage. From the many examples in our corpus, we can see that menopause is frequently characterized in terms of emotional turmoil and instability, loss of identity, and a wide range of symptoms and pathologies that are difficult to resolve, given that reversing women’s aging is not (yet) possible. This focus on the challenges and difficulties of menopause ignores or relegates the importance of a more comprehensive and positive understanding of the issues, often neglecting the diverse experiences of menopausal women and unnecessarily increasing negative perceptions about this life transition. Such multimodal representations often portray women as lacking agency and control over their emotional and physical states, which can significantly influence social attitudes toward menopause and reinforce stereotypes such as mentally troubled, emotionally unstable, and worthless older women.

However, it is equally important to recognize the benefits of menopause: the end of menstrual cycles, no longer needing menstrual hygiene products, freedom from the fear of unwanted pregnancy–allowing sexual relations without contraceptives, the cessation of pre-menstrual syndrome, and the discovery of emotional stability and liberation. These benefits highlight the need for a narrative shift that better aligns with women's empowerment at this life stage and its multimodal representation in images and oral and written texts.

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Notes

¹ This publication forms 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. [Volver]

² The page number corresponds to the Kindle version of the book. [Volver]

³ https://newlifemedcenters.com/hormone-therapy-for-women/ [Volver]

⁴ Available at: https://metaphor.icsi.berkeley.edu/pub/en/index.php/Category:Frame [Volver]

⁵ Due to space considerations, only a selection is shown here. A comprehensive list, including the total number of unique terms (types) and their frequencies across each emotion category, is available for download at: https://personal.ua.es/es/chelo-vargas/documentos/ewords.docx [Volver]

1. INTRODUCTION

Menopause is a crucial life stage where age and gender discrimination intersect, creating a complex set of challenges for women. These challenges often lead to premature exits from the workforce due to discrimination or debilitating physical and psychological health issues (Yoeli et al., 2021; Hardy et al., 2018 and 2019). This paper analyses and compares menopause-related discrimination cases dealing with labour issues in English Employment Tribunals (ET) and in Spanish courts (Juzgados and Tribunales de lo Social). In the background of the study are recent developments in the UK judicial system that increasingly recognize menopause as a hidden but significant contributor to women’s exclusion from the labour market (Griffiths et al., 2013; D’Angelo et al., 2023). In contrast, despite a substantial population of four million menopausal women in Spain (Rodríguez Muértegui, 2022), a thorough search of the Spanish official legal database, CENDOJ (2020-2022)¹, has revealed a noticeable absence of case-law evidence explicitly reflecting a growing trend of women invoking disability or impairment arising from menopausal-related afflictions to sustain their professional engagements. These disparities are further highlighted by various reports and research conducted in the UK, which are conspicuously absent in the Spanish context.

Indeed, women make up nearly half of the paid workforce in many high-income countries, and in some industries, they comprise the majority. A growing number of women aged 45 and older have been engaged in paid employment over the past two decades. In 2025, it is anticipated that the global postmenopausal female population will reach 1.1 billion (Rodríguez Muértegui, 2022). These demographic and economic imperatives align with the fact that menopause is being experienced by many women while they are actively engaged in the workforce.

Research by the UK’s Chartered Institute of Personnel and Development (CIPD)² indicates that 59% of women between the ages of 45 and 55 with menopausal symptoms experience work-related problems. The report underscores the lack of visibility and awareness of menopause-related issues in the workplace, emphasizing the importance of work environments offering support mechanisms and suggesting reasonable accommodations to women grappling with menopausal symptoms. There have been other significant developments in the UK, such as the establishment of the House of Commons Women and Equalities Committee, in June 2015³. Spain, however, appears to lack direct counterparts in terms of comprehensive research and assessments addressing menopausal discrimination at work. The country boasts robust gender equality laws enshrined in its Constitution, and many organizations promote gender equality in the workplace. However, these initiatives do not explicitly target menopause-related discrimination. What is more, Spain’s membership in the European Union brings the influence of EU directives and initiatives⁴ aimed at addressing gender equality and workplace discrimination, but such initiatives may not directly target menopause-related issues. Additionally, certain Spanish organizations, including the AEEM (Asociación Española de Estudio de la Menopausia⁵, raise awareness about menopause-related workplace challenges and offer resources for women and employers to navigate this life stage; even Spanish labour law provides reasonable adjustments to support employees with specific needs⁶, but menopause remains without explicit reference.

This study focuses on menopausal women involved in legal proceedings related to their job performance. The primary objective is to shed light on the level of awareness, or lack thereof, within employment courts and tribunals regarding the impact of menopause, which can significantly affect women’s well-being and self-esteem. It specifically analyses three judicial decisions in Great Britain and three judicial decisions from the CENDOJ database⁷ in Spain, centring on menopause as a workplace impediment. Using qualitative methods, this study employs emotion discourse analysis, as proposed by Koschut in 2018 and 2020, to scrutinize these judgments. The study commences with a macrostructural examination, unravelling the legal narratives contained within each subcorpus. It then proceeds to identify emotion-related linguistic patterns and emotional implicatures using the sentiment-analysis software Lingmotif 2.0 (Moreno-Ortiz 2021), revealing the cognitive mechanisms used to stigmatize or obscure the experiences of these women within the narratives. At this point, it is imperative to point out that, even if in this study we have chosen to single out emotion words, Lingmotif 2 calculates sentence polarity, taking into account both the number and the position of sentiment items, and, hence, being able to capture connotative emotion in the sentence.

In the following sections, we explore key theoretical aspects informed by multidisciplinary research on menopause’s impact on women’s work performance, societal perceptions in labour contexts, and menopausal women’s self-perception. We are analysing employment court organizational structures in different legal systems, comparing the UK and Spain to understand how they address cases involving menopausal women and their work-related challenges.

2. THEORETICAL BACKGROUND

2.1. Menopause and workplace challenges: a review

Recent research has increasingly highlighted the issue of workplace discrimination faced by women during the transformative phase that menopause represents. Our literature review has synthesized findings from various studies, shedding light on the multifaceted challenges that menopausal women confront in professional settings. A recurring theme across these studies is the intersectionality of menopause experiences, where gender, age, health, and work dynamics converge to shape women’s encounters with menopause. Riach and Jack (2021), Targett and Beck (2021), Whiley et al. (2023), and Verdonk et al. (2022) have all contributed to understanding this complex interplay. Riach and Jack (2021), specifically, reveal how physical and psychological factors intersect to shape women’s menopause experiences at work. They argue that it is often difficult to exclusively attribute discriminatory behaviour to menopause, leading to what they refer to as “slippery inequality”. Jack et al (2016) has previously pointed out that women commonly express their dissatisfaction with the lack of support, understanding, and accommodations in their workplaces. They believe that organizations should implement policies such as flexible work arrangements, temperature control measures, and educational initiatives for managers and colleagues, aiming to provide better support for women during menopause. Targett and Beck (2021) offer a different perspective, offering gender-specific considerations and addressing ageism within a workplace’s well-being strategy instead of a menopause policy, highlighting how gendered segregation and age-based bias influence menopause experiences.

Whiley et al. (2023), in turn, emphasize the invisibility, medicalization, stigmatization, and gendered nature of menopause at work, emphasizing the need for organizational support and further research in this area. They stress that a comprehensive understanding of menopause’s impact necessitates addressing its multifaceted nature, encompassing both physical and psychological aspects. Verdonk et al. (2022) carried out a narrative analysis covering a broad range of topics related to menopause and work, identifying knowledge gaps for further research. The study by these authors further highlights the lack of recognition of menopause as a workplace issue and identifies several key themes, including the impact of menopause on work ability and job characteristics, the role of psychosocial and cultural factors, and the need for interventions and support for women experiencing menopausal symptoms.

In terms of the relationship between menopause and job performance, several studies, including those by Steffan (2021) and D’Angelo et al. (2021), converge on the idea that menopausal symptoms can significantly impact success at work. Physical menopausal symptoms are closely linked to job performance but can be non-specific and hard to distinguish from other health problems. Along these lines Steffan (2021) found that women are engaged in conflicting behaviors to manage and make sense of their menopausal bodies at work, but all describe themselves in an emotion-laden narrative of fear, precarity, uncertainty, and isolation. D’Angelo et al. (2021) investigate the impact of menopausal symptoms on work outcomes, revealing their potential to reduce productivity and job satisfaction. The research underscores the necessity of employer support and accommodations for menopausal women.

Additionally, Bryson et al. (2022) study the consequences of early menopause on labour market participation, concluding that early natural menopause can curtail employment duration for women in their 50s, potentially affecting employment rates. Finally, Ambikairajah et al. (2022) address challenges in defining menopause stages in research, arguing for standardized criteria to enhance research comparability.

In summary, these studies collectively illuminate the multifaceted challenges encountered by menopausal women in the workplace. While each study emphasizes unique aspects, they all underscore the key role of organizational support, heightened awareness, and accommodations.

2.2. Work disputes in either system. The rationale of decisions on employment cases

As we have mentioned, the analysis compares the treatment of menopause-related discrimination cases in first-instance and appeal English Employment Tribunals (ETs), and appeals from Juzgados de lo Social (Spanish first-instance Employment Courts with provincial jurisdiction) to the Tribunales Superiores de Justicia, Sala de lo Social (Spanish Higher Courts of Justice, Employment Chamber, located in each Autonomous Government). These systems stem from the distinct legal traditions of Common Law and Continental Law, respectively. Notably, the treatment of judicial precedent and judgment styles in English and Spanish legal traditions differs significantly, in line with the tradition they belong to (Ruiz-Moneva, 2013; Orts, 2016, 2017).

In Spain, legal judgments, known as sentencias, are characterized by a distant and administrative tone. They employ alphanumeric references instead of litigant names and use highly impersonal language. These decisions adhere to a structured format characteristic of Continental-style judgments, as pointed out by Orts (2017: 227). In contrast, Orts (2017: 230-232) has identified a lack of consistent structure in English judicial decisions, challenging the assumption made by Bhatia (1997: 118) that they adhere to specific textual patterns. In her research, she asserts that English decisions display a more flexible structure than Spanish judgments, and are much more personal, incorporating litigant identities into the titles or headings of the judgments to enhance memorability, and convey the subjective perspectives of judges in their own first-person voice, and according to their particular vision of the case⁸.

Table 1 shows the typical structure of a judgment from a Juzgado de lo Social or that of a Tribunal Superior de Justicia, Sala de lo Social:

If the pattern is fixed, this structure does not necessarily make Spanish legal documents more straightforward to understand. The desire for textual precision leads to excessive wordiness, and the presence of intertextuality in the introduction of legislation and precedents creates epistemic asymmetry between judges as experts and recipients, making these texts challenging for laypersons to comprehend (Orts, 2017: 233).

In contrast, English legal judgments are concise and relatively intimate, though, as we remarked, sometimes lacking a clear, organized framework. Table 2 provides a suggested organization for ET judgments, which, as we shall see, is not consistently followed:

These structural and functional differences between the two legal systems significantly affect how employment issues, including those related to menopause, are perceived and addressed by judges and courts.

In the United Kingdom, additionally, employment tribunals function as independent bodies, entrusted with resolving employment-related disputes between employers and employees⁹. These tribunals possess jurisdiction over a wide range of employment issues, including claims of unfair dismissal, discrimination, harassment, breach of contract, and various other employment-related matters. Their primary objective is to provide a fair and accessible platform for resolving these disputes, and they operate as distinct entities separate from the ordinary court system. In cases of dissatisfaction with tribunal decisions, litigants can further petition to Employment Appeal Tribunals, serving as the appellate bodies for employment-related appeals.

In Spain, the Juzgados de lo Social serve as first-tier courts for labour and employment-related cases, handling a broader spectrum of disputes, including those related to employment contracts, terminations, wages, working conditions, and social security matters. The higher labour and social security tribunals, Tribunales Superiores de Justicia, Sala de lo Social, oversee cases appealed from the former¹⁰.

The differences in the way these judicial organs deem cases have an impact on how menopausal problems in the workplace are handled, as we shall see. Understanding these structural and functional distinctions is essential when analysing menopause-related discrimination cases and their outcomes in different legal systems.

3. MATERIALS AND METHODS

This study involves six employment law judgments, focusing on women dealing with menopause-related challenges. The corpus, while small due to its qualitative methodology, explores differences in sensitivities between the English Common Law and the Spanish Continental law systems. It examines how judges and parties handle women’s menopausal issues at work and their decisions to leave jobs due to irresolvable job-related conflicts. Three judgments originate from British Employment Tribunals (ET) and have set legal precedents in menopause-related cases. The other three were sourced out from 50 searches using the keyword menopausia from the Spanish CENDOJ database. They were selected for the sake of their similarity in topic with their English counterparts. Both were selected based on case types like ‘unfair dismissal’, ‘workplace discrimination’, and ‘permanent incapacity’. All Spanish cases are recursos de suplicación (appeals to the Superior Court of Justice, Employment division), while only one British case falls into the appeals category, with the other two resolved in initial stages. This asymmetry in the corpus might be further justified due to the scarcity of similar cases in Spanish legislation.

Tables 3 and 4 present the data for the two subcorpora, in English and Spanish, respectively:

In this study, we employ Koschut’s emotional discursive analysis (2018, 2020) to explore the emotional dimensions of menopause at work. Our analysis delves into various aspects, including:

1. Othering, Alterization, Stigmatization: This dimension focuses on characterizing menopausal women as the Other, and how emotional expressions may lead to stigmatization due to their responses to menopausal symptoms, resulting in stereotypes, discrimination, and a loss of social status (Koschut, 2020: 13). This concept can be related to how menopausal women may sometimes feel stigmatized or pressured to conform to certain emotional norms in the workplace, reflecting a belief that they should correct their emotional responses without external understanding and empathy.
2. Storytelling and Intertextuality: Narratives serve the purpose of making sense of emotional experiences and imbuing them with meaning. Sharing their stories about dealing with menopause can help others understand the emotional challenges they face and, in turn, promote empathy and support from the courts. Intertextual affectivity highlights the interconnectedness of different texts and their impact on authority and identity within historical and socio-cultural contexts (Koschut, 2020: 14).
3. Performativity and Interpellation: This idea can be related to how menopausal women may deliberately or inadvertently express their emotional states at the courts and in the workplace. It can help avoid situations where they may be cast as the Other due to their emotional responses during this life stage, ensuring a more inclusive and understanding workplace culture (Koschut, 2020: 15).

Our analysis seeks to unearth women’s narratives in legal contexts within the structural composition of court judgments, and the use of intertextuality might deepen our understanding of how the courts engage within the broader storytelling, particularly when addressing menopause-related matters in different legal systems.

First, a reading and summarization of the judicial decisions was conducted. Emotional items were then extracted using Lingmotif 2.0, discriminating between those items that were purely emotional and those that the system had classified as positive or negative (including words from the legal domain, especially in Spanish texts). Indeed, to aid our identification of emotional language and emotional implicatures, we employed Lingmotif 2.0 SA software (Moreno-Ortiz, 2021), a Sentiment Analysis tool which offers insights into the semantic tone and emotional intensity of textual content, making it a valuable resource for uncovering emotional undercurrents in texts related to menopause in the workplace. Subsequently, Koschut’s emotional discourse analysis was applied to give the results a deeper significance: We focus on expressions related to physical and psychological distress to unveil linguistic and cognitive tools employed to label and stigmatize women due to the consequences of menopause. We explore emotional words and emotional or e-implicatures – a term coined by Schwarz-Friesel (2015:186) to refer to possible inferences related to emotions – with a focus on expressions related to physical and psychological ailments and suffering.

4. MACROSTRUCTURE AND EMOTION DISCOURSE ANALYSIS IN UK JUDGMENTS

4.1. Case one: A v Bonmarche Ltd (in administration)

This first decision, the shortest in extension, unfolds into two distinct, yet interconnected parts, both articulated through the voice and perspective of Judge McFatridge. First, we are presented with the Employment Tribunal’s judgment, followed by an elaboration of the rationale underpinning this ruling. The latter segment, comprising 20 sections, is further organized into three subsections: the findings of fact (sections 4-10), an exploration of the narrative surrounding the anonymous Claimant, known as A (sections 11-14), and ultimately the discussion and final determination (sections 15-20). Throughout, the legal framework invoked includes references to the Equality Act of 2010 and pertinent precedents that align with the essence of this case.

In Table 5, we present the results of the 30 major negative words and collocations that emerged in the text of Case 1, as extracted by Lingmotif 2.0 software:

The selection of words is expressive of the suffering of Claimant, a seasoned 37-year retail professional, who filed an age and gender discrimination claim against her employer, CB. Despite her impressive career and reputation as a top-performing salesperson, a significant shift occurred when her menopause began in May 2017. Her employer’s behaviour turned humiliating, with demeaning actions and derogatory comments witnessed by her colleagues, causing profound distress and humiliation to the Claimant. Negative emotional states such as suffering, depression, anxiety, panic, and stress, in addition to negative discriminatory actions like ‘harassment’, ‘humiliation’, ‘hostility’, and ‘degradation’, constitute the majority of the selections by the software:

1. He would demean her and humiliate her in front of other staff. Other members of staff were younger and would laugh at CB’s remark.

She asserted that her manager’s actions amounted to harassment and abuse inflicted upon her due to her status as a menopausal woman:

2. He continued to criticise the claimant unreasonably. On one occasion he criticised her for failing to staple together two pieces of paper and related this to her being menopausal.

The specific incidents she detailed included offensive and derogatory remarks, such as being referred to as a “dinosaur”, and criticism for minor oversights, which were attributed to her menopausal state. The Claimant supported her case with a statement detailing the impact of discrimination on her health.

3. She suffered a serious panic attack which required paramedics to be called.

The Claimant’s experience aligns with Koschut’s concept of alterization. Menopause transformed how her employer and colleagues, particularly CB, perceived her, leading to demeaning behaviour and casting her as the Other. Her menopausal status exacerbated the alteration, deepening her humiliation and marginalization. Additionally, her manager’s actions stigmatized her emotional reactions, creating barriers, fostering stereotypes, and reducing her workplace status. Harassment and eventual dismissal resulted from her emotional responses, significantly impacting her workplace experience.

Judge McFatridge analysed the Claimant’s methodical presentation of incidents categorizing them as direct discrimination, harassment, and victimization. The Employment Tribunal ruled in her favour, affirming the UK’s commitment to tackling workplace discrimination.

4.2. Case two: Ms M Rooney v Leicester City Council

Case two stands out among the analysed cases as the only one on appeal, sent back to the Employment Tribunal due to a ruling in favour of the Claimant by the Employment Appeal Tribunal. While, predictably, its judgment lacks a fixed structure, it spans 7,610 words, more than double the previous one. It starts with a Practice and Procedure section followed by the ruling. Judge James Tayler’s reasons for the Court of Appeal decision, like other cases, use a first-person voice and consist of 65 subsections, often lacking specific titles. The decision employs intertextuality by including excerpts from the original claim and references to the ET Judges. This intertextual pattern helps clarify the EAT’s role, expound on Equality Act implications for disability appeals, and provide recommendations to the Employment Tribunal for case revision. As far the narrative of the case goes, it is fairly illustrated in the negative words that Table 6 shows:

Similar to A v Bonmarche, the case under discussion frequently mentions climacteric issues, emotional states like anxiety, and various forms of suffering and discrimination-related terms. It centres on the Claimant, a social worker employed by Leicester City Council, who lodged multiple complaints against the Council, including disability discrimination, based on their treatment of her during her challenging two-year struggle with menopausal symptoms. Her claim form vividly described severe peri-menopausal symptoms, including insomnia, fatigue, light-headedness, confusion, stress, depression, anxiety, palpitations, memory loss, migraines, and hot flushes. She explicitly asserted that she had faced workplace discrimination due to her menopausal symptoms. Extracts 4 and 5 present the Claimant’s declarations:

4. I endured considerable suffering due to my menopausal symptoms, affecting my well-being and work performance.
5. My emotional state deteriorated, and I was subject to harassment and detriment, directly linked to my menopausal condition.

This scenario is closely tied to Koschut’s emotional discourse analysis, embedding emotional meanings within discourses. The Claimant’s extensive description of her menopausal symptoms, affecting her daily life, serves as an emotional narrative within this analysis. Her storytelling confers significance upon her emotional experiences, portraying them as notable challenges and shaping her identity as someone grappling with the emotional and physical toll of menopause. Moreover, her argument –that the ET erred by not recognizing her as disabled and subsequently dismissing her discrimination claims without proper analysis and rationale– aligns with Koschut’s concept of performativity (the activation of speech act chains and motifs through the deliberate construction of subjects) and interpellation of emotions (2020:10). She emphasized the importance of her emotional experiences, particularly their impact on her work capacity and overall well-being, which made the tribunal rule in her favour:

6. The Claimant has confirmed that her disability discrimination claims are direct disability discrimination […] and harassment and victimisation.

Highlighting the significance of her emotional experiences, particularly how her menopausal symptoms affected her ability to work and her overall well-being, she framed her experiences as discrimination based on her emotional state during menopause.

4.3. Case three: Leigh Best v Embark on Raw Ltd

The case of Leigh Best v. Embark, the longest in the corpus at 8,291 words, is among the recent UK employment cases explicitly addressing unfavourable treatment linked to menopause. The case revolves around Leigh Best, a 52-year-old employee who alleged age and sex discrimination. Intertextuality is heavily relied upon, referencing the Employment Rights Act 1996. Judge Elgot’s detailed decision is of particular significance within this context, carefully structured with 54 sections to address the unique aspects of Leigh Best’s case. The judgment comprises two main sections: the Summary of the judgment and the Reasons for the tribunal’s decisions, lacking a predetermined macrostructure. Key elements include the case narrative and defining main constructs such as “protected disclosure”, “unfair dismissal”, and “unfair detriment”, providing factors for remedy determination. Table 7 outlines the 30 primary emotion words and implicatures in the text, extracted from Lingmotif 2.0.

Similar to other cases, ‘menopause’ is mentioned three times, and words like ‘anxiety,’ ‘worry,’ ‘paranoia,’ ‘obsession,’ ‘fear,’ ‘petrified,’ and ‘meltdown’ convey negative emotions. Terms associated with actions against the Claimant include ‘complaint,’ ‘warn,’ ‘detriment,’ ‘threaten,’ ‘harassment,’ and ‘victimization.’ COVID-related words like ‘pandemic,’ ‘virus,’ and ‘lockdown’ are central to the narrative.

Judge Elgot’s ruling found that Leigh Best was unfairly dismissed due to ‘whistleblowing,’ making ‘protected disclosures.’ Furthermore, the Respondent, her employer, unlawfully subjected her to detriment, as a result of which the judge noted that she experienced anxiety, frustration, confusion, and danger. The extracts provided illustrate the judge’s narration of Ms. Leigh’s story:

7. [The Claimant was] very stressed and anxious, having a ‘meltdown’ about the covid 19 pandemic and its potential health and safety impact upon her and others including her two sisters and a nephew. She described herself as ‘petrified’.

Central to the Claimant’s complaint were her pre-dismissal priorities, notably her efforts to secure management support for enforcing COVID safety measures among her co-workers, which created a process of alterization and stigmatization, whereby she was laughed at, and called ‘menopausal’ because she was feeling that her health and safety were ‘endangered’ by the careless conduct of the staff. Both her employers and co-workers ‘harangued’ her and accused her of being ‘obsessed’ and ‘paranoid’ about the virus, and intimated she was old and deserved no better treatment than anyone else, hence the allegations on the part of the Claimant of ‘ageism’ and ‘sexism’. As an example:

8. […] the Claimant complains that Mr David Fletcher made inappropriate and derogatory comments about her age and remarks, relevant to her sex as a woman, relating to his perception or ‘guess’ that she might be menopausal or be experiencing stereotypical menopausal symptoms including that her husband would start looking at other younger women.

The Claimant’s experience in a hostile work environment, including personal space violations and harassment, is fraught with emotional distress. Her words and actions, taken to end the harassment and address health and safety concerns, reflect her emotional responses to an uncomfortable situation. The emotional context in the narrative extends to her relationship with her employer and co-workers, who cast her as the Other. This labelling leads to her being viewed as an outsider or someone different from the norm, causing her feelings of isolation and humiliation.

The tribunal’s decision also carries emotional weight. It recognizes that the Respondent, in an attempt to justify her dismissal, had retroactively fabricated misconduct issues. The ruling in favour of the Claimant regarding her unfair dismissal and unlawful detriment complaints acknowledges the emotional harm she endured.

5. MACROSTRUCTURE AND EMOTION DISCOURSE ANALYSIS IN SPANISH JUDGMENTS

5.1. Case four: STSJ PV 109/2016 (María Luisa v NSS, TGSS, Mutua Fraternidad-Muprespa, and Atento Teleservicios España S.A.)

This initial case in the Spanish subcorpus adheres to the traditional format of the respective legal system, encompassing key sections such as Antecedentes de hecho, Fundamentos de derecho, and Fallo. The structure mirrors the typical format of Spanish legal decisions, characterized by a rigid and impersonal tone, featuring administrative and judicial language. This juridical style is often employed to uphold an aura of objectivity and impartiality, in contrast to the more personalized approach observed in English legal decisions. It underscores the formal and standardized characteristics inherent in Spanish legal discourse. Table 8 shows the most salient emotion words and emotional implicatures in the decision highlighted in red:

The first difference in relation to the English cases is the absence of the word menopausia, ‘menopause’, instead replaced by an array of words having to do with illness and pain, such as accidente, incapacidad temporal, enfermedad, trastorno, estrés, ansiedad, dolencia, lesión, insomnio, dolor, retraimiento, and padecimiento, highlighted in red, to distinguish them from the rest of terms. ‘Discrimination’ (discriminación) plays an important role, but other procedural words (absent in the English subcorpora) are also very frequent, such as condenar, impugnar, revocar, causar baja or imponer¹¹.

In this case, María Luisa claimed to have suffered an injury during her work. According to the medical report upholding her claims:

1. Cuadro de estrés, insomnio, ansiedad, falta de concentración que relaciona con la menopausia (desde hace 4 años) y con estrés en su trabajo, tras dos meses de baja [sic], acude a un psicólogo, toma Lexatin 1,5/ 12 horas, va estando mejor, nota aún dificultades para dormir, con despertar precoz, y se levanta cansada, con jaquecas y con dolor lumbar.

The Claimant, despite experiencing menopause-related symptoms, sought disability benefits, due to what was described as a ‘workplace accident’, rather than acknowledging her age-related condition. However, she could not establish a solid connection between her ailments and the alleged workplace accident which was the origin of her discrimination. The court found insufficient evidence of her claims, resulting in the dismissal of her appeal. It is crucial to emphasize, then, that María Luisa’s reference to menopause was minimal, and that she downplayed her true symptoms by attributing them to a work accident, which was not a typical incident, but a series of symptoms provoked by her work situation:

2. La actora causó baja por incapacidad transitoria con el diagnóstico de “trastorno de adaptación” y “estado de ansiedad”

These diagnoses of ‘adjustment disorder’ and ‘anxiety disorder’ reflect her ongoing struggles, which culminated in her medical condition. The strategic choice to link her symptoms to a workplace accident adds a layer of complexity to the emotional discourse within the legal context. By making this choice, the Claimant indirectly acknowledged the potential stigmatization or othering that could arise if she openly associated her symptoms with menopause. In this context, her emotional experiences, which she likely knew were tied to menopause, were presented in a way that deviated from a direct admission of their cause. A subsequent medical report states the following and confirms her diversionary strategy:

3. Todas sus patologías son susceptibles de estar relacionadas con’ una ansiedad crónica derivada de [sic] problemática laboral.

How the Claimant handles the emotional discourse to shield herself from potential negative repercussions or perceptions, aligns with Koschut’s concept of performativity and interpellation, reflecting the choices individuals make in expressing their emotional states and addressing the expectations and reactions of their audience within a specific context.

5.2 Case five: STSJ AS 3221/2022 (Celia v Clínica de Asturias, S.A.)

The second Spanish judgment, once again, adheres to the macrostructural rigidity of Spanish judicial texts, with a listing of the Antecedentes de hecho in 6 sections (the second section further subdivided into 28 established facts), followed by two Fundamentos de derecho (’the legal issues’) and the ruling (Fallo). Celia, an administrative assistant with over a decade at Clínica Asturias S.A., was dismissed in March 2022 for a long list of lacks of compliance on the part of her employer. Table 9 shows the main negative items gathered by the software, among which emotion words showing the Appellant’s feelings are basically absent:

We can see in the list of negative words that most of them are related to the legal process itself (despido, sentenciar, sanción, imputar, interponer, infracción, presentar demanda, despido diciplinario) and the accusations by the Respondent (riesgo, desobediencia, desatención, vulneración, sin autorización, riesgo, muy grave), who alleged reasons for her dismissal including uniform non-compliance, not wearing a mask during the pandemic and mobile phone policy violations:

1. Pero no solo incumple continuamente el manual de comportamiento de la empresa, sino que a su vez incumple el protocolo de actuación frente al Covid- 19. Estos, lejos de tratarse de hechos aislados son reincidencias y no puede ser tolerados por la Compañía por el perjuicio y las implicaciones que puede suponer. […] Consideramos que su comportamiento es muy grave […] poniendo en riesgo con este comportamiento su salud, la de sus compañeros y la de las personas que se encuentran en las instalaciones.

Contesting her dismissal, the Claimant cited health problems, possibly indicating a reluctance to disclose her condition due to concerns about climacteric. In her own narrative menopause is only mentioned once, but her symptoms are detailed:

2. […] todos estos problemas que tengo son de sequedad de las mucosas a raíz de mi comienzo con la menopausia en el 2019, vengo pegada a las gotas oculares […] por empeorar a raíz de la pandemia fue cuando me comentó que la mascarilla resecaba las mucosas.

Despite the deluge of accusations and reasons for her dismissal, Celia succeeded in having her concerns addressed by the tribunal, who ruled in her favour. The dismissal was deemed unjustified and discriminatory due to her undisclosed health issues and the company’s mishandling of the dismissal procedures. Among the established facts, the court states:

3. […] le [sic] sancionaron por mal uso de mascarilla, se siente acosada en el trabajo por temor a despido, taquicardia sinusal epigastralgia por ansiedad; También lo fue el día 18 de febrero de 2022 por presentar lesiones dermatológicas, maculares con prurito en ambas mejillas, sequedad nasal a tratamiento sintomático.

The Claimant’s array of maladies underscores her employer’s tendency to perceive her as the Other based on her menopausal symptoms. Her difficulties with mask-wearing during hot flashes amplified the stigmatization she experienced, ultimately leading to unfair treatment and her subsequent dismissal. As her story is narrated by the appellate judges, we are presented with the powerful impact of storytelling, characterized by the struggles associated with wearing a mask and the fact that her dismissal was unjust and discriminatory.

5.3. Case six: STSJ GAL 1377/2023 (Camila v Instituto Nacional De La Seguridad Social, INSS)

Like in the other cases, the macrostructure of this one adheres to the typical rigidity found in Spanish judicial decisions, structured into three fundamental parts: Antecedentes de hecho, Fundamentos de derecho, and Fallo. In Table 10 all the 30 most salient words are shown, with special emphasis upon her physical and psychological ailments:

The Appellant presented successive medical leaves due to temporary disability and requested a total permanent disability for her profession as a textile operator, which was initially denied by the first-instance court. Table 10 reveals a significant number of physical ailments and negative emotions that she experienced since she had her menopause at 40, and that had made her job unbearable. These terms include dolor, degenerativo, obsesivo, depresivo, patología, limitación, afectar, tristeza, empeoramiento, recaída, riesgo, ‘disability’ (no longer being able), lesión, and invalidez. The use of such words corresponds to a series of unsuccessful requests included in the decision, and the language in Table 10 further mirrors these demands, including incapacidad, incapacidad temporal, incapacidad permanente total, and incapacidad permanente absoluta. Demonstrating how intertextuality is vital in the case, the judgment reflects the list of medical conditions suffered by Camila, according to her medical reports:

1. […] la parte actora presentaba como cuadro clínico residual: trastorno distímico de personalidad con rasgos obsesivos, fibromialgia, artrosis cervical con discopatía C5- C6, C6-
2. espondiloartrosis dorsal y lumbar, artrosis de rodillas, artrosis manos, hallux valgas bilateral, hemangiomas hepáticos […]

In the discussed case, a notable link emerges between the Appellant’s early menopause and subsequent chronic health issues, including fibromyalgia and arthrosis. Although the judicial decision in her favour does not explicitly establish a direct connection, there is a potential interplay between these factors:

3. En base a lo argumentado procede la estimación del recurso presentado en su petición subsidiaria, y dictar un pronunciamiento revocatorio del recurrido, declarando a la actora afecta de una incapacidad permanente total para su profesión habitual de operaria textil.

In fact, emerging research (Jones et al., 2020; Koçak and Beji, 2023) indicates a plausible association between early menopause and an increased risk of certain chronic health conditions. This condition can worsen the risk of developing osteoarthritis (arthrosis) due to hormonal changes impacting bone density and joint health. Additionally, fibromyalgia, characterized by widespread musculoskeletal pain, may have potential links to hormonal fluctuations during menopause.

Although the Appellant could/would not overtly link her early climacteric to her health issues, the potential connection stands out. The court’s in-depth examination of her medical history stresses the need for a comprehensive understanding. While not explicitly stating a direct link between menopause and her chronic ailments, the text underscores the importance of intertextual elements, like previous leave applications and numerous medical reports, which enrich the narrative by providing context and historical perspective. They play a key role in contextualizing the emotional aspects of her case, aiding in connecting Camila’s menopausal condition to its potential impact on chronic health issues.

6. CONCLUSIONS

Our study represents a modest, yet significant stride toward raising awareness of the emotional dimensions of menopause in the workplace. Although our research is quantitatively limited, it lays a qualitative foundation, emphasizing the vital role that linguists can play in fostering such awareness. The analysis stresses the potential of the narratives presented here to increase understanding of the emotional aspects of menopause at work and contributes to creating a more compassionate work environment.

Extant research on menopause in the workplace highlights the complex interplay of biological, social, organizational, and legal factors shaping the experiences of menopausal women and the need for comprehensive approaches to support their health, well-being, and professional success. Our examination of English cases demonstrates a recognition of menopause as a significant factor in workplace challenges. Established precedents in case law acknowledge the impact of climacteric conditions, as evidenced by prominent cases we reviewed. Conversely, our analysis of Spanish judgments reveals a striking absence of direct references to ‘menopause’, reflecting a legislative asymmetry between the UK and Spain. While menopause-related difficulties were occasionally hinted at in Spanish cases, they were rarely explicitly acknowledged. This discrepancy unveils varying degrees of societal recognition and legal accommodation for menopause as a workplace challenge. Indeed, if case law has established clear precedents for women experiencing climacteric conditions in the workplace, in our Spanish corpus of three judgments –retrieved from the Spanish judicial database CENDOJ deploying the keyword menopausia as a search token–, we found that the term was seldom used, the issue rarely addressed as such. The absence of Spanish judicial rulings directly referencing ‘menopause’ is due to a clear legislative asymmetry between the two countries: in the United Kingdom, menopause with disabling symptoms is recognized as a cause of disability in employment cases, whereas in Spain the disabling menopausal syndrome does not enjoy the same legal recognition. Accordingly, menopause was often subsumed among various other health issues that rendered women unfit to work. In the Spanish cases resembling their English counterparts in topic, menopause was subtly alluded to, but not explicitly acknowledged as the primary cause of workplace difficulties. The differential responses in English and Spanish judicial discourse reveal varying degrees of societal recognition and legal accommodation for menopause as a workplace challenge. Our work highlights the pressing need for a more nuanced understanding of this temporary condition as an intersectional phenomenon and calls for transformative legislative changes to address the current disparity.

Our analysis, then, could contribute to creating sensitivities in translators and applied linguists, to the least, even as we acknowledge the quantitative limitations of our specific study. We anticipate that future research can offer deeper insights into this important topic, paving the way for more comprehensive solutions. Ultimately, it is imperative for both the legal system and society to reflect on these issues, recognizing and addressing the challenges faced by women experiencing menopause in the workplace globally. And linguist and translators should be poised to the feat.

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Notes

¹ CENDOJ, Judicial Documentation Center, https://www.poderjudicial.es/search/ (Last accessed 24th march 2024). [Volver]

² https://www.cipd.org/en/topics/menopause/ [Volver]

³ https://committees.parliament.uk/committee/328/women-and-equalities-committee/ [Volver]

⁴ https://commission.europa.eu/strategy-and-policy/policies/justice-and-fundamental-rights/gender-equality/women-labour-market-work-life-balance/womens-situation-labour-market_en [Volver]

⁵ https://aeem.es/, or Spanish Association for Menopause Studies (my translation). [Volver]

⁶ https://www.inmujeres.gob.es/servRecursos/organismos/home.htm [Volver]

⁷ https://www.poderjudicial.es/search/indexAN.jsp [Volver]

⁸ Spanish judicial rulings tend towards impersonal style and obscuring the voice of the judge, but without total stylistic consistency. Especially in judgments of collegiate bodies, where multiple judges sit, the voice of the ruling body is expressed through an alternation of verbal forms in the third person singular and the first person plural (Garofalo 2009). [Volver]

⁹ Employment Tribunal system in the UK: https://www.gov.uk/courts-tribunals/employment-tribunal [date of consultation] [Volver]

¹⁰ Juzgados and Tribunales Superiores de Justicia, Sala de lo Social are regulated by the Ley Reguladora de la Función Social: https://www.boe.es/eli/es/l/2011/10/10/36/con [date of consultation] [Volver]

¹¹ In the context of a judicial case involving mistreatment of women at work due to their menopausal status, seemingly neutral Spanish terms from the judicial procedural field, such as interponer (’to file’), impugnar (to challenge), revocar (’to revoke’), and desestimar (’to dismiss’), can indeed imply a negative connotation or emotion akin to terms like enfermedad (’illness’) or accidente (’accident’), which are intrinsically negative. This is because they often carry implications of conflict, dispute, and negative outcomes, such as the dismissal or rejection of their grievances, reflecting the complex interplay between language, culture, and the legal system in shaping perceptions of justice and equity. [Volver]

1. INTRODUCTION

Metaphors play a pivotal role in shaping our perceptions and understanding of complex topics. They map our knowledge from familiar domains onto abstract ones, thus serving as powerful tools for comprehension and communication, amounting to approximately 20% of our discourse (Steen et al., 2010). Over the past few decades, research has shown that metaphors can mold our thoughts, emotions, behaviors, and even our recollections (Sontag, 1978; Lakoff and Johnson, 1980; Lakoff, 1987; Thibodeau & Boroditsky, 2011; Thibodeau et al., 2019). In this study, we delve into the intricate world of the metaphorical conceptualization of menopause. Society has traditionally placed a taboo on this natural phase of women’s life, thus imposing silence on a topic that many women still do not feel at ease talking about. This silence mandate reflects itself in the names commonly used to refer to menopause (e.g., the big M, the change, the visitor, etc.), which often involve metonymies, metaphors, and other patterns of conceptual interaction to avoid literal reference. The discourse of menopause has often been circumscribed to medical settings, where it has been conceptualized as a condition that needs treatment due to its associated negative physical, emotional, and social consequences (see Niland, 2010 for a comprehensive summary of this view). The negative portrayal and subsequent medicalization of menopause in the biomedical discourse has been contested by several waves of feminist movements and cross-cultural sociological studies which have surfaced a more diverse, as well as positive conceptualization of menopause (see Dickson, 1990; and Quental et al. 2023 for an overview).

It has become increasingly apparent that there is a crucial need to shift our gaze from a medicalized discourse of menopause towards the actual narratives and testimonies of women experiencing it. These first-hand accounts represent an invaluable resource for uncovering alternative metaphorical frames that can reshape the discourse around menopause. However, in-depth analyses of the metaphorical conceptualization of menopause within cognitive linguistics and conceptual metaphor theory are scarce (Bogo Jorgensen, 2020, 2021, 2022). In our study, we embark on this vital journey, emphasizing the exploration of women's personal stories and experiences during menopause. By delving into their narratives, we specially aim to unearth the metaphorical frames they use to talk about this phase of life. This endeavor may not only acknowledge the diversity of women's experiences but also allow for a more balanced and empowering perspective on menopause, one that also celebrates its unique aspects and fosters a more supportive societal understanding of this natural phase of life.

We approach this objective from a Critical Metaphor Analysis theoretical framework (Charteris-Black, 2004; Wodak and Meyer, 2009; Hart, 2019), and we aim at contrasting biomedical and feminist metaphorical conceptualizations of menopause, both ideologically charged visions of the matter under consideration, with those emerging from the analysis of the everyday life language used by real contemporary women. The final aim is to offer a faithful and updated view of what menopause means for those who experience it firsthand.

The study is based on a collection of 300 metaphorical expressions stemming from testimonials of menopausal, perimenopausal, and postmenopausal British women. For each metaphorical expression, their source and target domains have been identified and classified in relation to their axiological portrayal of menopause, and their discourse function (descriptive or evaluative). A detailed qualitative analysis of the most pervasive metaphors in the data has then been carried out to unveil the characteristics of contemporary women’s views of menopause as reflected in their metaphorical language.

The remainder of the paper is organized as follows. Section 2 presents the theoretical tools adopted for the present study and an overview of previous studies on the metaphorical conceptualization of menopause. Section 3 includes methodological considerations regarding the criteria for corpus selection, the protocol for metaphor identification, and the data annotation scheme. Section 4 offers a description and discussion of the four main conceptual metaphors of menopause identified in the analysis. The final section summarizes the main findings of the study and suggests some paths for further research.

2. CRITICAL METAPHOR ANALYSIS AND THE METAPHORICAL CONCEPTUALIZATION OF MENOPAUSE

The appeal of metaphors hinges on the user’s familiarity with the source domain, which offers knowledge and convenient expressions to understand and talk about a more abstract notion. In addition, their persuasive power has also been attested in the literature (Charteris-Black, 2011; Musolff, 2017). However, as Rosenblueth et al. (1943) rightly warned us, «the price of metaphor is eternal vigilance.» While metaphorical conceptualization is often convenient, it also conceals potential risks because concepts and reasoning patterns established in one domain (the source) are employed in another domain (the target) with the implicit assumption that they transfer with reasonably accurate validity. Even when used merely as a shortcut, and maybe in a colloquial manner, we tend to adopt the thought patterns of the more familiar source domain to reason and talk about the target domain. These framing effects of conceptual metaphor and their influence on how we perceive, act upon, and even recall facts have been unveiled in the works by philosophers, linguists, and psychologists (Sontag, 1978; Lakoff and Johnson, 1980; Thibodeau & Boroditsky, 2011; Pérez-Hernández and Pérez Sobrino, 2024). The choice of a metaphor against others is not inconsequential. Metaphors may lead to different emotional reactions and diverse logical conclusions about a topic (Hart, 2019). They can also divert attention to some aspects of a matter, while blinding us about other equally relevant issues. In this connection, metaphor is a powerful ideological tool as has been extensively argued in a large body of literature carried out within Critical Metaphor Analysis, which also involves the exposure of biased metaphors, the promotion of an active resistance against them, and the creation of alternative, more appropriate mappings to reframe discourse on certain topics (Charteris-Black, 2004; Wodak and Meyer, 2009; Hart, 2019). Among them, there are investigations on the replacement of metaphors about immigration (Santa Ana, 2002), the misleading assumptions of science metaphors (Nerlich and Hellsten, 2004), the ineffectiveness and potential risk of cancer metaphors (Sontag, 1978; Hauser and Schwarz, 2015; Hendricks et al., 2018; Semino et al., 2016), the more recent re-frame Covid initiative (Olza et al., 2021; Pérez Sobrino et al., 2022), and works on metaphor on climate change (Flusberg et al.,2017).

The notion of metaphor resistance has been amply dealt with in Gibbs and Siman (2021), who pointed out the need speakers have of sometimes resisting or rejecting metaphors for various reasons: their meaningfulness, their incoherence, their lack of explanatory power, their creation of interpretation biases (e.g. in science), the inferences they may trigger about a particular issue in different contexts (e.g., the war metaphor in relation to cancer or COVID), their stigmatization of a social group, etc. Additionally, as shown in Wackers et al. (2021), since metaphors are a matter of thought, language, and communication, they can be resisted in one or more of these dimensions. Yet another factor affecting the resistance against a metaphor has been shown to be their offensive or derogatory nature, with «extreme metaphors» of this type being more readily «resisted» by speakers (de Lavalette et al., 2019; Hart, 2021).

To be effective, resistance metaphors should be linked to existing ones through the preservation of the same source domain (Santa Ana, 2002; Wackers and Plug, 2022). By way of illustration, Santa Ana (2002: 298) suggests that if, for instance, immigrants are metaphorically conceptualized as flowing water, it would be a good idea to preserve the same source domain while enriching it with new positive values as in «in the American Southwest, the immigrant stream makes the desert bloom.»

Still, the emergence of new metaphors that oppose existing ones to subvert their negative assumptions is a heterogeneous process. As observed in Gibbs and Siman (2021), there are many ways in which new metaphors can stand up against previous metaphorical conceptualizations. Speakers may dislike and resist a particular metaphor (e.g., I prefer to think of my cancer treatment as a journey rather than a war). But this rejection may also be partial and affect only certain aspects of a metaphorical mapping (e.g., in the love is a Journey metaphor, people may like the fact that love surmounts all obstacles but dislike the fact that love journeys are often plagued with interruptions and changes of itinerary). It is also possible to find contradictory positions in people’s resistance of metaphors (e.g., important is big, but «Good things come in small packages»). Conscious rebellion about a metaphor in a particular setting does not necessarily reflect a total rejection of that metaphor in all contexts. Metaphors can be resisted individually, as the result of personal experience (i.e., war metaphor against cancer, Sontag (1978)), or collectively, such as the immigration is flowing water metaphor, identified in Santa Ana et al. (1998) and since then amply condemned in subsequent studies (Santa Ana, 2002; Hart, 2010; Montagut & Moragas-Fernández, 2020; Porto, 2022). There are other cases in which the opposition to metaphors comes naturally from the speakers themselves rather than being the result of scientific analysis, and experts’ proposals. In this connection, Hart (2011) showed how readers rejected the inferences derived from radical anti-immigration metaphors.

The remainder of this section offers a summary of those metaphors of menopause that have conformed the main discourses about this matter to date. This will allow a comparison with those metaphors in use in UK women’s present-day talk about this topic and shed light on their adherence or resistance to those traditional mainstream metaphors of menopause. As Lazar et al. (2019) point out, menopause is a major life change often expressed in semantically dense figurative language. Its conceptualization often falls into one of two fragmentary and reductionist views which focus either on its biological or sociocultural dimensions (Voda and George, 1986).

The biomedical portrait of menopause makes use of the breakdown metaphor, based on the more general women’s bodies as reproductive machines. It conceptualizes this event as a factory (ovarian factory) that is failing, resulting in failed production (deficiency of reproductive hormones) and, therefore, leading to degeneration, loss of femineity and ageing (Martin,1987). This view goes back to the middle 20^th century when menopause was also considered a struggle against the consequences of such breakdown (Deutsch, 1945). Metaphors at work in the biomedical conceptualization of menopause largely overlook its positive side (see Niland, 2010 for an exhaustive account).

The sociocultural view of menopause emerged in 1970s in reaction to the biomedical view and its medicalization (Dickson, 1990). Menopause is conceptualized as a natural process or phase of life, as well as a culturally constructed heterogeneous event that is diversely conceptualized as either a conflict or critical point in western culture, or a period with a high social prestige in eastern societies (Flint, 1975; Wilbush, 1982). As observed by Charlap (2015), some cultures even lack a word to describe this life process. Kabir and Chan’s (2023) meta-analysis of twelve papers focusing on menopausal experiences of Chinese women showed that cultural stereotypes could even have an impact on how they perceived their menopausal symptoms. In the same line, Jin et al. (2015) argue that Asian midlife women, notably Chinese, have lower rates of physical and psychological symptoms and more favorable attitudes regarding menopause than other ethnic groups. The sociocultural understanding of menopause has also changed over time. Thus, it has been variously conceptualized as a sin in Victorian times, as neurosis in the early 20^th century, as a disease in the late 20^th century, and either as a health condition/issue or a natural phase of life in recent times.

Menopause metaphors found within the sociocultural, feminist stance are resistance metaphors that focus mainly on its positive aspects. Zeserson (2001) identified the metaphor ‘chi no michi’ (path of blood) in the discourse about menopause of Japanese women, where blood metonymically stands for women, and showed how this metaphor challenges purely biomedical explanations and amounts to resistance against globalizing definitions of the embodied experience of menopause. In this connection, in a study aimed at improving human-computer interaction systems, Lazar et al. (2019), analyzed women’s talk about menopause in a Reddit forum and found that they made use of certain recurring conceptual projections. Thus, menopause was conceptualized as either a stranger in the body (an alien, a beast, or a possessor), a journey, an expiration date, or a learning process. From a feminist literary criticism approach, Quental et al. (2023) unveiled certain metaphors aimed at destigmatizing menopause in the works of contemporary feminist writers (Margaret Mead, Virginia Woolf, and Julia Kristeva), as well as in a collection of women’s testimonials in 150 articles published in The Guardian between 2005 and 2020. These metaphors included: (1) «killing the angel in the house» (liberation from gendered social expectations and from the reproductive mandate), (2) discovering the «foreigner» within; and (3) the [menopause] «zest».

All in all, since the 19^th century to our days, the discourse about menopause has gone from an initial silencing to a rise in awareness based on its negative physical, psychological, and emotional aspects, its subsequent stigmatization, and a recent re-framing in a more positive view. As Geddes (2022) points out, menopause «is having a moment» with a rise of news coverage in the media (Orgard and Rottenberg, 2023). Despite this rise in visibility, specific studies about the metaphorical conceptualization of menopause are scarce. This paper attempts to fill this gap by analyzing the metaphors about menopause in the discourse of a collection of present-day perimenopausal, menopausal, and postmenopausal UK women.

3. CORPUS AND METHODOLOGY

This section describes the criteria for corpus selection, the protocol for metaphor identification, and the data annotation scheme. Albeit being qualitative in nature, the present study adopts a corpus-based approach with data stemming from actual communicative use. The sampling for analysis consists of 300 metaphorical expressions about menopausal experiences retrieved from a variety of sources. Compared to simple Google searches, the sources chosen for analysis were selected to ensure the diversity and representativity of the sample.

To guarantee the diversity of the corpus, sources include testimonials of women talking about their menopausal experience in different contexts, from private online clinics websites to non-profit online health charities, the media, academic archives, or associations of women activists:

1. menopause websites and online clinics aimed at commercializing a variety of advisory and medical services related to menopause:
   The Menopause Centre [www.mymenopausecentre.com]
   Health and Her [www.healthandher.com]
   Medical Prime [www.medicalprime.co.uk]
2. commercial companies:
   Boots-Menopause Stories [www.boots.com]
3. non-profit health charities aimed at educating and advising women and the general public about menopause and related issues (e.g. nutrition during menopause):
   The Menopause Charity [www.themenopausecharity.org]
   British Nutrition Foundation
   [https://www.nutrition.org.uk]
4. associations of women activists:
   Menopause Mandate [www.menopausemandate.com]
5. the media, including newspapers, magazines, and TV broadcasts offering testimonials of well-known public figures, as well as of non-public local women:
   The Guardian [www.theguardian.com]
   The Courier [www.thecourier.co.uk]
   The Daily Mail [www.dailymail.co.uk]
   BBC [https://www.bbc.com]
6. academic websites:
   The Silent Archive-University of Leicester-Spoken testimonies of menopause [https://le.ac.uk/emoha/themes/the-silent-archive]
   University of Leeds
   [https://ahc.leeds.ac.uk/]
   Emma’s menopause blog (University of Huddersfield)
   [https://www.hud.ac.uk/news/wellbeing-blogs/emmas-menopause-blog/]
   University of Warwick
   [https://warwick.ac.uk/services/socialinclusion/projects/groups/personalstories/#menopause]

To minimized potential biases in the selection of the examples and to maximize the representativity of the final corpus, I gathered the first metaphorical expressions from each of the websites, in order of appearance, until the number of required examples was obtained (50 examples per source type). Table 1 illustrates the distribution of the metaphorical expressions comprising the final corpus per source type.

Sources include testimonials from women talking about their diverse menopausal experiences with symptoms raging from mild to severe, thus further contributing to the variety and representativity of the final corpus of data.

The texts were carefully examined to identify metaphorical expressions that women used to describe their experiences with menopause. Since the automatic identification of metaphors is not yet possible, the retrieval of metaphorical expressions was carried out in accordance with the protocol outlined in the Metaphor Identification Procedure of the Vrije Universiteit-MIPVU (Steen et al., 2010: 769). This method includes several systematic steps for identifying metaphor-related utterances. As per the MIPVU procedure, the meanings of words in the selected expressions were cross-checked in a dictionary to determine if a more basic, concrete, human-related meaning could also fit the context of the utterance. If such a basic meaning could be identified for a word and if the contextual and basic meanings were distinct but related by some similarity (e.g., navigate and sail menopause), then the expression was marked as potentially involving a metaphor. This protocol has been adapted to the needs and characteristics of the present study as follows.

1. Identification of target domains. Since all testimonials have as their main goal to explain the menopausal experience of the speaker (i.e. its physical and emotional symptoms, social consequences, duration, etc.), it was hypothesized that the general target domain is the notion of menopause itself or of some of its symptoms. These different dimensions of the notion of menopause, as the target domains, are the recipients of the positive and negative inferences generated by the metaphors at work.
2. Identification of source domains. Once a specific dimension of the target domain has been identified in step 1, I proceeded to analyze the rest of the co-text in search of verbal elements conveying descriptive or evaluative information about it. Among them, those that comply with the requirements of the MIPVU procedure, as described above, were annotated as potential source domains.
3. Identification of conceptual mapping. In this step of the process, it was determined whether the mapping connected two independent concepts or whether it took place within one single domain. Only in the first case was the mapping considered an instance of metaphor. Additionally, the transition from linguistic to conceptual metaphor was based on careful consideration of the full co-text containing the linguistic examples. Thus, a linguistic metaphor was only coded as a potential conceptual metaphor if additional terms in the co-text or in other testimonials corroborated the choice of source domain. Additionally, previous studies on metaphors and existing classifications of conceptual metaphor repositories (i.e., the MetaNet Metaphor Wiki; Dodge et al. 2015; Grady’s (1997) classification of primary metaphors) were also consulted in the process of metaphor identification. Most disagreements were due to coding errors that were resolved through discussion.
4. Control of analysts’ bias. The coding process was performed by a linguistics graduate student, a cognitive linguistics doctoral student, and the author herself. The graduate student received specific instruction on conceptual metaphor and training on metaphor coding procedure. The doctoral student only required training in established criteria for metaphor coding. Only those examples that received full agreement were included in the final corpus of analysis.

The implementation of this protocol resulted in the identification of 300 metaphorical expressions which were then manually annotated to ease the qualitative analysis of the most relevant metaphors underlying the conceptualization of menopause. The annotation scheme comprised 7 categories: (1) source domain, (2) target domain (different dimensions of the concept of menopause), (3) co-text, (4) source type (online clinics, commercial companies, health charities, activists’ associations, media (newspapers and TV), and academic websites), (5) link to source, (6) discourse function (descriptive/evaluative), and (7) axiological value (positive/negative).

The annotation plan was designed to facilitate the subsequent qualitative analysis in relation to the diverse aspects of menopause (i.e., duration, physical symptoms and effects, social consequences, etc.) that are highlighted by the different metaphorical mappings, as well as to the discourse functions of the metaphors identified in the study, and their axiological values.

4. ANALYSIS: MENOPAUSE METAPHORS

As advanced in section 2, throughout the 20^th century and to our date the official discourse of menopause has fluctuated between the diametrically opposed positions represented by the biomedical and feminist communities. The former has highlighted those aspects of menopause that are relevant from a medical perspective, therefore adopting a metaphorical view of menopause as a health condition that needs to be treated. This discourse has been largely amplified by the pharmaceutical lobbies eager to find a market for their products (e.g., Hormone Replacement Treatments, vaginal gels and rings, etc.). At the other end of the spectrum, feminist groups have reacted to the medicalization of menopause by embracing several metaphors that focus on the positive effects of this phase of life and portrayed it as a liberation, a new beginning, or a sort of internal zest.

This section offers a qualitative analysis of the main four metaphors used by ordinary UK women in their conceptualization of menopause. As shall be explained in sections 4.1 to 4.4, they succeed in offering a rich characterization of this phase of life. The metaphors they use allow them to offer vivid descriptions of their feelings, as well as of the physical changes that they have undergone because of menopause, without limiting its characterization to either a negative health condition or a positive liberation force. Table 2 offers a summary of the metaphors found in the corpus and the number of occurrences for each of them:

As can be observed, there are four metaphors that stand up from the rest: menopause is a journey, menopause is a force, menopause is a struggle/fight, and the divided self metaphor. Unlike other more creative mappings (e.g. menopause is a game, menopause is a thief), these four metaphors are pervasive in the discourse of different women in our corpus, thus signaling their relevance in their conceptualization of menopause. Most testimonials make use of a combination of them, which seems only logical since each of them highlights different aspects of a multifaceted entity. Each of them is analyzed in the following sections in relation to their discourse functions (i.e. descriptive vs. evaluative) and their axiology (i.e. positive vs. negative).

4.1. Menopause is a journey

Journeys are a recursive source domain in many well-known conceptual metaphors involved in the conceptualization of notions that conform to the more abstract event-structure metaphor (e.g., life is a journey, love is a journey, etc., Lakoff, 1993). In a similar vein, in their testimonials, women often refer to their menopause as an unchosen, unexpected journey that often starts abruptly without prior notice. The journey metaphor is flexible enough to accommodate difference experiences of sudden, as well as smooth onsets of menopause:

1. My perimenopause journey began in my mid 40’s in 2010, although I didn’t realise that was what it was. [My Menopause Centre]
2. My journey began with a crash landing; I am discomfited to confess that at the age of 43, I had been diagnosed as perimenopausal. [The Menopause Charity]

Menopause is often depicted as a journey of self-discovery in which women embarked unprepared, thus alluding to the taboo nature of this process and the silence that has traditionally surrounded it:

3. Ultimately, this journey of self-discovery led to me asking for a divorce […] I quickly realised that I was travelling into menopause without a guide. […] Surely there should be a leaflet that says: ‘Welcome to the first destination on your menopause holiday! Here’s some information to help you – what to pack, what you need.’ [My Menopause Centre]

The source domain of journeys also provides conceptual fabric to understand that menopause is not a unique event, but that it consists of several distinct phases which are conceptualized as landmarks or destinations along the journey, the first one being the perimenopause (example 1), followed by menopause (examples 2, 3, 4, and 5), and post menopause (example 6):

4. When I talk about my ‘menopause holiday’, I’m describing my journey to many destinations along the way to menopause, with a lot of suitcases being packed and unpacked as I tried to decide what I needed to take with me. Now I can admit that, at first, I didn’t recognise any of these menopause destinations that I was fortunate enough to visit – and I know there are many more destinations to come. Alas, my HRT journey has ended abruptly while I undergo tests, but that’s another story. I still have many more destinations to visit on my menopause holiday, though my suitcases are now significantly better equipped. I wish I had known more when I first set off on my journey, but it isn’t too late – it never is. [The Menopause Charity]
5. ‘I’m partway into a journey I didn’t know I’d begun. It started around 2015, and happened so slowly it took me around a year to work out what was happening. [My Menopause Centre]
6. She sent me for blood tests and to my shock, the results showed I was way past menopause. [My Menopause Centre]

As in any journey, the traveler may be accompanied, and in the case of menopause there is the fixed company of hormonal changes which often take the steering wheel, hence making women lose control of their journey:

7. I know what it’s like to live with your hormones in the driving seat. [My Menopause Centre]

The journey metaphor can take different specific configurations. It can be a long road trip or a sea crossing, a short but intense roller-coaster ride, a brief walk through muddy waters, an open air travel or a dark one through a tunnel, a surface trip or one that goes deep into the ground. Each of these journey metaphors allows women to verbalize their diverse menopausal experiences. Thus, the highly volatile emotional changes brought about by menopause find a vivid source domain in the roller-coaster metaphor:

8. Personally, perimenopause has been an emotional rollercoaster. [British Nutrition Foundation]

The state of depression experienced by some women during their menopause is conceptualized as a downward trip into the depths. In these cases, the journey metaphor combines with the good is up/bad is down, and the container metaphors. Thus, menopause is conceptualized as a container which is the destination of a downward journey. Women reaching that destination are affected by its negative effects:

9. I would never have imagined, three years ago, in the depths of the menopause… [Medical Prime]

Road trip metaphors can also help women express some of the negative aspects of the menopause journey, with hormonal unbalances understood as bumps along the road:

10. There is still a long road ahead of me, but now I finally feel I have the right support in place for when I hit those hormonal bumps, which I inevitably I will. [The Menopause Charity]

The road trip metaphor often combines with the image of a tunnel which activates the correlation metaphor good is light/bad is darkness, thus highlighting the difficulties or rough patches of this journey:

11. I’m coming out of the other side of menopause.[My Menopause Centre]

In yet other testimonials these difficulties are alternatively conceptualized as a tiresome walk through watery terrains or as sailing through a rough sea:

12. Conversely at 47 I am wading through the perimenopause and my own confidence and certitudes can get railroaded by fears of anxiety or self doubt. [Health & Her]
13. I finally started HRT mid-2017, but it was not plain sailing. [The Menopause Charity
14. «navigating their own menopausal journeys.» [My Menopause Centre]

But not all trips are dark, rough, and bumpy. They can also be slow and pleasant, full of new landscapes and discoveries. Additionally, travelling is also culturally associated with a sense of liberation and a feeling of freedom. Therefore, this same source domain is useful in the conceptualization of menopause for those women whose experience of it is less traumatic or for those who choose to look on the bright side of this phase of their lives:

15. When I was younger, there was always a finish line, but now I’m at the stage where there isn’t – this is my life and if I don’t do my best to be strong and healthy and grateful for what I’ve got, then I’m missing something. Instead of tearing down the motorway, I’m going down all the little side roads enjoying the view. And that’s hugely liberating.» [My Menopause Centre]

In these cases, the tunnel metaphor holds a promising destination once one gets through to the other side:

16. […] and said that we could look forward to experiencing a ‘post-menopausal zest’ when we got through to the other side. I laughed when she said it and thought, that doesn’t seem very likely. But she was so right – now I’m there – insomnia gone, full of energy, no more night sweats, only very occasional flushes and a newfound confidence and stronger sense of self. I’m enjoying looking after myself during this stage of life. [The Guardian]

As shown in this section, the journey metaphor is useful in structuring women’s knowledge of the different phases they go through during menopause and their associated feelings. Thirty-seven out of one hundred and six (35%) of the instances of the menopause is a journey metaphor have a descriptive function that presents menopause as a process consisting in several stages (destinations) in a neutral fashion. The remaining sixty-nine examples of the menopause is a journey metaphor (65% of the total) have been found to be evaluative in nature. Although most of the latter (51 instances) offer a negative conceptualization of menopause as a long, bumpy road, such negative portrayal is also sometimes resisted by exploiting the metaphor in a more positive way (18 instances), and picturing some of the destinations of the journey as promising and desirable places (e.g., she feels now she has come through menopause, she has entered a new stage of 'freedom, self-knowledge, purpose and a life that’s no longer worrying about your fertility' [The Daily Mail]; Now I can admit that, at first, I didn’t recognize any of these menopause destinations that I was fortunate enough to visit [The Menopause Charity]). This metaphor, therefore, allows women to express both the negative, but also the positive aspects of the menopause journey.

4.2. Menopause is a force

The second most pervasive group of metaphors in our data involves the use of force schemata as source domains, as illustrated by the following testimonials:

17. It’s great that there’s so much more talk about menopause now. If I had known right from the start what was happening it wouldn’t have hit me so hard, and that’s why I’m sharing my story. [My Menopause Centre]
18. But then the menopause kicked in […] Then the deep menopausal symptoms hit and I thought I was going mad. [My Menopause Centre]
19. so instead of building up slowly through perimenopause, my symptoms had all crashed in on me at once. [My Menopause Centre]

In examples (17) and (18), menopause is depicted as an agent exerting a sort of violent force on the woman (i.e., hit me so hard, kicked in). In (19) the exertion of the force is presented as the result of an involuntary action, nonetheless, impacting the woman in a destructive way (i.e., crashed in on me). Other words that activate the force frame are those of «impact» and «stunned» in examples (20) and (21), respectively:

20. The menopause had an impact on me, it was incredibly physical. [U. of Leeds]
21. During a routine gynae exam, another doctor suggested it might be menopause. I was completely stunned. [My Menopause Centre]

In both cases the metaphorical expression of menopause is part of a pattern of conceptual interaction with metonymic mappings. In (20), the impact is the effect of the exertion of the force (cause). Similarly, in (21) the state described by the adjective stunned is the effect of the exertion of the force (cause).

These examples are linguistic realizations of the menopause is a force metaphor, which may be considered as a subcase of the well-attested metaphor causes are forces (Dodge et al. 2015). The multiple symptoms of menopause act as the causing agents that exert negative forces onto women. As argued in Johnson (1987: 42), these metaphors have an experiential basis.

The gestalt structure for force, which underlies the conceptualization of menopause in examples (17)-(21), involves several features such as its interactional nature, its directionality, a particular path of motion, the involvement of an agent (origin) and a patient (target), the existence of different degrees of power or intensity, etc. As examples (17)-(21) illustrate, menopause is conceptualized as a powerful agent that exerts its force on women (targets). Most testimonials depict this force as one of high intensity through a careful choice of verbs (i.e., impact, hit, kicked in, stun, or crash in); as well as by means of intensifying adverbs (so hard, incredibly, completely). Thus, menopause is a forceful agent that exerts its effects on different aspects of a woman’s life, including her emotions, mental stability, career, family relations, and sexual interactions, among others.

Johnson (1987: 45) distinguishes seven specific force schemata depending on the degree of intensity of the force and the existence of blockages to the exertion of the force (e.g., compulsion, blockage, counterforce, diversion, removal of restraint, enablement, attraction).

The metaphorical expressions found in the testimonials reflect several of these schemata. In some of them menopause is conceptualized as a compulsion schemata (i.e., as an irresistible force that comes from nowhere and is difficult to resist).

Figure 1. Compulsion Schema (Johnson, 1987)

Example (22) illustrates the compulsion schema, where menopause is an irresistible force that moves the woman out of her comfort zone:

22. I’d never found it easy to talk about sex, but this had forced me out of my comfort zone, to communicate about what felt good for me, what worked and what didn’t. And Andrew listened, responded. [My Menopause Centre]

In some cases, the force exerted on the target can be iterative, consisting in several blows, as in example (23):

23. This felt like one blow too many. I couldn’t stop thinking, why me? [My Menopause Centre]

Alternatively, menopause can also be metaphorically depicted as a destructive force that makes a woman’s life collapse:

24. When your whole life collapses, you can start to treat it like Jenga. I picked the bits of my personality I liked, and decided to keep those and then tried to pull out the unhealthier aspects – like being too hard on myself – and work on those. […] It took a while to rebuild my life. [My Menopause Centre]

Other expressions illustrate the diversion schema, where one of the force vectors is diverted as the result of the causal interaction with a more powerful opposed force.

Figure 2. Diversion Schema (Johnson, 1987)

Examples (25) and (26) illustrate the diversion schema at work in the menopause metaphors. In (25) the woman’s love for her job collides with the symptoms of menopause which leads her off her desired path into relinquishing a potential new position. In (26) again, menopause takes a woman off her chosen path, forcing her to stay at home instead of attending her professional duties.

25. In September, she will return to school as a part-time teacher, the symptoms of the menopause having forced her to step back from a role she loved. [The Guardian]
26. […] and often forced me to stay home. [The Guardian]

Interestingly enough, in some cases, the force schema is inverted, and women are the ones that are conceptualized as forces, while menopause functions as a restraining force preventing their normal movements and functions. This is the case in example (27) which exemplifies the menopause is a cage metaphor, where menopause is represented as a container (i.e., a cage) that limits women’s freedom of action.

27. I felt like a cage was constructing itself around me, putting up barriers to hinder me from functioning as before. [Health & Her]

In these cases, women’ feelings are also conceptualized as pressurized forces that need an outlet to avoid a metaphorical emotional burst:

28. Life is still full-on, and I still have menopause symptoms, but I have an outlet now. Some days I’ll come to practice all stressed and nervous, but I’ll grab my bass and just let it all out. [My Menopause Centre]

The metaphors in this group have an evaluative function. As shown in examples (17) to (28), most of them (65 instances, 80%) depict menopause under a negative light, but forces need not be axiologically negative. In fact, 20% of the testimonials metaphorically portray menopause in terms of a compulsion schema that leads to positive consequences for the woman’s life. See examples (29) and (30).

29. The changing hormones that gave me the oomph to start to question what was going on, and to start to put myself first. [My Menopause Centre]
30. It forced me to start looking after myself after years of only looking after everyone else. [Health & Her]

This positive rendering of the menopause is a force metaphor is at the basis of other equally positive views of menopause that have also emerged in the testimonials under scrutiny. Among these resistance metaphors, there are some instances that present menopause as a liberating force (see example 31) that frees women from their reproductive role in society.

31. It’s time to talk about the menopause… and freedom at last. The menopause comes,» says Kristin Scott Thomas’s character in Fleabag, «and it is the most wonderful fucking thing in the world.» «You’re free, no longer a slave, no longer a machine with parts. You’re just a person.» [The Guardian]

Example 32 also highlights this liberating effect of menopause by means of a metonymic mapping where «middle finger» stands for a non-conformist person, which then maps metaphorically onto the target domain of menopause. Both examples elaborate on the idea that menopausal experiences are forces that push women towards non-conformism and liberation from social impositions (i.e., motherhood, caring, beauty slavery, and eternal youth mandates, among others):

32. I also educated myself about the hormonal changes I was going through. I learnt that as oestrogen declines, we have less of a tendency to want to nurture any offspring (which is one of oestrogen’s many roles!), plus we have a relative rise in testosterone, meaning we are more inclined to look after number one. In my work as a fitness trainer, I’d done some official learning around the menopause, and the trainer on the course called it ‘the middle finger years’, which really resonated with me! [My Menopause Centre]

4.3. The divided Self Metaphor

menopause is a journey and menopause is a force metaphors offer women a means to reflect and talk about the various phases and effects of menopause on their physical, emotional, social, and professional life. In addition, the divided person metaphor, which recurrently emerges in the examined testimonials, equips them with the essential conceptual framework to comprehend the nature and scope of its effects. It also aids in articulating their self-perceptions during this phase of life.

Lakoff's (1996) theory on the conceptual structure of the self establishes a system of conventional conceptual metaphors that seem to underlie our understanding of what a human being is. In this framework, a person is conceptualized as a composite entity comprised of a subject and a self, embodying what Lakoff refers to as the divided person metaphor. The subject represents the locus of reason, consciousness, and subjective experiences, whereas the self encompasses other aspects, including one's physical body, emotions, present and past social face, among others. Typically, the subject maintains control over the self, particularly when it resides in its expected position within or above the self. However, there are instances when the subject loses control over the self, resulting in a scenario where the latter lacks guidance (lost self metaphor). When incompatible aspects or interests within an individual come into conflict, they are metaphorically conceptualized as distinct individuals engaged in discord (termed "different selves") or as individuals occupying different locations (referred to as the split and scattered self metaphor). Many of the testimonials under scrutiny include metaphorical expressions that capture a disconnection between subject and self. In examples (33) to (35) women manifest this dissociation by expressing their incapacity to recognize their old selves.

33. Chris would always tell me I looked lovely, but my changing body was an unavoidable reminder that I didn’t feel like myself anymore. [My Menopause Centre]
34. I almost didn’t know myself anymore. [My Menopause Centre]
35. That wasn’t me at all. [My Menopause Centre]

In (36), a woman elaborates the metaphor further to express that the subject has left the self and is now outside of it.

36. I stopped feeling like ‘myself’. I couldn’t pin it down or put it into words, just a feeling that I was outside of myself or just not in touch with my old self. I really disliked my new self. Grumpy, short-tempered, anxious. [The Guardian

Example (37) conveys the same feeling of detachment by pointing to an absent subject which has been replaced by an alien, who is now in control of her body (self), and example (38) makes manifest that the subject does not like her new self which is represented by a changing body and new emotions, usually including a considerable amount of rage and emotional instability.

37. She asked if it felt like an alien had taken over my body. And that’s exactly what it was like. [My Menopause Centre]
38. I hated the person I saw staring back at me in the mirror. [The Menopause Charity]

The absence of a subject or the feeling of disconnection with it leaves the self without guidance, a lost self, as in example (39):

39. I felt very different, as though I’d lost myself somewhere. I was feeling really hideous and not like myself. [The Menopause Charity]

In addition, a split self is not functional. Since subject and self are disconnected the human being cannot function properly. For this reason, most women openly manifest their desire to recover their old selves, and their happiness when this occurs, as illustrated in examples (40) to (42):

40. I want to get through this. I want to be me again. [The Menopause Centre]
41. Hormonal Replacement Treatment […] it’s helped me feel like myself again.
    [The Menopause Centre]
42. But more importantly, I feel like Vicky again. [The Menopause Centre]

The divided self metaphor is mainly used with an evaluative function (96% of the instances). As was the case with the conceptualizations of menopause as a journey or a force, the divided self metaphor is flexible enough to accommodate both the negative aspects of menopause (conceptualized as the loss of own’s self, 56% of the examples) and a positive representation of menopause (40% of the examples) as a process with a happy ending in which either the old self is rescued (examples 41 and 42) or alternatively, women come to terms and realize the advantages of their new selves (example 43):

43. It’s a new you, and that’s wonderful. [Health & Her]

4.4. menopause is a struggle/fight

Given its conceptualization as a compulsion force that impacts women’s lives to the point of detaching them from their own selves, it is no surprise that the fourth most common metaphor at work in the testimonials under consideration is one that projects the source domain of war over the target domain of menopause. These examples are expressions of the more general disease treatment is a war metaphor (Dodge et al. 2015). Menopause is thus metaphorically portrayed as a fight against many diverse adversaries, such as one’s new self and the new body and negative feelings that come along with it, as illustrated in examples (44) and (45).

44. ‘I’m nearly 40, I’m done for, doesn’t matter what I wear, I just always feel awful’. Then at some point I decided I’m going to fight against that feeling. [Health & Her]
45. I’m also more able to cope with stuff, definitely a bit wiser, less likely to topple at the first hurdle. I still want to live and love and have fun. I’m just having to fight a bit harder to get there. [The Guardian]

Interestingly enough, women also use the war metaphor to express their feelings against the social pressure to medicalize the process of menopause (see example 46).

46. My five-year struggle to avoid anti-depressants and get the right HRT. [The Menopause Charity]

In this metaphorical fight, women perceive themselves as the sufferers or victims:

47. Louise said: «I suffered from night sweats, sometimes two to three times a night, and often five days a week. [U. of Leeds]

In turn, menopause is seen as the adversary who can take many different forms. In examples (48) and (49) it is alternatively personified as a silent assailant that appears without prior notice in her life or as a thief who steals relevant physical, emotional, and personal features of a woman, thus being responsible to a certain extent of the disconnection between subject and self, as shown in relation to the divided person metaphor.

48. Menopause crept up on me with a variety of different symptoms that appeared out of nowhere. [The Menopause Charity]
49. My friend jokes that she's been the victim of 'The Menopause Thief': he's taken her figure, quite a bit of her hair, her sex drive, and what she describes as 'my sense of myself as a woman'. I know what she means. He's taken quite a few bits of me, too. [The Daily Mail]

In those cases in which menopausal symptoms are mild, the fight is conceptualized as a game, in which women even have allies (e.g., hormonal replacement treatment), as in (50):

50. HRT can be a total game-changer, so make sure you understand the benefits of it before you dismiss it like I had. [My Menopause Centre]

In other cases, especially those in which women have to face the worst menopausal symptoms (e.g., hot flushes, mental fog, rage fits, depression, etc.), the fight intensifies and is conceptualized as a full war:

51. I tried to battle on but the hot flushes crept up over a year. [My Menopause Centre]
52. When she was battling a host of other worsening menopausal symptoms. [The Menopause Charity]

The Menopause is a struggle/fight metaphor is eminently evaluative. All instances of this metaphor found in our data provide a negative portrayal of the menopause and of its various stages and effects.

As shown in this section, the analysis of the corpus data yields four main metaphorical mappings at work in UK women’s discourse about menopause (i.e., menopause is a journey, menopause is a force, the divided self metaphor, and menopause is a struggle/battle). As has been made manifest, most of the instances of these metaphors in our corpus describe the effects of menopause and evaluate them negatively. However, except for the menopause is a struggle/battle metaphor, the other three metaphorical renderings of menopause have also been shown to be flexible enough to accommodate both negative and positive portrayals of this stage of life. The divided self metaphor, in particular, yields a similar number of axiologically positive and negative instances. While those metaphors found in the biomedical literature focus exclusively on the negative aspects of menopause (Deutsch, 1945; Martin, 1987; Niland, 2010), and those found in feminist contexts tend to highlight what is positive about this process (Zeserson, 2001; Quental et al. 2023), three of the metaphors used by UK women identified in our corpus offer a richer view of this stage of their lives by depicting its hardships as well as its advantages.

5. CONCLUSIONS

UK women’s conceptualization of menopause involves mainly four conceptual metaphors: Menopause is a journey, Menopause is a force, The divided person metaphor, and Menopause is a struggle/fight. These conceptual mappings allow them to draw a faithful portrait of this phase of their lives, including its development, its different stages, and its negative and positive aspects.

Unlike biomedical discourse, ordinary women’s metaphorical talk about menopause does not make an extensive use of the Menopause is a health condition metaphor (Niland, 2010) or other conceptual mappings that involve its medicalization (i.e., Breakdown system and broken factory metaphors; Deutsch, 1945; Martin, 1987). The metaphorical conceptualization of menopause by ordinary UK women does not reflect an understanding of menopause in terms of an illness or health condition. Neither do they focus exclusively on a positive re-framing of menopause, as is the case with those metaphors stemming from sociological (feminist) perspectives (Menopause is a liberation/zest).

Our data shows that UK women resist those biased metaphors stemming from the biomedical and the feminist realms, and promote, through their use, alternative metaphorical conceptualizations of menopause which suit better its ambiguous nature and its varied effects on women. All metaphors at work in the testimonials under scrutiny reflect the relevance of this period of any woman’s life. Three of them (Menopause is a journey, Menopause is a force, The divided person metaphor) cover all aspects of the impact of menopause, both positive (liberating force), and negative (physical, emotional, social impact), in their lives. One of the positive effects of menopause is its capacity to push women towards non-conformism and liberation from social impositions (i.e., the motherhood, caring, beauty and eternal youth mandates). Further research should compare the metaphors arising in the language of UK women with those underlying the conceptualization of menopause by women belonging to other cultures in which some of those social mandates do not end with menopause (e.g., Mediterranean cultures in which women are expected to care for their relatives, including their elder, and also their grandchildren, long after they have entered their menopausal age).

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Notes

¹ This publication is part of the R&D&i project PID2020-118349GB-I00 funded by MICIU/AEI/10.13039/501100011033 (Spain). [Volver]

1. INTRODUCTION

The historical treatment of women’s health phenomena has, regrettably, been marred by collective norms that often render natural processes as illnesses or stigmatising syndromes to be hidden from the public eye (Barona, 2023; Wood, 2020; Ussher and Perz, 2014). This overarching tendency is especially evident in the discourse surrounding menstruation, a fundamental aspect of women’s lives. Instead of embracing menstruation as a natural and positive occurrence, it has traditionally been relegated to the shadows, obscured by cultural taboos, and darkened with an inclination to view it through a lens of fault or handicap (Blázquez Rodríguez, 2023; Gottlieb, 2020; Jackson and Falmagne, 2013; Luke, 1997; Idoiaga-Mondragon and Belasko-Txertudi, 2019).

The narrative surrounding menstruation, kept by centuries of cultural influence, extends beyond mere perceptions and has penetrated the medical discourse as well (Blázquez Rodríguez, 2023; Jeoung, 2020). In fact, the language used to describe menstruation both in scientific and general discourse has contributed significantly to the perpetuation of negative stereotypes, portraying this natural process as undesirable and in need of concealment rather than acceptance (Bonilla Campos, 2023; Burrows and Johnson, 2005; Johnston-Robledo and Chrisler, 2020; Newton, 2016; Wood, 2020).

Our specific focus is to unravel the metaphorical language encapsulating menstruation. By employing a corpus-based methodology, we aim to shed light on prevalent figurative expressions and their social implications, transcending the boundaries of negative biases that have clouded the discourse on women’s health.

As we navigate the linguistic landscape surrounding menstruation, our mission extends beyond analysis to action. We strive to challenge the historical discourse that has obscured the natural and positive essence of menstruation. This exploration is not merely an academic endeavour but a call to transform the prevailing narrative, fostering inclusive and empathetic discourse that recognises menstruation as an inherent and fundamental aspect of women’s lives.

In summary, our overarching goal is to exhibit how figurative language contributes to the consolidation of stereotypes and taboo-centred attitudes involving concealment and silence, which were perpetuated within the discourse surrounding menstruation all over history and somewhat validated with scientific and medical discourse seconding them. After a meticulous observation of the corpus, we aim to bring to light ingrained assumptions and biases on menstruation references. With this knowledge, our ultimate purpose is to propose inclusive and gender-sensitive alternatives in the future. Through this multifaceted analysis, we aspire to contribute meaningfully to the ongoing transformation of the narrative, fostering a language that embraces the natural and positive essence of menstruation within the broader female experience.

1.1. Menstruation through the ages. biases in medical discourse

From a scientific perspective, it may be assumed that medical discourse is devoid of stereotypes and biased assumptions (Blázquez Rodríguez, 2023: 133). This belief is particularly rooted in the expectation that specialised language in the medical field is objective, accurate, and respectful, given its significant impact on society and its role in disseminating fair practices (Bobel, 2010; Foucault, 1973; Hyland, 2010; McHugh, 2020; Pao, 2023). Consequently, the recurring metaphors on menstruation in medical language may be initially expected as distant from stereotyped images or stigma, considering the professional overtone attributed to the prototypical discourse of medicine (Bonilla Campos, 2023; Northup, 2020; Pao, 2023; Wilce, 2009; Zeidler, 2013). However, numerous samples of medical and health discourse on menstruation through the ages demonstrate that figurative language referring to this natural process is mainly negative, undesirable, and therefore likely to be camouflaged (Blázquez Rodríguez, 2023; Gottlieb, 2020; Jeoung, 2023; Wood, 2020; Paterson, 2014).

Historically, the perception of menstruation by different doctors and within the medical field has evolved significantly (Barona, 2023: 48). Early medical perspectives often framed menstruation within a context of pathology or imbalance, viewing it as a discharge of toxins or impurities (Gottlieb, 2020; Jackson and Falmagne, 2013; Ussher and Perz, 2014). Ancient Greek and Roman physicians, such as Hippocrates, attributed menstrual symptoms to a supposed excess of "female humours" that needed to be purged from the body (Gómez Sánchez et al., 2012: 375).

During the Middle Ages, menstruation continued to be associated with notions of imbalance and impurity. Some medical practitioners, influenced by prevailing religious and cultural beliefs, regarded menstruation as a consequence of women’s inherent inferiority or as a form of punishment for Eve’s biblical transgressions (Barona, 2023; Gómez Sánchez et al., 2012).

In the 19th century, as medical understanding advanced, there was a gradual shift toward more scientific interpretations. However, many doctors still viewed menstruation through the optics of pathology. Menstrual disorders were often pathologized, and prevailing cultural norms influenced the medical discourse, reinforcing negative perceptions (Gómez Sánchez et al., 2012; Jeoung, 2023; Ussher and Perz, 2014).

The early to mid-20th century witnessed increased medicalisation of menstruation. (Ussher and Perz, 2014). Menstrual hygiene products were developed, and medical professionals contributed to the understanding of menstrual cycles (Donat Colomer, 2023; Margaix Fontestad, 2023). Nevertheless, societal taboos persisted, influencing medical discourse and the perception of menstruation as a topic not to be openly discussed (Bobel, 2010; McHugh, 2020; Newton, 2016; Wood, 2020).

In recent decades, there has been a growing acknowledgement within the medical community of the normalcy and importance of menstruation (Blázquez Rodríguez, 2023; Botello Hermosa y Casado Mejía, 2017). Efforts to destigmatise menstrual health (Blázquez Rodríguez, 2023; Hennegan et al., 2021), coupled with advancements in women’s health research, have contributed to a more nuanced understanding of menstruation as a natural and essential aspect of reproductive health (Espejo Martínez et al, 2019). Nevertheless, despite contemporary advancements in medical publications, a considerable portion of images and analogies employed today in reputed medical publications echoes the figurative language and stereotypes that have traditionally enshrouded the discourse on menstruation (Cimino et al, 1994; Jeoung, 2023; Patterson, 2014; Semino, 2011). This perpetuation of age-old linguistic constructs contributes to the endurance of negative connotations and a persistent inclination towards the concealment of menstruation references (Jeoung, 2023; Newton, 2016; Weedon, 1987; Wood, 2020). The traces of these linguistic patterns extend beyond menstruation to encompass the broader spectrum of language concerning women’s health phenomena (Espejo Martínez et al, 2019)

Throughout history, diverse cultural, religious, and social influences have shaped medical perspectives on menstruation, reflecting broader attitudes. The evolution of these perspectives highlights the intersectionality of medical discourse, gender norms, and cultural beliefs surrounding this natural bodily process, which contributes to the persistence of biases, stereotypes, and assumptions in the present discourse (Johnston-Robledo and Chrisler, 2020; McHugh, 2020; Patterson, 2014)

2. HEALTH AND GENDER-SENSITIVE PERSPECTIVES

2.1. DIGITENDER: A research project as a framework

The significance of addressing women’s health issues through a gender-sensitive view has become increasingly prominent in recent years (Espejo-Martínez et al, 2019; Idoiaga-Mondragon and Belasko-Txertudi, 2019; Luke, 1997; WHO, 2022). Responding to this imperative, our project emerged in pursuit of a more equitable society that values gender diversity.

This work is integrated into DIGITENDER, a gender terminology research project (DIGITENDER, TED2021-130040B-C21) that undertakes a comprehensive examination of language within women’s health discourse. This project is dedicated to digitising, processing, and digitally publishing open, multilingual terminology resources, with a specific emphasis on gender perspectives in the digital realm. The integrative objective is to generate an extensive and accessible resource set capable of mitigating gender bias in language usage across diverse digital platforms.

At the heart of the research project is the development of a centralised repository containing gender-sensitive terminology. This repository is envisioned as a practical tool for individuals and organisations committed to fostering inclusive and equitable language practices. Our study involves an in-depth analysis of existing terminology resources, the establishment of a digital infrastructure for data storage and dissemination, and the implementation of a community-driven approach to ensure continuous evolution and enhancement of the resources.

In essence, our project aspires to make meaningful contributions toward fostering a more inclusive and gender-sensitive digital society.

DIGITENDER is also related to the creation of WHealth, an extensive open-access repository of terms, which serves as a fundamental aspect of the above-described initiative. WHealth aims to bring visibility to health problems and issues impacting women, addressing topics such as menstruation, infertility, menopause, and eating disorders. Through this comprehensive resource, the project seeks to empower the public with relevant information, challenging taboos and stereotypes that can contribute to health problems and their assumption as biased or limiting processes.

2.2. Menstruation and gender considerations

The definition given by Oxford Dictionary for menstruation is:

It is worth observing that this definition does not contain any references indicating that menstruation is an illness, a pathology, or a disease, but it alludes to a stage in a cycle when fecundation has not taken place. Therefore, it is assumed that additional constructs may have been culturally disseminated but not lexically supported or preliminarily prejudiced.

In terms of global health, a statement on menstrual health and rights was included in the 50^th session of the Human Rights Council Panel discussion on menstrual hygiene management, human rights, and gender equality (2022). This initiative was relevant in the sense that previous global conferences and events did not consider this step significant, as mentioned on the World Health Organisation website:

Additionally, some specific actions are also expressly mentioned in this representative organisation’s publications for a positive approach to be attributed to menstruation:

Given the aforesaid reflections, it is manifested that WHO’s directives align closely with the goals of our research project in promoting gender sensitivity. This organisation emphasises the need to destigmatise menstruation and eliminate negative assumptions. Notably, WHO advocates for comprehensive menstrual health, encompassing access to information, education, menstrual products, water, sanitation, and disposal facilities, as well as empathic care. Importantly, it calls for an environment where menstruation is viewed positively, devoid of shame, enabling individuals to fully participate in various aspects of life. It is conceived, therefore, that language is to be integrated into the positive atmosphere promoted and appealed to by this representative body.

The WHO statement serves as a powerful validation of our project’s objectives, signalling the global recognition of menstruation as a gendered subject that requires dedicated attention. The acknowledgement of menstrual health as a priority by a global institution in 2022 underscores the overdue need for such initiatives and challenges to transform existing societies.

Furthermore, the identification of menstruation as a gender issue (Song et al., 2016: 185) discloses the evident disparity in the cultural and linguistic treatment of non-female reproductive or hormonal processes in terms of neutrality, which entails a stark contrast with the embarrassment, stigma or pathology-based attitudes exhibited toward individuals menstruating. (Espejo Martínez et al., 2019: 206). Hence the need for a gender-sensitive approach and the core of this research work.

By fostering inclusive, respectful, and equitable language after showing linguistic evidence of unfair and impartial conceptions, our project aims to contribute to breaking the silence and destigmatising menstruation, ultimately enhancing equality among individuals preliminarily prejudiced.

2.3. Metaphors and gendered women’s health discourse

The utilisation of metaphors in medical discourse is linguistically substantiated, as referenced in a prior work by Navarro-i-Ferrando (2017). This assertion is grounded in the recognition that metaphors serve a fundamental role in bridging our comprehension of the world with the language employed in scientific contexts (Brown, 2003; Navarro-i-Ferrando, 2017). In our work, the intricate interplay between metaphorical language and medical discourse becomes evident as well, with an essential contribution to shaping our understanding of complex concepts within the realm of women’s health.

The integral role of metaphors in scientific language, particularly in conceptualisation and theory representation, has been underlined by scholars for decades, and more recently by Navarro-i-Ferrando in his article (2017: 164), where he expressly alludes to several authors and experts who agree on the relevance of metaphors in science and medicine (Black, 1962; Gentner and Gentner, 1983; Kuhn, 1993). As referenced by Navarro-i-Ferrando (ibid.) recent in-depth analyses by Brown (2003: 11) and Zeidler (2013: 101) further illuminate the significance of metaphors in scientific discourse. In the field of Medicine, researchers have approached discourse through genre analysis, as stated by Navarro-i-Ferrando (Yanoff, 1988; Salager-Meyer, 1994; Gotti and Salager-Meyer, 2006; Navarro-i-Ferrando, 2017; Wilce, 2009) and terminology studies (Dirckx, 1983; Cimino et al., 1994).

A noteworthy contribution involves the qualitative analysis of specific metaphors within medical discourse (Navarro-i-Ferrando, 2016, 2017; Semino et al., 2004; Semino, 2008, 2011). According to Semino (2011: 130), metaphors exhibit distinct adaptations across genres with varying social scopes, particularly in terms of communicative and conceptual functions. Research in healthcare and illness, influenced by Sontag’s seminal work Illness as Metaphor (1978: 18), often adopts a sociological perspective, exploring metaphor usage in therapy, doctor-patient communication, and healing processes (Demjén and Semino, 2016).

In this case, our corpus study has also contributed significantly by revealing the pervasive nature of metaphors in technical medical texts (Mungra, 2007; Navarro-i-Ferrando, 2017), although not exactly to improve communicative interaction or healing attitudes, but to extend, and somewhat endorse, traditional beliefs and conventions on embarrassment and impurity in menstruation.

3. METHODOLOGY

3.1. Metaphors, gender, and corpus analysis

The corpus analysis serves as both the methodological approach and the analytical tool for identifying prominent figurative patterns and examining their contextual usage, including gendered nuances and recurrent themes (Timofeeva and Vargas-Sierra, 2015). Specialized software, particularly Sketch Engine (2023), facilitated the compilation, location, and contextual analysis of recurring metaphors. This software enabled not only the quantification and identification of key terms and related metaphors but also the automation of processes preceding the qualitative study of gendered conceptions and usual connotations. Particularly noteworthy functions included the ’Wordlist’ feature for identifying frequent items according to predefined categories and the ’Concordance’ function for displaying frequent keywords in context, facilitating a more nuanced interpretation and evaluation of connotations.

The selection of the corpus source was deliberate and meticulous, taking into account factors such as the recent publication of the monograph that inspired the study, the inclusion of a historical review on menstruation, the predominantly biomedical and scientific discourse, and the expertise of the contributing authors (Leech, 2007). The corpus, compiled via Sketch Engine, is derived from a reputable treatise on menstruation titled «La menstruación: de la ideología al símbolo» (Donat Colomer, 2023), authored by esteemed experts, men and women. It represents an innovative and comprehensive resource for Spanish discourse on menstruation, integrating current knowledge, frequent terminology, new perspectives on biomedical discourse, and authentic scientific language in women’s health.

While biased metaphors and stereotyped images may initially appear concentrated in chapters discussing the historical evolution of menstruation discourse, the qualitative analysis revealed their pervasive presence throughout the corpus. Although adverse and stigmatised patterns are more prevalent in historical references, recurring figurative elements across chapters disclose the persistence of negative associations. The corpus-based study provides statistical confirmation of the gendered analogies and stigmatisation within menstruation discourse, offering a comprehensive and representative sample for analysis (Berber Sardinha, 2002; Bowker and Pearson, 2002; Leech, 2007; Vargas-Sierra, 2012).

The representativeness and value of the corpus stem from its association with a reputable publication, its recent release, its acceptance within the expert community, and the support provided by Sketch Engine. This software enables the identification and display of total frequencies, occurrences, collocates, and contexts based on predefined criteria and categories, facilitating rigorous analysis and interpretation (Baker, 2003; Bowker and Pearson, 2002; Croft, 1991). Following this initial observation, qualitative exploration serves as the next logical step to enhance data interpretation, particularly concerning gendered concepts.

3.2. Figurativeness in the corpus

Our research methodology has been delineated aiming to assess the prevalence of figurative patterns associated with gendered concepts (Fernández Díaz, 2013: 50), which act as influencers of social perceptions within menstruation discourse. We posit that these linguistic elements play a crucial role in shaping cultural stereotypes and biases related to women’s health, portraying menstruation as a pathology, an unhygienic concern, or a concealed process evoking shame (Jeoung, 2023; Newton, 2016; Wood, 2020).

Our investigation initiates with the creation of a specialised ad-hoc corpus (Bowker and Pearson, 2002) in Spanish, consisting of approximately 90,000 words. Despite its modest size and consideration as small (Berber Sardinha, 2002; Vargas-Sierra, 2012), the corpus is strategically tailored to the specialised focus of our research (Leech et al., 1994). As advanced in the section above, text samples are sourced from a credible publication on women’s health, authored by medical professionals and experts (Donat Colomer, 2023), ensuring representativeness according to our study’s objectives (Leech et al., 1994).

The compilation process involved the inclusion of the whole book as a scholarly compendium notable for its up-to-the-minute and extensive coverage of menstruation. This book includes a comprehensive tour, incorporating anthropological, historical, psychological, and biological perspectives along with recommendations on women’s care and details on menstrual alterations, providing a thorough review of its significance both historically and in contemporary contexts. (This compilation was facilitated through the automation capabilities of the Sketch Engine software (2023), optimising data quantification and enhancing research efficiency.

In the initial phase of the corpus analysis, we adopt a quantitative approach, focusing on keywords and expressions, particularly perception nouns and adjectives, given their presence in triggering metaphorical senses (Baker, 2003; Cifuentes Honrubia, 1994; Croft, 1991; Gordon and Lakoff, 1971; Halliday, 1978, 1994; Langacker, 2008). This quantitative assessment provides an empirical measure of the significance and prominence of these elements in the discourse.

Furthermore, to comprehensively understand the conceptual landscape of women’s health discourse on menstruation, we identify and quantify three mental conceptions arising from the quantitative stage: menstruation is a pathology, menstruation is against hygiene, and menstruation is to be camouflaged. Employing these keywords and their synonymous as search prompts, as well as observing the segments surrounding them, we determine the prevalence of metaphorical sequences, exploring not only their frequency but also their emotional transcendence.

This single-minded approach extends our research scope, offering insights into the connotational nuances of recurrent metaphorical sequences within the discourse. It unveils not only the analogies present, but also their positive or negative implications, contributing to a more refined understanding of how metaphors are intertwined with menstruation discourse shaping cultural narratives on women’s health.

Following the quantitative analysis, we progress to qualitative scrutiny, exploring contextual overtones of frequent linguistic patterns. Our objective is to identify specific metaphors and connotations related to menstruation (Timofeeva and Vargas-Sierra, 2015). This qualitative analysis provides insights into the figurative dimensions present in the language related to menstruation across historical periods.

In summary, our corpus analysis methodology leverages the automation capabilities of Sketch Engine to compile and search a specialised corpus. This approach allows us to investigate the frequency, figurativeness, and biased content of language related to menstruation. We assert that frequency indicates linguistic relevance and authenticity, while metaphorical and connotational dimensions reveal the extent of embedded stereotypes and biases.

By employing this methodology, we aim to offer a comprehensive understanding of the metaphorical components within women’s health discourse, shedding light on their societal impact.

4. RESULTS AND DISCUSSION

The results gleaned from our corpus analysis manifest the dominant metaphorical patterns embedded in women’s health discourse, particularly within the realm of menstruation. Our investigation unveils the sociocultural lenses that have influenced the language employed to articulate menstruation women’s experiences across different periods and cultures.

4.1. Metaphorical narratives as sociocultural constructs

Examining the data obtained through Sketch Engine search queries, the frequent use of revealing perception nouns such as pain, change, discomfort, unease, inconvenience, silence, irritability, odour, impurity, dirt, disgust, invisibility, upset, or burning pain contributes to a noticeably biased portrayal of menstruation as an unpleasant process, rather than a natural one. Specifically, out of a total frequency of 1,418 occurrences, these nouns constitute 438 (30.9%). Moreover, the contexts surrounding many other nouns, most of them sense-related references, including vision, quantity, intensity, heat, sensation, image, contact (especially blood contact), dryness, size, colour, perception, texture, and volume, also incorporate predominantly negative notions, resulting in an additional 301 occurrences with disagreeable connotations (see Figure 1).

The analysis of our corpus reveals a significant tapestry of metaphors and fundamental analogies intricately interlaced into the discourse on women’s health. These linguistic constructions vividly portray conventional sociocultural perspectives on menstruation and how women face them, as emphasised by Northrup (2020). The significance of this revelation lies in recognising language as a medium that conveys deeply rooted beliefs.

To exemplify the correspondences related to the fundamental constructs in focus, some of the search findings are exhibited below in Table 2. In this context, the presented capture in Figure 1 depicts a search query for pathology- or illness-centred key nouns, displaying a primary mental conception defining the corpus. The substantial total frequency of these terms related to illness is notable, amounting to 119 occurrences (exclusively as nouns; key adjectives are additional). A sample of accompanying contextual segments is also provided to offer further insights into metaphorical assumptions and their lexical impact. It is worth noting that considering menstruation a pathology or insisting on its symptomatology conveys a figurative interpretation given the scientific evidence and the official recommendations for this cyclic phenomenon to be conceived as a natural process rather than as a disease. Continuous references to menstruation effects, signs, symptoms, pains, and incapacities may be cognitively identified by women as a confirmation that they are ill while menstruating, which is neither exact nor technically true.

Figure 1. Sample of contexts for ’patología’. Source: Sketch Engine

The sample below corresponds to a short collection of recurring nouns with meanings close to the concept of hygiene, dirt, impurity, and their frame semantic field. The contextual examples exposed contain hygiene-based key adjectives, but the content they refer to is determining to understand a wide range of figurative patterns concerning menstruation which are frequently remarked on all over the ages, persisting to the present.

It is interesting to refine that the contextual display of these key adjectives encompasses not only their literal meaning but also a figurative sense, which is visibly influenced by cultural, religious, or mythological factors among others. What we can find frequently expressed in the corpus is not only a set of allusions to dirt or unhygienic circumstances but also some references to spiritual impurity or contamination. This final inference is very revealing to understand the extent to which menstruation may have been prejudiced and gendered, which is likely to have affected and probably still affects women’s cognitive interpretation of their condition when menstruating.

Figure 2. Sample of contexts for ’impuro’ and ’sucio’ as adjectives. Source: Sketch Engine

In the following figure, the affluence of key nouns related to shame, embarrassment, and taboo is evident, providing a direct explanation for the presence of terms related to concealment, silence, distance, and references to limitation or handicaps, among other similar notions. The contextual selection, with ’embarrassment’ as a core term, contains a substantial visual representation of prevalent metaphors resulting in stereotypes on menstruation, which may have prompted women to camouflage their condition on numerous occasions.

It is convenient to bear in mind that the frequency of these perception keywords is relevant in the corpus not only due to the number of occurrences but also given the scientific character of the publication which originated the compilation (Colomer Ed., 2023). In fact, it could be verified in our analysis that the abundance of some perception nouns and adjectives is evident, despite the preliminary assumption of objectivity we may associate with science and medicine (Hyland, 2010). Additionally, the biased sense of such key terms and the contexts they are integrated into also unveils evidence of gendered discourse.

Figure 3. Sample of contexts for ’vergüenza’. Source: Sketch Engine

4.2. Stereotyped beliefs and gendered attitudes

The most prevalent metaphorical patterns related to menstruation are presented in the following table, offering an overview of the most common ones to provide a comprehensive understanding of the cognitive constructs that may influence women and their health. Notably, health and hygiene are frequently referenced, often intertwined with taboos or shame, as well as terms associated with silence or concealment. The recurring notion of limitation is also substantial, reflecting the impact of the unfavourable atmosphere created by these metaphorical representations.

Table 5 discloses a general overview of the main metaphorical segments and their basic interpretation in the corpus. Interestingly, only one of the conceptions shows menstruation as a positive condition – that is when it refers to the origin of fecundation as the origin of a new life. The rest of the constructs are negative, adverse and in many cases visibly prejudiced.

A more in-depth contextual analysis uncovers a troubling reality conveyed by the discourse – the persistence of gender stereotypes and normalised imagery. Metaphors and emotionally charged language portray menstruation as a period associated with notions of illness, pain, apathy, dirt, impurity, repugnance, disgust, and the necessity for seclusion, concealment (Figure 4 below), or isolation in women, among other concepts. These exclusive associations, defining and impacting only women, have been scientifically normalised (Espejo-Martínez et al., 2019; Fernández Díaz, 2013), extensively propagated, and socially embraced for centuries, as evident in the observed contextual samples from the corpus (Table 5).

Figure 4. Example of recurring contexts with ’ocultamiento’ as a key noun. Source: Sketch Engine

In terms of occurrences, most metaphorical associations are related to health, since menstruation is directly related to this women’s dimension. For example, the frequency of pathology-based perception terms is 119, whereas 37 occurrences in total correspond to key hygiene words (not all, but the basic ones) and 83 are references to taboos, embarrassment, concealment, or limitations arising from social rejection.

The following graph (Figure 5) shows the exact percentages of key nouns for each cognitive conception, which is of visual help to understand the effect of each one.

Figure 5. Occurrence of key nouns introducing metaphorical patterns.
Source: Designed by the author from Sketch Engine results

Significantly, with about 35% of terms referring to embarrassment, limitation and need for seclusion, the constructs we can consider the most prejudiced figurative conceptions are not only affluent but also revealing on the sociocultural effect the language of menstruation has and may have had.

Moreover, at first sight, it can be confirmed with the analysis of main contexts that the intensity of connotations related to the taboo-concealment group of nouns, is more notable than in the rest of the cases, although some hygiene contexts are also charged with an intense connotation of rejection.

4.3. Impact of negative connotations

In the prevailing recurring elements and their respective contexts, the associations and emotions tied to menstruation predominantly gravitate towards the negative end of the spectrum. This prevalent negativity contributes to the reinforcement of gendered perceptions and biases surrounding women’s health. It is noteworthy, however, that one notable exception exists – instances where joy and positivity are commonly linked to menstruation, especially in the context of fecundation and fertility. Yet, across most cases, the discourse appears distinctly polarised, with negative effects or considerations not merely emphasised but almost exclusively referenced. In Figure 6, we can see how the connotations are distributed in figurative patterns. It shows how a significant majority of connotations related to menstruation through metaphorical content are adverse.

Figure 6. Connotations in metaphoric segments.
Source: Designed by the author from Sketch Engine results

The overwhelming prevalence of negative connotations uncovered in the corpus analysis prompts a critical reflection, particularly in light of the recommendations outlined by the World Health Organization (WHO) in their 2022 statement on Women’s Health Rights. The WHO emphasises the importance of recognising menstruation as a woman’s health condition, urging a shift from viewing it through the perspective of pathology, hygiene or stigma. In contrast, the notable number of negative conceptions identified in the discourse contradicts the WHO’s call for acknowledging the positive aspects of menstruation. This dissonance highlights a significant gap between the recommended approach and the prevailing language constructs in women’s health discourse.

Admitting the positive character of menstruation is fundamental not only to respecting women’s condition and promoting equality but also to preventing gender-based discrimination. The extensive presence of negative conceptions, as revealed by our analysis, calls for concerted efforts to foster more positive attitudes and cultivate inclusive language practices. Efforts in this direction are crucial to aligning with global initiatives that seek to destigmatise menstruation and promote a more respectful and equitable narrative.

Addressing this disjunction between recommended principles and the actual language use necessitates a multifaceted approach. Initiatives focusing on terminology, awareness (Cabré, 1999), and advocacy can play a crucial role in transforming social perceptions. Gender-sensitive resources aimed at healthcare professionals, scholars, educators, and the general public can contribute to dismantling ingrained stereotypes and fostering a more nuanced understanding of menstruation.

Moreover, media campaigns and public discourse initiatives can be instrumental in reshaping cultural attitudes. By promoting positive narratives and debunking myths surrounding menstruation, these efforts can contribute to creating an environment where women’s health is discussed openly, respectfully, and free from the burden of gender biases (Hennegan et al., 2021).

In conclusion, the dissonance between the prevalent negative connotations in women’s health discourse and the recommended positive approach by global health authorities calls for urgent attention and action. By embracing inclusive language, challenging stereotypes, and fostering positive attitudes, we can contribute to a cultural shift that respects and celebrates the natural and essential aspects of women’s health. This transformation is not only essential for individual well-being but also sustains the broader goals of gender equality and the promotion of women’s health rights on a global scale.

4.4. Gender-sensitive approaches and their expected influence on women’s experiences

The comprehensive exploration of metaphorical patterns within the discourse on menstruation has offered profound insights into the influential role these linguistic elements play in shaping social perceptions and cultural biases. Our examination has effectively demonstrated that recurring metaphors, coupled with prevailing connotations, are fundamental components that significantly influence the societal understanding of menstruation.

As proven in the corpus, menstruation is subjected to pathologisation, with symptoms magnified to depict it as a disease rather than a natural process. Moreover, references to dirt and lack of hygiene have been recurrent, extending to include mentions of disgusting smells and colours, contrary to the World Health Organization’s recommendations. This analysis reaffirms that menstruation is frequently portrayed as a phenomenon to be concealed, rooted in feelings of embarrassment, shame, and negative influence.

What emerges starkly from this analysis is the prevalence of negative connotations and emotions linked to menstruation. This exposes the pervasive presence of stigmatised beliefs and enduring stereotypes, significantly impacting how women’s experiences are perceived and communicated in the public sphere (Coupland, 2003). The language and discourse surrounding menstruation have long been entrenched with biases, contributing to a narrative that can adversely affect individuals experiencing menstruation (Weedon, 1987).

The results exhibit the enduring influence of conventional perceptions and biases preserved in women’s health discourse (Northup, 2020). These stereotypical conceptions have been expanded and culturally transmitted through language and specialised discourse, shaping women’s experiences and affecting their self-perception (Northup, 2020; Slade et. al., 2009). It becomes evident that specialised terminology plays an essential role (Alcaraz et al., 2007; Ciapuscio and Kuguel, 2002) in defining how women understand and relate to their own bodies and natural processes (Foucault, 1973).

Our findings emphasise the dire need for a gender-sensitive approach in women’s health discourse. Language is not just a tool for communication but a reflection of social values and beliefs. To foster a more inclusive and equitable society, it is imperative to address the deeply rooted stigmas and biases that language perpetuates.

Conclusively, the results of this study highlight the extensive influence of language on women’s health and experience. By unravelling the connotations and metaphors within menstruation discourse, we take a critical step towards challenging and reshaping cultural perceptions, ultimately fostering a more informed and gender-sensitive society. This journey from analysis to advocacy underscores the imperative for more respectful, inclusive, and gender-sensitive language practices as we strive to cultivate a linguistic landscape that respects, includes, and empowers women in discussions about their health and experiences.

5. CONCLUSIONS

The in-depth exploration of metaphors within the medical discourse on menstruation has yielded essential insights into their profound impact on cultural biases and social perceptions. This investigation effectively illustrates that recurring metaphors and persistent connotations in specialised and scientific publications are determining elements in shaping general attitudes and assumptions towards menstruation. Specifically, our analysis affirms the prevalent pathologisation of menstruation, figuratively magnifying or scorning its symptoms as if it were an annoying disease rather than a natural process. Additionally, references to dirt and hygiene-related negativity, including allusions to unpleasant smells and fluids, persist against WHO’s recommendations. Eventually, we have concluded that menstruation is shown as a phenomenon to be concealed, obscured, silenced, or masked due to the embarrassment, shame, and negative influence it allegedly entails.

Undoubtedly, a noteworthy revelation from our study is the prevalence of negative connotations and emotions linked with menstruation, uncovering deeply ingrained stigmatised beliefs and enduring stereotypes. These pervasive unfavourable perceptions significantly impact how women’s experiences are perceived and communicated within the public domain. On this point, our corpus analysis has proven that the metaphorical language surrounding menstruation has been entrenched with unsympathetic biases, perpetuating a narrative that can adversely affect individuals undergoing menstruation.

In response to these findings, our research assumes a broader mission – one committed to transforming gendered perceptions into more constructive and equitable alternatives. We firmly assert that employing gender-sensitive terminology is fundamental in challenging the existing circumstances. Through advocating for the creation and dissemination of inclusive language resources taking this research as a starting point, our project endeavours to disrupt the cycle of stereotypes and biases pervasive in women’s health discourse.

In essence, this research is intended to serve as a catalyst, emphasising the claim for more respectful, inclusive, and gender-sensitive language practices. As we move forward, our goal is to cultivate a society where women’s health language is not only precise and rigorous but also unprejudiced and respectful, laying the foundation for a more equitable and enlightened discourse.

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Notas

¹ This publication forms 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 «Next GenerationEU»/Plan de Recuperación, Transformación y Resiliencia. [Volver]

1. INTRODUCCIÓN

Este estudio aborda la estrecha relación entre lenguaje y medicina y se enmarca en el contexto de dos proyectos de investigación, DIGITENDER y NEOTERMED, que, aunque con objetivos distintos, se complementan en el análisis crítico del lenguaje biomédico y las narrativas relacionadas con la salud de la mujer. Por un lado, contamos con el Proyecto DIGITENDER³, cuyo objetivo es la digitalización, tratamiento y publicación en línea de recursos terminológicos multilingües abiertos con perspectiva de género en la sociedad digital. Por otro, nos situamos en el proyecto NEOTERMED⁴, centrado en la neología y la terminología en ciencias de la salud, cuyo objetivo es el estudio de la variación y el análisis multidimensional del discurso biomédico relacionado con la salud reproductiva con el fin de favorecer la alfabetización en salud y la igualdad de género.

A partir de estudios anteriores (Estopà, 2012 y 2019; Domènech, Estopà y Santamaría, 2022; Santamaría, 2023a y 2023b), se ha comprobado que el avance científico en el contexto médico está fuertemente ligado tanto al lenguaje como a las necesidades sociales y permite analizar la evolución cultural, científica, económica, política e ideológica que ha experimentado la sociedad. Durante mucho tiempo las ciencias de la salud han estado ciegas al género, mostrando una mirada patriarcal y sesgada hacia la salud y el cuerpo femenino, con importantes consecuencias para su bienestar. Solo en los últimos treinta años la medicina se ha hecho sensible al género y al sexo, influenciada de forma positiva por el feminismo y sus políticas y acciones; es decir, estamos ante una medicina que tiene en cuenta las diferencias biológicas y las estructuras de poder socioculturales que marcan las desigualdades entre las personas.

Si bien es cierto que la salud de las mujeres y la de los hombres muestran diferencias debido a su conformación biológica por sexo, también las hay derivadas del género por circunstancias socioculturales. Así, existe una relación entre la construcción social del género y los comportamientos y actitudes de hombres y mujeres ante la salud, la sexualidad y la reproducción (Moreno y Carrillo, 2016; Ruiz Cantero, 2019). Con la incorporación de la perspectiva de género, se ha avanzado mucho en el ámbito, pero persisten ideologías sexistas relacionadas con el cuerpo y la libertad sexual de las mujeres. Nos planteamos si uno de los temas que mejor refleja estos patrones ideológicos es el de las Infecciones de Transmisión Sexual (ITS), tema sobre el que aún hoy recae un cierto tabú o sigue connotado negativamente y que necesita ser visibilizado. Dentro de las enfermedades silenciosas, aquellas que no desarrollan síntomas, se incluyen las enfermedades ‘silenciadas’ u ‘ocultadas’, que sí presentan síntomas, pero las personas que las padecen se resisten a admitirlo públicamente porque se consideran vergonzosas. Entre estas enfermedades se encuentran las que causan las ITS.

Al tiempo que disminuye la propagación del VIH, la enfermedad de transmisión sexual más conocida, con mayor investigación y centro de atención desde los años ochenta, tanto en el ámbito sanitario como en la divulgación en campañas sanitarias, otras infecciones como la gonorrea, la sífilis o la clamidia no paran de aumentar desde hace una década, debido a cambios sociales estructurales que favorecen y facilitan las relaciones sexuales. Aunque la mayoría de estas infecciones se producen en hombres, el incremento en las mujeres alcanza más de un 1.000 %, según datos del observatorio de salud femenina Bloom. De hecho, ante esta situación el Ministerio de Sanidad aprobó en 2021 un Plan de prevención y control de la infección por VIH y las ITS, que además de impulsar y coordinar acciones conjuntas para su prevención y diagnóstico, también tiene como objetivo evitar su tratamiento estigmatizado y discriminatorio, sobre todo, en determinados colectivos y grupos de población.

Por otra parte, el discurso médico posee una presencia importante en el discurso divulgativo de los medios de comunicación. Para muchas personas la prensa es un medio fiable de información, por lo que la influencia de lo que en ella se nos cuenta es muy importante. Hay que tener en cuenta que el desarrollo de internet y las redes sociales en las últimas décadas ha facilitado el acceso a este tipo de conocimiento especializado a través de muchas publicaciones en línea -revistas, portales, blogs, páginas web, etc.- orientadas a la divulgación científica, con un grado de especialización medio-bajo y enfocadas a distintos aspectos temáticos sobre la salud. En estas publicaciones suelen incluirse un amplio abanico de temas relacionados con la salud y el bienestar, y en muchos casos asociados a las mujeres: embarazo, menopausia, trastornos alimentarios, relaciones de pareja, etc. La actualidad y la inmediatez a las que están expuestas estas publicaciones implica que tengan que abordar cuestiones que ocupan un lugar central en la evolución de la sociedad actual, como por ejemplo dar una mayor visibilidad a ciertos problemas o enfermedades de la mujer. Con respecto a la divulgación sobre las distintas ITS, dado que se trata de un problema de salud pública y organizaciones como la OMS alertan periódicamente de su incremento, los medios de comunicación deberían hacerse eco de su repercusión y, tanto en la prensa general como en artículos divulgativos sobre la salud, difundir su terminología a la vez que se define y se informa de aspectos relacionados con las enfermedades que causan (sintomatología, tratamiento, prevención).

Tal y como señala Sanmartín (2023), existe una estrecha vinculación entre las expresiones lingüísticas y la construcción conceptual y representación de la realidad por parte de quienes hablan. Siguiendo a Van Dijk (1999: 337): «la forma más obvia, y por lo tanto más ampliamente estudiada, de expresión ideológica en el discurso puede encontrarse en las palabras escogidas para expresar un concepto». Por tanto, cualquier selección léxica que realiza el hablante implica un posicionamiento ideológico, y así se ha demostrado en las descripciones sobre la conexión entre percepción de la inmigración y el sustantivo ilegal (Portolés, 2011); o sobre algunos neologismos, como turismofobia (Sanmartín 2019), menas (Martín Piñeiro, 2019), gordofobia (Guerrero Salazar, 2020) o turismo ecológico y sostenible (Sánchez Manzanares, 2020).

Por todo lo anterior, nos preguntamos si en el discurso de los medios sobre las ITS hay un sesgo ideológico de género y si, en tal caso, estaría motivado por la base cognitiva misma de la denominación, según lo que conceptualiza, o si tal sesgo se debería a que la representación de las ITS en discurso está condicionada por una ideología patriarcal que discrimina a las mujeres con una vida sexual activa y que mantiene frecuentes relaciones sexuales.

El objetivo general de este estudio es analizar la base cognitiva de la terminología empleada en el ámbito de las ITS, así como la representación con relación al género de las ITS en el discurso de los medios de comunicación. Para ello llevaremos a cabo, en primer lugar, un estudio terminológico en el que analizaremos lo representado conceptualmente en las denominaciones de las distintas ITS y estableceremos una tipología de las mismas; en segundo lugar, realizaremos un análisis discursivo cuantitativo-cualitativo de los términos de las ITS asociadas a la mujer o con mayor prevalencia en ellas, atendiendo a su presencia en el discurso de los medios de comunicación con el fin de mostrar el ocultamiento en la representación discursiva de las ITS en la mujer y la persistencia y la prevalencia de ideologías sexistas.

Los resultados mostrarán de qué manera las decisiones léxicas o terminológicas que se realizan influyen en la comprensión y representación de temas concretos relacionados con la salud sexual y, por otra parte, cómo se revela la ideología sexista en la representación de las ITS en discurso. Con ello podremos observar si la construcción discursiva de la salud reproductiva y sexual y las nuevas narrativas están desmontando ciertos estereotipos anclados en la sociedad o si persisten marcos conceptuales relacionados con las mujeres que siguen transmitiendo ideologías propias de una sociedad patriarcal.

Con el fin de proceder ordenadamente, en el apartado siguiente (2) se expone el contexto sociosanitario en el que nos situamos y la inclusión de la perspectiva de género a la hora de abordar las ITS. En el siguiente apartado (3) se explica el corpus y la metodología de análisis. En el punto (4) abordamos el análisis de la terminología de las ITS y en (5) la representación en el discurso de los medios de comunicación de las ITS. Finalmente, presentamos las conclusiones.

2. LAS ITS DESDE UNA PERSPECTIVA DE GÉNERO

2.1. Las ITS: un problema de salud pública en aumento

La salud sexual forma parte de la salud integral de las personas y tiene relación con su bienestar y calidad de vida. Parte del cuidado de la salud sexual es la prevención de los problemas de salud derivados de las Infecciones de Transmisión Sexual (ITS), definidas como infecciones que se transmiten de una persona a otra a través del contacto sexual vaginal, oral y anal, producidas por bacterias, virus o parásitos. De acuerdo con la información obtenida en Medlineplus hay más de 20 tipos de ITS y la mayoría afectan a hombres y mujeres, pero con consecuencias más graves para la salud de estas últimas.

En el Diccionario de Términos Médicos (DTM)⁵ aparecen otras formas alternativas o sinónimas a la denominación de ITS, como enfermedad de transmisión sexual, enfermedad venérea, infección venérea, mal venéreo, dependiendo del contexto y registro. En la actualidad se prima el término infección de transmisión sexual, pero enfermedad de transmisión sexual sigue siendo la forma predominante, pues si hacemos una búsqueda en Google en páginas en español, en el último año se obtienen más de dos millones de resultados para ETS frente a los 11.000 de ITS.

Aunque normalmente en las fuentes consultadas se tratan como sinónimos, no son totalmente equivalentes. En el informe publicado por FEXITS (Foro de Expertos en ITS) o el Observatorio Bloom, las infecciones sexuales se diferencian de las enfermedades por el hecho de que una ITS implica la presencia de un patógeno de transmisión sexual, y cuando el patógeno desencadena una enfermedad, se habla de ETS. Así, por ejemplo, el VIH es una ITS, pero puede desarrollar el síndrome de la inmunodeficiencia adquirida, el sida, una de las ETS más conocidas.

Independientemente de la denominación empleada, las infecciones de transmisión sexual (ITS) son un problema importante de salud pública, debido a su alta incidencia, pero también como consecuencia de las complicaciones derivadas de la falta de diagnóstico y tratamiento precoces. Para hacer frente a este problema de Salud pública se ha desarrollado el Plan Estratégico para la Prevención y Control de la Infección por el VIH y otras ITS (2021-2030) en España, cuyo objetivo es impulsar y coordinar acciones para eliminar el VIH y las ITS como problema de salud pública en 2030, a través de un programa de prevención, diagnóstico precoz y tratamiento, y una serie de estrategias para evitar el estigma y la discriminación asociadas a estas infecciones. La novedad de este Plan es que incorpora el enfoque de género y la diversidad sexual, lo que supone «abordar de forma explícita la desigualdad de las normas y roles de género, las dinámicas de poder, la violencia machista […]» (2021: 18). Además, el Plan tiene en cuenta «a grupos de población clave o que presentan una mayor vulnerabilidad ante el VIH y otras ITS, tal y como las define ONUSIDA y, por otro, a población general, con una especial atención a la población joven y a las mujeres» (2021: 5).

Los informes revisados constatan un crecimiento general de las ITS, pero existe una marcada diferencia de género, ya que, aunque los hombres registran un mayor número de casos, son las mujeres las que han experimentado un mayor incremento de diagnósticos de ITS. Dentro de estas, cabe diferenciar aquellas infecciones dentro de la clasificación EDO (Enfermedades de Declaración Obligatoria) -cuyas cifras son registradas y contabilizadas por las administraciones públicas-y aquellas infecciones que no han de ser notificadas (Virus del Papiloma Humano y Virus del Herpes Simple) de forma obligatoria y cuyos nuevos casos no son registrados ni tienen un seguimiento oficial y sistemático. Según los últimos datos recogidos por el Ministerio de Sanidad (2022), las ITS con mayor prevalencia en las mujeres son la clamidia -donde los diagnósticos en mujeres superan el 50 %-, la gonorrea y la sífilis.

Otro de los datos preocupantes que derivan del informe institucional es que las mayores tasas de incidencia se producen entre mujeres jóvenes, de entre 20 y 24 años, a edades más tempranas que en los hombres. En términos de edad, las ITS no afectan a todas las mujeres por igual: las más jóvenes tienden a registrar un mayor número de casos en comparación con las mujeres de avanzada edad, especialmente de clamidia. Conforme se avanza en edad, se reducen los casos de clamidia y aumentan los de sífilis y gonorrea. Esta situación inversa, a mayor edad, menos casos diagnosticados, se explica por los hábitos sexuales, porque conforme se avanza en edad, mujeres mayores de 35 años registran menos casos de ITS al reducirse el número de parejas sexuales y las prácticas de riesgo. Con respecto al uso de métodos profilácticos, la situación varía según la identidad sexual de las mujeres: en el caso de las mujeres cis, emplean métodos de barrera para evitar embarazos; en cambio, mujeres homosexuales, mujeres bisexuales, mujeres trans utilizan estos métodos para prevenir ITS.

2.2. ITS, ideología y tabú

Aunque la incidencia de las ITS sometidas a vigilancia sea menor que en los hombres, a excepción de la infección por clamidia, su aumento exponencial en mujeres, su mayor incidencia en chicas jóvenes y en mujeres inmigrantes, conlleva la necesidad de elaborar estrategias de prevención específicas adaptadas a ellas, pero sobre todo debemos buscar una explicación para esta situación.

Moreno y Carrillo (2016: 72) insisten en la idea de que, pese a todos los cambios sociales con respecto a la sexualidad femenina, «la autonomía de las mujeres en términos sexuales y reproductivos todavía está proscrita socialmente» y «persiste el estigma social asociado al cuerpo y a las conductas de las mujeres jóvenes y solteras, en función de determinados estereotipos de género que se unen a otras desigualdades sociales como clase social, etnia, generación, entre otras».

En relación con el tema que nos ocupa, las ITS, que son infecciones que se transmiten por vía sexual, están connotadas negativamente, pues se contagian por tener muchas y variadas relaciones sexuales y de forma irresponsable, al no usar métodos barrera para frenar su transmisión. Se construye socialmente una imagen negativa en general, pero en particular en el caso de las mujeres como sexualmente demasiado activas e irresponsables, y con ello se refuerza la visión dicotómica de las mismas como vírgenes/prostitutas. También se perpetúa la ideología judeocristiana de «temor ante la incontrolable y peligrosa naturaleza de la sexualidad femenina» (Moreno y Carrillo 2016: 73). Este imaginario y construcción social hace que las enfermedades sexuales estén totalmente estigmatizadas, sean tabú y se escondan, tal y como se refleja en las respuestas de mujeres encuestadas por el Observatorio Bloom: «sigue habiendo mucho estigma»; «fruto de ese estigma»; «se genera un estigma que te mueres». Esta situación las hace sentir culpables y ocultar la enfermedad: «te sientes responsable»; «sientes que algo está mal»; «te sientas bastante sola, sole y solo porque lo vives de forma aislada».

En general, las pacientes se sienten juzgadas por los mismos profesionales que muestran una falta de sensibilidad y atención, principalmente cuando el médico es un hombre: «Mi experiencia en el médico fue mala, muy mala»; «Hay mucha falta de sensibilidad y dejadez en cuanto a la atención…»; «al ginecólogo le daba reparo o pensaba que me iba a dar vergüenza»; «Yo me sentí juzgada por este hombre».

Finalmente, las mujeres encuestadas denuncian la falta de información clara y transparente y la necesidad de mayor educación sexual: «no me informaron de nada»; «falta muchísima información»; «la gente tiene muy poca conciencia sobre lo que son las ITS». La ausencia de un conocimiento sobre las ITS trae consigo el miedo: «empecé a temer lo peor»; «me preocupó aún más», lo primero que sentí fue miedo»; «estaba en shock»; a la vez, genera sensación de culpa: «sentí vergüenza, pero lo peor fue la culpa, el sentirme una inconsciente y una irresponsable».

Si en general se detecta poca información, esta es aún mayor en el caso de mujeres con otra identidad sexual, mujeres lesbianas o trans; por tanto, se sigue practicando la medicina con sesgo de género y poco inclusiva con la diversidad sexual: «nadie antes le había informado que podía contraerlo siendo lesbiana»; «siendo lesbiana puedes contraer ITS como hepatitis, gonorrea, sífilis. No hay información dirigida a las mujeres».

3. CORPUS Y METODOLOGÍA

Para la realización de este estudio acotamos, por un lado, el conjunto terminológico en el que analizaremos la base cognitiva de las denominaciones de las ITS; por otro lado, establecemos un corpus textual ad hoc para analizar la representación discursiva de las ITS en los medios de comunicación

El conjunto terminológico está constituido por las denominaciones usadas para nombrar las diez infecciones sexuales más frecuentes, que suman un total de 40, sin contar las variantes que resultan de una abreviación formal o un cruce léxico; estas diez infecciones, si recurrimos a la denominación más empleada, serían las siguientes (por orden alfabético): candidiasis, chancroide, clamidia, gonorrea, herpes genital, ladilla, sida, sífilis, tricomoniasis, virus del papiloma humano. Más adelante, presentaremos una tabla en la que aparecen los 40 términos analizados.

Con respecto al corpus textual, se han seleccionado 6 revistas de divulgación sobre salud. Considerando, además, una mayor apertura de la juventud en las relaciones sexoafectivas, añadimos una revista con tématicas del ámbito de la salud, https://azsalud.com/, de creación reciente (2018) y con un equipo de jóvenes al frente, y una web destinada a los jóvenes donde se trata esta temática en la sección de estilo de vida o salud, https://experienciajoven.com. El corpus ha sido creado manualmente para la investigación y está constituido por ocho publicaciones donde se han revisado todas las noticias publicadas sobre ITS desde 2015; contiene 66 545 tokens y 58 052 palabras.

A partir de la interfaz de búsqueda que ofrece cada publicación, hemos buscado noticias relacionadas con infecciones sexuales desde el 2015, mediante palabras clave (ITS, ETS, infección sexual, enfermedad sexual, sífilis, clamidia, etc.). Tal y como se registra en la tabla 1, hemos accedido a escasos artículos sobre enfermedades de transmisión sexual en estas publicaciones electrónicas, en total, 66.

El corpus textual compilado se ha explorado con las funciones Concordancias y Lista de palabras de la herramienta de análisis lingüístico Sketch Engine. Se ha combinado una perspectiva cualitativa con un método basado en corpus (Martínez Sánchez y Santamaría Pérez, 2023) que nos ha permitido analizar las palabras frecuentes, los colocados y la caracterización semántica para determinar la selección temática (Mapelli, 2023; Pontrandolfo y Piccioni, 2022). En particular, la función Lista de palabras nos ha permitido observar los lemas más frecuentes a partir de los cuales hemos reconocido diferentes categorías semánticas y las connotaciones del léxico empleado. También hemos realizado una exploración manual para el análisis cualitativo, en el que presentaremos citas indicando la publicación, pero no la fecha del artículo, por actualizarse este periódicamente.

Para el análisis de la base cognitiva de la terminología relativa a las ITS, nos hemos servido, por un lado, de dos diccionarios especializados: el Diccionario panhispánico de términos médicos (DPTM) de la Real Academia Nacional de Medicina de España y las Academias de ALANAM (https://dptm.es/), actualizado en noviembre de 2023, y el Diccionario médico-biológico, histórico y etimológico (DiccioMed), coordinado por Cortés Gabaudan (https://dicciomed.usal.es/introduccion-cientifica); por otro lado, para el estudio etimológico también empleamos el Diccionario histórico de la lengua española (DHLE) de la Real Academia Española, en su versión electrónica actualizada de 2018 (https://www.rae.es/dhle/); y el Diccionario crítico etimológico castellano e hispánico (DCECH), de Corominas y Pascual, publicado entre 1980 y 1991.

4. TÉRMINOS DE LAS ITS: ANÁLISIS Y TIPOLOGÍA COGNITIVA DE DENOMINACIONES

Conviene observar, por un lado, que la terminología de las enfermedades se traslada en algunos casos a la de las infecciones, como es el caso de la gonorrea, enfermedad causada por infección por el gonococo Neisseria gonorrohoeae, mientras que en otros casos sucede al contrario y así, por ejemplo, la infección por el virus del papiloma humano da nombre a la enfermedad del virus del papiloma humano. Esto tiene que ver con la relación de contigüidad entre causa y efecto, que motiva usos metonímicos en los dos sentidos. Por otro lado, conforme al Principio de Variación formulado por Cabré (1999), en el ámbito de las ITS encontramos formas alternativas de denominación de un mismo concepto o diversas manifestaciones de una forma, las cuales generan sinonimia y polisemia, respectivamente.

En la siguiente tabla presentamos, en la primera columna, las denominaciones de 10 ITS, dispuestas por orden alfabético atendiendo a la denominación más empleada para cada una de ellas y dando a continuación de esta, en cada caso, la relación de sinónimos disponibles; en la segunda columna, recogemos el patógeno que la genera. En la primera columna puede observarse la variación terminológica para la denominación de una ITS, llegando a constar nuestro conjunto terminológico de análisis de un total de 40 denominaciones si no sumamos las variantes.

En nuestro análisis de los términos consignados en la tabla hemos llegado a establecer los siguientes tipos de denominación atendiendo a su base cognitiva desde el punto de vista de su creación:

• Denominaciones por el patógeno (virus, bacteria o parásito) (17): candidiasis, clamidia, clamidiosis, ftiriasis, herpes genital, gonococia, gonorrea, hongos, ladilla, pediculosis púbica, piojo del pubis, Pthirus pubis, tricomonas, tricomoniasis, trichomonas vaginalis, virus del papiloma humano, VIH
• Denominaciones por signos de la enfermedad (15): blenorrea, condiloma acuminado, chancroide, chancro blando, gota matinal, gota militar, linfogranuloma venéreo, mal de bubas, mentagra, podagra, uretritis blenorrágica, sida, síndrome de inmunodeficiencia adquirida, uretritis gonocócica, verruga genital.
• Denominaciones genéricas basadas en metáforas o metonimias (7): lúes (venérea), mal francés, mal gálico, mal napolitano, mal venéreo, morbo gálico, chinche.
• Denominaciones por eponimia (1): sífilis

En la clasificación de los términos hay que tener presente que tanto la denominación más frecuente como cada uno de los sinónimos pueden pertenecer a tipos distintos. Por ejemplo, el término virus del papiloma humano pertenece al tipo de denominaciones por el patógeno y su sinónimo condiloma acuminado al tipo por signos de la enfermedad. Además de clasificar los términos en alguno de los tipos establecidos, realizaremos cuando sea pertinente un análisis de los étimos para dilucidar si se fundan en algún tipo de representación objetiva o figurada (metafórica o metonímica) con una base cognitiva o ideológica de orden sexual. Por otro lado, comprobaremos la dependencia terminológica del inglés en el ámbito de la salud sexual, pues, por lo general, los términos se introducen en español a partir del inglés, donde se documentan con anterioridad. Esto sucede igualmente en otras disciplinas científicas, como han constatado García Palacios y Humbley (2012: 20) con relación a la terminología de distintas lenguas románicas, que es calcada de la terminología inglesa.

4.1. Denominaciones por el patógeno (metonimias)

La denominación de la infección se reduce, por metonimia, a la denominación del virus que la causa. La OMS publicó un comunicado en 2015⁶ sobre las buenas prácticas en la denominación de nuevas enfermedades humanas minimizando su impacto en actividades como el comercio, los viajes o el turismo, así como en el bienestar animal, y para evitar cualquier ofensa a cualquier grupo humano (cultural, social, nacional, regional, profesional o étnico). En dicho comunicado advierte que podrá emitir informe con nueva propuesta de denominación⁷ si se divulgara alguna inapropiada, si bien reconoce la potestad de los organismos responsables de la taxonomía y nomenclatura de los patógenos, que no se ven directamente afectados. Entre los principios de estas buenas prácticas, expone los siguientes: 1) usar términos descriptivos genéricos; 2) usar términos descriptivos específicos; 3) incluir el nombre del patógeno, si se conoce, junto con otros descriptores, pero sin equipararlo al nombre de la enfermedad, puesto que el patógeno puede originar otras enfermedades⁸; 4) usar nombres cortos y revisar las siglas que sustituyen a nombres largos. Comprobaremos que en las denominaciones de las ITS se siguen, por lo general, estos criterios, a excepción del 3), puesto que en ocasiones se equiparan patógeno y enfermedad; además, algunos descriptores específicos darían como resultado una denominación que no se inscribiría entre las recomendadas, puesto que atentaría contra la imagen de algún grupo humano, como veremos.

1. candidiasis, hongos
   El hongo Candida albicans produce la ITS candidiasis, por lo que la denominación se basa en el patógeno. Si examinamos su origen, encontramos que, según el DPTM, procede de Candid(a) albicans + -iāsis gr. ‘enfermedad’, documentado en ingl. desde 1951. Por otra parte, Candida se acuña en 1923 y procede del lat. científico Candida [candida(m) lat. ‘blanca’]. Por tanto, la denominación del hongo se basaría en un signo de la infección, por hacer referencia a la secreción blanca que se produce durante la misma. En cuanto a la variante hongos, sería el hiperónimo del hipónimo Candida.
2. clamidia, clamidiosis
   El nombre de la bacteria que causa la infección es del género Chlamydia. El DPTM da como étimo de clamidia el lat. científico chlamydia [khlamyd- gr. ‘capa corta’ + -ia lat., sufijo neutro plural], documentado en ingl. desde 1945. Estamos ante un sentido metafórico en griego: analogía entre el manto que envuelve los hombros y la incrustación de la bacteria en la célula infectada, envolviendo su núcleo. Por derivación sufijal se forma clamidiosis (clamidi(a) + -ōsis gr. ‘proceso patológico’), documentado en ingl. desde 1971.
3. herpes genital
   El herpes es una enfermedad provocada por la infección que consiste en una dermatosis inflamatoria por el virus del herpes o herpesvirus. En DiccioMed se nos da como étimo de herpes la forma del lat. Herpēs, que procede del gr. Hérpēs ‘que rampa’, por referencia al recorrido que es similar al que traza una serpiente al reptar. Por tanto, etimológicamente estamos ante una denominación metafórica. Es el único caso en el que encontramos uso de términos sinónimos diferenciados para hombre y mujer, pues en la anterior edición del DPTM, el Diccionario de Términos Médicos (2012), se indicaba para la voz herpes genital el uso de balanitis herpética (donde balanitis es una inflamación de la mucosa del glande que en este caso se produce por el virus del herpes, pero que también puede producirse por la bacteria Candida, que causa la ITS candidiasis) y herpes prepucial para el varón, mientras que para la mujer se emplea vulvitis herpética y herpes vulvar. Esta observación ha desparecido en el DPTM.
4. gonorrea, gonococia
   La denominación gonorrea toma una parte léxica de la denominación del patógeno, la bacteria Neisseria gonorrhoeae, que se denomina también gonococo. Según el DPTM, procede del lat. medieval gonorrhoea(m) del gr. gonórroia [gon- ‘órganos sexuales’ + -o- + rhoíā ‘flujo’], docum. en esp. en la forma gomorrea desde 1495 y después reintroducido en su forma culta. Por consiguiente, tenemos referencia a uno de los signos de la enfermedad, la secreción vaginal o del cuello uterino.
   Del sinónimo con el que se nombra la bacteria, gonococo, deriva gonococia. El étimo de gonococo es, según el DPTM, gono(rrea) + kokko- gr. ‘grano’, gr. cient. ‘bacteria redondeada’, docum. en ingl. desde 1889. Por tanto, etimológicamente la denominación alude a la forma redondeada de la bacteria sobre la base de la metáfora del griego kokko ‘grano’.
5. ladilla, piojo del pubis, Pthirus pubis, ftiriasis, pediculosis púbica
   El parásito, cuyo nombre científico es Pthirus pubis, pero cuya denominación más frecuente es ladilla, se emplea para denominar la ITS. La ladilla es un insecto que se transmite por contacto sexual pero que, según el DPTM, no parece transmitir enfermedad alguna. Este diccionario observa que, aunque fue voz coloquial, ladilla se usa ampliamente en el ámbito médico. Por lo que respecta a su etimología, procede del lat. tardío blatella(m) [blatt(am) lat. ‘ácaro’ + -ellam lat. ‘pequeña’]; docum. en esp. desde 1493. Por otro lado, el piojo es también un insecto áptero del mismo suborden que la ladilla y la pediculosis es la infestación por piojos, por lo que las denominaciones piojo del pubis y pediculosis púbica presentan la especificación de la zona afectada. Por último, ftiriasis deriva de la base Pthirus.
6. tricomonas, trichomonas vaginalis, tricomoniasis
   El protozoo Trichomonas vaginalis es causa de la ITS conocida como tricomoniasis, pero que también se conoce por el nombre del patógeno, que a veces se presenta en la forma reducida tricomona(s). Según el DPTM, el término tricomona procede del lat. cient. Trichomona [trikho- gr. ‘pelo’ + moná(s) gr. ‘unidad’, gr. cient. ‘organismo unicelular’], acuñado en 1836. Por tanto, se tiene un descriptor genérico del organismo modificado por vaginalis, término específico referido al tramo infectado (en las mujeres, la tricomoniasis provoca secreción vaginal con mal olor, picazón genital y micción dolorosa, mientras que los hombres generalmente no tienen síntomas). Por derivación sufijal a partir de tricomona se forma tricomoniasis, que, por tanto, puede clasificarse como denominación por el patógeno.
7. virus del papiloma humano
   El étimo de papiloma pasó del griego al latín con el significado de ‘pezón’, lo que se relaciona por analogía con la forma puntiaguda de las verrugas que son signo de esta infección; por tanto, etimológicamente estamos ante una metáfora a la hora de denominar al patógeno que hace referencia, por otra parte, a un signo de la enfermedad, la verruga. Por otro lado, la especificación humano se presenta porque estamos ante un virus de distribución universal que produce infección tanto en humanos como en animales. Finalmente, la variante virus del papiloma de herpes o papilomavirus se corresponde con la denominación inglesa herpes papilomavirus.
   En los medios de comunicación se difundió ampliamente el término virus del papiloma humano, frente a la escasa aparición de los otros términos, a partir de 2007, cuando comenzaron a comercializarse en España las vacunas para prevenir infecciones por el VPH y se incluyeron en el calendario vacunal de niñas; en 2023, se ha recomendado para varones⁹.
8. VIH (sinónimo: sida)
   Esta sigla de virus de la inmunodeficiencia humana se ha generalizado para la denominación de la infección que da lugar al sida.

4.2. Denominaciones por signos de la enfermedad (metonimias)

En el DPTM se diferencia signo de síntoma, pues el primero es una manifestación objetiva de una enfermedad o síndrome, mientras que el síntoma es subjetivo por cuanto solo puede ser observado por la persona que lo experimenta. Teniendo en cuenta esta distinción, las denominaciones aquí clasificadas se refieren a signos, o al conjunto de signos y síntomas, de las enfermedades causadas por la ITS.

9. blenorrea (sinónimo: gonorrea)
   La denominación blenorrea es definida en el DPTM como ‘Flujo mucoso procedente de la uretra o la vagina’, con lo cual representa conceptualmente un signo de la enfermedad.
10. condiloma acuminado, verruga genital (sinónimo: virus del papiloma humano)
    Como así nos informa el DPTM, condiloma procede del griego kondýlōma ‘verruga’ [kondyl(o)- ‘nudo’ + -ōma ‘tumor’¹⁰], siendo la verruga un tumor benigno; por otra parte, papiloma y papiloma cutáneo se presentan como sinónimos de verruga y, en efecto, el étimo de papiloma –docum. en fr. desde 1858– es el término griego papill(am) ‘tumor’ lat. ‘pezón’ + -ōma gr. ‘tumor’. En cuanto al modificador acuminado ‘terminado en punta’, es una especificación referida a la forma de la verruga, contenido este que también aparece en el sentido ‘pezón’ de papill(am) en latín; el DPTM indica que procede del lat. acūmināt-u(m)/-a(m) ‘puntiagudo’ y que fue reintroducido y se documenta en ingl. desde 1646.
    La otra denominación, verruga genital, especifica, no ya la forma de la verruga, sino dónde se localiza, si bien en la web de la Asociación Española Patología Cervical y Colposcopia¹¹ se detalla que puede afectar, además de a los genitales, a otras áreas mucosas como la boca. En la misma web definen los condilomas como lesiones causadas por la infección del virus del papiloma humano –con superficie rugosa similar a la cresta de un gallo–, con lo cual se confirma que la denominación referencia los signos; sin embargo, más adelante, identifica condiloma como denominación de una infección de transmisión sexual al informar de que es la de mayor frecuencia.
    En la web profesional de una clínica especializada en citopatologías¹², se recoge la información sobre la denominación histórica de estos signos:

11. chancroide, chancro blando
    En este caso, la bacteria Haemophilus ducreyi produce una infección que se manifiesta mediante úlceras mucocutáneas como las denominadas chancro, con lo cual estamos ante un signo de la infección. El étimo de chancro, según el DPTM, es el fr. chancre, que procede del lat. cancer ‘úlcera cancerosa’, docum. en esp. desde 1814.
12. gota matinal, gota militar (sinónimo: gonorrea)
    La denominación genérica gota parece referirse a la secreción en forma de gota que se produce en la uretra por su inflamación como resultado de la infección. Por tanto, sería una metáfora referida a este signo de la enfermedad.
13. linfogranuloma venéreo (sinónimo: clamidia).
    La infección por algunos serotipos de la bacteria Chlamydia trachomatis tiene entre sus manifestaciones clínicas el linfogranuloma venéreo (LGV), signo de la enfermedad. El término linfogranuloma designa una lesión de tipo granulomatoso en un ganglio linfático y el modificador venéreo hace referencia a que resulta de relaciones sexuales; como indica el DPTM, el étimo de venéreo -rea ‘transmitido por contacto sexual’ es el lat. venere-u(m)/-a(m) [de Vener(is), genitivo de Venus, diosa del amor y del sexo, + -e-u(n)/-a(m)] ‘relacionado con el amor y el sexo’ (docum. en esp. desde 1427). Por tanto, venéreo se funda sobre una sinécdoque del individuo (antonomasia del nombre propio por el nombre común).
14. mal de bubas (sinónimo: sífilis)
    Según el DPTM, buba procede del latín medieval *būba, del lat. tardío būbōn(em), del gr. boubōn ‘ingle’, ‘tumor en la ingle’, que se documenta en fr. en 1230 y en esp. desde 1494. En cuanto a la expresión mal de bubas, donde mal es sinónimo de enfermedad, supone una especificación atendiendo a estas lesiones en tanto que signos.
15. mentagra, mentulagra, podagra, pudendagra (sinónimo: sífilis)
    Otros términos para denominar la sífilis, según el DHLE, son mentagra, mentulagra, podagra y pudendagra¹³, todos ellos tomados del latín científico y relacionados entre sí por cuanto probablemente se basan en una metáfora que representa un signo de la infección: gota por secreción que provoca la infección, como sucedía con las denominaciones gota matinal y gota militar de la gonorrea. Como sinónimo de pudendagra nuestro diccionario histórico recoge en su primera acepción, además de sífilis, sifilismo y sifiliberto.¹⁴
16. uretritis blenorrágica; uretritis gonocócica (sinónimo: gonorrea)
    El proceso inflamatorio de la uretra (uretritis) por la infección por el gonococo o gonococia (gonocócica) y la blenorrea o flujo asociado, da lugar a estas dos denominaciones por signos de la infección.
17. síndrome de inmunodeficiencia adquirida, sida
    El DiccioMed define síndrome como ‘Conjunto de síntomas y signos que concurren en una enfermedad, de forma que la presencia de alguno de ellos suele ir asociada con otros; la etiología de cada uno puede ser diversa’. Por tanto, podemos clasificar la denominación síndrome de inmunodeficiencia adquirida en este grupo, en la que se especifica como signo principal una inmunodeficiencia no congénita. La siglación de este término se ha convertido en nombre común, sida.

4.3. Denominaciones genéricas basadas en metáforas o metonimias

18. lúes (sinónimo: sífilis), mal venéreo
    La forma lúes (variante, lúe) es una abreviación de lúes venérea (variante, lúe venérea) y procede del lat. científico lues ‘contagio; enfermedad contagiosa; epidemia’, del verbo luere ‘desatar, soltar’. Según el DHLE, lues, acompañada generalmente del modificador venerea, se atestigua en español al menos desde 1563. Por tanto, la referencia genérica a la infección de lúes se especifica mediante venérea, que sitúa la voz en el ámbito sexual, como antes comentamos al tratar este modificador (véase linfogranuloma venéreo). Según el DPTM, mientras el ámbito geográfico de uso de lúes es España y México, la forma completa lúes venérea (que se usa solo en contextos históricos) se extiende además en otros países latinoamericanos. Finalmente, del uso de mal como sinónimo de enfermedad, resulta mal venéreo.
19. mal francés; mal gálico; mal napolitano; morbo gálico; regalo de Colón (sinónimo: sífilis).
    La denominación de la ITS consta de una base genérica, mal o morbo, y un modificador locativo (francés, napolitano, gálico) que da lugar a una denominación metonímica. El uso de morbo (étimo: lat. morbu(m) ‘enfermedad’, docum. en esp. desde 1270) como sinónimo de mal es hoy infrecuente, pero ambos se han usado como sinónimos de enfermedad.¹⁵ La creación por metonimia de estos términos se basa en la relación de contigüidad entre el «producto» (el mal) y su lugar de procedencia (Francia o, en la antigua Europa, la Galia y Nápoles)¹⁶. En cuanto a la denominación regalo de Colón tiene que ver con la creencia de que fueron los descubridores de América los que trajeron de allí la enfermedad, según apostilla Corominas al referirse a la preferencia en castellano de las denominaciones mal francés o mal gálico; por esta creencia también ha recibido la denominación púa de los indios. A partir del siglo XVIII se extiende el empleo de sífilis, hoy el término más frecuente, por reprobarse estas denominaciones que asocian la infección a algún país o región y dañan así su imagen.
20. chinche (sinónimo: sífilis)
    Probablemente se trate de una denominación metafórica porque este insecto, denominado también chinche de las camas, desarrolla la mayor parte de su actividad por la noche y es transmisor de enfermedades, con lo cual se establece una analogía con la infección por práctica de relaciones sexuales.

4.4. Denominaciones por eponimia

21. sífilis
    Se ha puesto de relieve que en la actualidad en las ciencias médicas se insta a no usar epónimos en terminología. De hecho, gran parte de los epónimos se introducen en este campo a finales del siglo XIX y principios del XX, cuando dominan como lenguas científicas el inglés y el alemán, pero comienzan a evitarse conforme avanza el siglo XX a favor del uso de términos más descriptivos, priorizándose denominaciones que incluyan nombres de objetos que permitan una asociación con la enfermedad, técnica, estructura anatómica, etc. (Aleixandre-Benavent et al., 2015: 165). Por ejemplo, con respecto a los epónimos que nombran estructuras anatómicas, Duque-Parra et al. (2018: 88) indican que, además de difundirse en artículos científicos la inconveniencia de su uso, en 1933 el Comité Internacional de Nomenclatura Anatómica publicó una declaración para la eliminación formal de la eponimia en la terminología morfológica¹⁷ y recuerdan que existe un sistema internacional de Terminología anatómica, histológica y embriológica.
    El DHLE indica que sífilis se documenta en esp. desde 1828 y que procede del lat. científico Syphilis, nombre de un pastor¹⁸ que contrae el morbus gallicus en el poema del médico veronés G. Fracastoro titulado Syphilis sive morbus gallicus, en el que se describe la enfermedad y que fue publicado en 1530. Fracastoro elige este nombre propio porque en griego tiene el sentido ‘pastor’ (siph ‘cerdo’ y philus ‘amor’) y rehúsa usar morbus gallicus para nombrar la enfermedad, reemplazándolo por lúes o plaga (Leitner et al., 2007: 7). Corominas indica que el mismo Fracastoro empleó posteriormente syphilis en un tratado médico en latín para nombrar la enfermedad, pero que el término no se generaliza hasta siglos más tarde (se documenta en inglés en 1718; en francés, en 1808; en cast., en 1884).
    Por tanto, se trata de un epónimo, del tipo personalidad literaria (Aleixandre-Benavent et al., 2015: 165), que toma el nombre propio de un personaje de la ficción con esta enfermedad. Martín Camacho (2021: 265-267) señala que la mayoría de los epónimos se fundamentan en una relación de metonimia, metáfora o antonomasia¹⁹, si bien considera que en ocasiones obedecen a causas extralingüísticas históricas (entre los ejemplos de este último caso, señala moisés con el sentido ‘cuna portátil’); además, nos advierte de que no puede examinarse la eponimia como un mero caso de cambio semántico, por cuanto la recategorización de los epónimos puede implicar una modificación de las propiedades morfosintácticas de la base, lo que solo ocurre en un cambio semántico para la elipsis semántica. Como metonimia, la considera como una extensión del significado primigenio –siguiendo, en este punto, a Alcaraz Varó y Martínez Linares (2004)– del tipo el efecto por la causa. Por otro lado, en los estudios semánticos, el tipo de antonomasia del nombre propio por el nombre común se ha observado como metáfora, como así hace Le Gern (1980); en el caso del epónimo sífilis podemos identificar como base de la metáfora la analogía que se establece entre los individuos enfermos del morbus gallicus y el pastor Syphilis del poema del siglo XVI.

5. REPRESENTACIÓN DISCURSIVA DE LAS ITS EN REVISTAS Y BLOGS DE SALUD DIVULGATIVOS

5.1. Léxico y categorías semánticas

Una vez realizado el análisis lingüístico-terminológico donde se ha mostrado que no existe sesgo de género, vamos a fijarnos en la manera en que se representan estas ITS en los medios de comunicación seleccionados para comprobar si en su uso discursivo se muestra sensibilidad de género.

En primer lugar, nos fijaremos en las palabras más frecuentes y categorías semánticas. Para ello, seleccionamos los términos con mayor recurrencia mediante la búsqueda por wordlist>noun, wordlist >adjective, wordlist>verb y analizamos y categorizamos semánticamente los primeros 50 sustantivos, adjetivos y verbos de forma manual. En este caso, la primera categoría semántica que hemos extraído está relacionada con el ser humano o partes del mismo.

Encontramos 2 341 sustantivos de la frecuencia total que es de 15 491. Los más frecuentes son los nombres que designan a los propios individuos: persona (266), mujer (233), hombre (143) o pareja (78), que suman 720 (30,7 %). Pese a que estas enfermedades son más habituales en hombres y se transmiten por relaciones entre parejas, el sustantivo mujer es más frecuente en el corpus (10%) que el de hombre, con un 6 %, lo que mostraremos que está relacionado con el hecho de que los artículos del corpus tratan cómo afecta la ITS a la salud reproductiva de las mujeres. En este tipo de textos divulgativos se busca también el distanciamiento y la objetividad a través de sustantivos como caso (232), contacto (70) o referencias metonímicas mediante el término cuerpo (53) o partes del cuerpo, zona (64).

En cuanto a los adjetivos relacionados con esta categoría hemos hallado 876 de una frecuencia total de 4 942 y predominan los relacionados con la práctica sexual (428) o partes íntimas del cuerpo: vaginal (192), genital (122), oral (55), anal (37). Cabe destacar que, dentro de los adjetivos relativos a personas que pueden sufrir ITS, tenga mayor presencia el adjetivo femenino (22) que el adjetivo del sexo opuesto, masculino (7).

La segunda categoría está relacionada con la medicina, pues estamos tratando infecciones o enfermedades de transmisión sexual. De ahí que los sustantivos más frecuentes sean enfermedad (387), infección (355), tratamiento (211), síntoma (210), salud (101), virus (184), bacteria (81), vacuna (72) y las denominaciones génericas: ETS (81) e ITS (56) o los distintos tipos de ITS: clamidia (156), gonorrea (132), sífilis (86), sida (85), VPH (64), candidiasis (63). Las denominaciones de las ITS aparecen entre estos sustantivos con una representación del 28.7%. De igual modo, hallamos adjetivos propios de esta categoría: inmunitario (30), inmune (24), bacteriano (22), crónico (27), médico (24), grave (46) y verbos como infectar (117) o contagiar (65).

Por otra parte, encontramos un léxico connotado negativamente para referirse a este tipo de infecciones sexuales, porque se las considera un riesgo (147), un problema (95), se asocia al dolor (117), hay contagio (82), y otros sustantivos que se valoran negativamente dentro de este contexto como causa (84), contacto (70), transmisión (206), diagnóstico (59). También encontramos verbos que se asocian a un contexto negativo como provocar (144), afectar (123), causar (102), evitar (85), contraer (72), transmitir (69), aumentar (61), detectar (57), prevenir (53), padecer (41), sufrir (41), proteger (37). Finalmente, hallamos adjetivos valorativos relacionados con las enfermedades sexuales: común (80), importante (74), frecuente (61), grave (46), alto (28), difícil (28). Un resultado llamativo, aun siendo el tema las infecciones y enfermedades sexuales, es la poca presencia de la palabra sexo en el corpus (65). Si a ello se suma que para evitar las infecciones se recomienda el uso de métodos barrera como el preservativo, su presencia en el corpus es testimonial también (57). De manera que, con estos resultados obtenidos a partir de la selección léxica, se muestran las categorías semánticas que predominan y la carga negativa que rodea estas enfermedades.

5.2. Narrativas de las ITS en el discurso

En segundo lugar, si nos fijamos en la representación discursiva de las ITS más frecuentes actualmente como son la clamidia, la gonorrea o la sífilis, se observa que hay narrativas marcadas por el género o referencias a la identidad sexual solo por lo que se refiere a la salud reproductiva. Cuando se tratan infecciones o enfermedades sexuales que afectan a ambos sexos por igual («puede producirse en hombres y mujeres», «afecta por igual a hombres y mujeres»), se centran principalmente en los síntomas, que en este caso sí marcan la diferencia entre hombres y mujeres («a veces difieren ligeramente los síntomas entre hombres y mujeres», «otras veces la diferencia es mayor») y en el tratamiento de la enfermedad. La principal referencia a las mujeres viene dada cuando en estos artículos se tratan las consecuencias de la infección, ocupando en la exposición los efectos sobre la reproducción mayor espacio y haciendo notar que estas enfermedades tienen repercusiones más graves o complicaciones para la salud de la mujer. Lo comprobamos en los siguientes extractos. Por ejemplo, con respecto a la clamidia, con mayor prevalencia en las mujeres, se destaca que en la mujer la infección puede desembocar en infertilidad, aborto, malformaciones en el feto, incluso la muerte:

Igualmente, se subraya el riesgo de infertilidad y de complicaciones durante el embarazo y el parto y las consecuencias para el bebé que acarrean otras ITS. En cambio, en el caso de la infertilidad del hombre, se menciona en escasas ocasiones y nunca se desarrolla este aspecto.

• Gonorrea: En las mujeres puede provocar enfermedad inflamatoria pélvica que aumenta el riesgo de infertilidad o de embarazos ectópicos. (Cuerpo y mente)
• Tricomoniasis: En mujeres embarazadas se ha visto que puede provocar prematuridad y bajo peso en el recién nacido, e incluso puede llegar a transmitirse la enfermedad al feto. (Psicología y mente)
• Sida: También puede producirse el contagio madre-hijo en mujeres embarazadas que no siguen ningún tratamiento, tanto durante el parto como en la lactancia. (Psicología y mente)

Otra de las narrativas de las ITS en los medios es el desconocimiento y la falta de información: «se trata de un tipo de infección poco discutida a nivel social»; «es el desconocimiento por parte de la mayoría de la población respecto a las vías de contagio». Ello deriva en la necesidad de más educación sexual como el mejor instrumento para prevenir las infecciones de transmisión sexual. Esta desinformación conduce en ocasiones a la discriminación de determinados colectivos como gais, prostitutas o drogadictos:

Entramos así en otra narrativa, la de las prácticas sexuales, en la que se focaliza en su frecuencia y en la monogamia frente a las parejas múltiples. Ciertamente, la idea de ITS está asociada a la promiscuidad, tanto en hombres como en mujeres, pero sabemos que la condena social es mayor para las mujeres y que una mujer sexualmente activa se identifica como promiscua. En los artículos de nuestro corpus se alerta del riesgo que supone la actividad sexual para la mujer: «Es cierto que todas las mujeres activas sexualmente corren cierto riesgo» (Psicología y mente), pero no se detecta discriminación ni asociación negativa con relación a la frecuencia. No se representa discursivamente una reprobación explícita a que la mujer tenga múltiples parejas, más bien se insiste en el riesgo de contagio, como así se muestra en un artículo sobre el virus del papiloma humano, en el que previamente hay una referencia a la monogamia:

Especialmente esta advertencia se presenta en los artículos dedicados a ITS con mayor prevalencia en mujeres, como la clamidia:

Finalmente, otra narrativa tiene que ver con el uso de métodos barrera para la prevención; seleccionamos esta cita de un artículo dedicado a la tricomoniasis:

Excepcionalmente en algún artículo se presenta la imagen de la mujer como una persona irreflexiva en sus prácticas sexuales por no usar preservativo: