A Woman's Hell? Medical Perceptions of Menopause in Preindustrial Europe

“There is a period in the life of females to which, for the most part, they are taught to look with some degree of anxiety.” ¹ Written by an English physician more than two hundred years ago, this statement could equally well refer to the predominant perception of menopause in Western societies today. Most women dread its effects. Books and the communications media abound in discussions and medical advice. The etiology and treatment of menopausal disorders have prompted intense research activity and created a lucrative medical and pharmaceutical market.

The idea that menopause presents a kind of natural pathology has also met with serious criticism in recent years, however. Sociologists and feminists have described menopause as another example of the increasing “medicalization” of the female body by modern medicine, a process by which perfectly natural life events are redefined as medical problems in need of specialist treatment. ² Cultural anthropologists have pointed out the many different forms that the physical and emotional disorders associated with menopause can take in various cultures. In a study among Japanese women, for example, stiff shoulders, headaches, sore joints, and constipation topped the list of the most frequently named symptoms of menopause—not the flashes thought to be particularly characteristic of menopause in modern Western culture. ³

Historical work on menopause and menopausal disorders, scant as it is, has followed similar lines: the view that menopause is a medical problem and warrants preventive and therapeutic intervention is described as a fairly recent phenomenon. We have, it is affirmed, “no record of climacteric disturbances prior to the eighteenth century,” ⁴ “no evidence” that women then “were troubled at the menopause.” ⁵ Eighteenth-century descriptions of menopause are said to still “clearly predate its later medicalization.” ⁶

My own study of early modern Latin and vernacular gynecologic writing on menstruation and of women’s personal accounts has led me to a rather different conclusion. Tracing notions of menopause and its disorders in the West, from the sixteenth to the early nineteenth centuries, I will show here that many premodern physicians and women considered menopausal disorders to be a common and often very serious medical problem. The description and interpretation of these disorders varied substantially, however, over the centuries—reflecting, above all, changing and competing concepts of menstruation and the female body. I should add that my discussion will be limited to menopause as a health concern. I will thus not deal with demographic aspects such as the average age at menopause, ⁷ and I will touch upon the wider issues of the female experience of aging only where these had a noticeable influence on the perception of menopause as a bodily phenomenon.

The Clogging of the Weaker Vessel

Medical writing before 1650 does not abound in discussions of menopausal disorders. Where they are mentioned, however, the picture is sometimes drastic. Giovanni Marinello, for example, in “Le medicine partenenti alle infermità delle donne” (1563), gives the following description:

Those [women], on the contrary, in whom they [the periods] have stopped or do not come: like those in whom they begin to end for reasons of age, are always infirm and most of all in those parts of the body which are connected to and have some kind of correspondence with the uterus, such as the stomach and the head; thus as soon as the periods stop, pains arise, apostemata, eye disorders, weak sight, vomiting, fever; and they desire the male more than ever; the disorderly uterus rises or descends all the time or commits other actions difficult to endure. From this soon a tightness of the chest arises, faintings of the heart, breathlessness, hiccups, and other troublesome accidents, from which the woman sometimes dies. Also spitting of blood, hemorrhoids, and, especially in maidens, copious nose bleeding come from it, and endless other ills, which we think too many to relate. ⁸

Clearly, the relatively limited space that most sixteenth- and seventeenth-century physicians accorded to menopause and its disorders cannot simply be taken to mean that it was seen as an unproblematic natural event. It would be equally...