French medicine of the turn of the nineteenth century invented menopause. Invented, that is, in the sense of a new word and concept that radically impacts corporeal experience and helps to form a new bio-psycho-social construct.
It was first proposed in 1812 as the rather ungainly “la menespausie” by the Paris medical doctoral candidate Charles-Paul-Louis de Gardanne, and later refined into the neologism we still recognise today, around 1821 when Gardanne published his work on the topic. The new concept referred to the ‘cessation of menses’, claiming a total neutrality about its meaning and symptomology to replace concurrent terms that doctors ridiculed as catastrophising: l’âge critique (the critical age) or l’âge de retour (the turning age). Both these other concepts referred to the ancient model of life cycles (generally seven years), at the juncture of which bodies supposedly underwent a period of vulnerability before the new cycle was established. Such cycles made the age of 40-50 a ‘critical’ one for both women and men, it was thought.
But ironically, even though early nineteenth-century doctors claimed to be overturning popular catastrophic thinking about the cessation of menses, in fact they described for the first time a broad symptomology that appeared precisely to elaborate the notion that this was indeed a terrible moment for women. The idea of male menopause held some currency, but overall, the new concept formed part of an increasingly asymmetric view of the sexes in ageing, in which men were thought to age evenly across their lifespan, while women hit an abrupt bump, after which they were never the same again.
Partly, this occurred via a novel uptake of Hippocratic quotation, in the Galenic rendition of Hippocrates that claimed “Propter uterum mulier tota est morbus” (The uterus is the sole source of all women’s diseases). But others proposed an even more reductive translation derived from the Paracelsian Flemish physician of the seventeenth century, Jan Baptist van Helmont. In this version, “Propter solum uterum, mulier est id quod est”, woman was claimed, in all her being, to be determined by the action of the uterus. Menopause, in this model, was the loss of all a woman’s womanhood – truly a critical moment. Some even claimed that a woman after menopause was effectively now a man.
Modern city life was often blamed for the symptoms of menopause, and doctors writing on the matter typically offered copious hygienic advice that included avoiding dances and gambling, alcohol, meat and vigorous exercise, sexual excitement and emotional turmoil, and encouraging gentle walks and carriage-rides, platonic love and caring for others.
One doctor writing about the question claimed to have interviewed peasant women in the French countryside about it, and to have found them largely symptom-free and mystified by the thought that they should experience the loss of menses as anything other than a relief.
Many of those writing on the topic scolded women for worrying about the matter, even as they described it in the most dire terms. One medical writer even proposed that the primary symptom of menopause was in fact hypochondria. But here again, the uterus was blamed – the menopausal hypochondriac represented the opposite pole in a dyad that included that other great feminine archetype of nineteenth-century medicine, the hysteric.
In presenting an historical account of this question at an interdisciplinary seminar as part of the inter-institutional Critical Sexology series recently, I was reminded how powerfully this historical moment has helped to shape our current perceptions of what one of the speakers called “this strange non-event that one does not know has happened until after it has finished”.
Across cultures, we find vastly different accounts of menopause, just as we find very different symptoms attributed to it today compared to the nineteenth century. While European women complain of hot flushes, Japanese women complain of feeling cold. We take regular menstrual periods for granted, though they are uncommon in contemporary cultures outside the affluent world, and most likely historically as well. It seems likely that what changed in the nineteenth century was not only medical thinking on the matter, but the function of living bodies as well. Ironically, just as doctors began telling women “its all in your head”, the hormonal environment of bodies was undergoing unprecedented historical change.
– This post was contributed by BiGS Visiting Research Fellow Dr. Alison Moore (September – December 2017). Dr. Moore has published widely in the field of history of European psychiatry and modern history of sexuality, with other areas of expertise in the history of medicine and health, historiography,