The History of Menopause
I wouldn't say we're there yet, but history tells us that we've come a long way when it comes to menopause. Here's some historical context on the way this natural process/transition has been "treated" throughout the ages to add some perspective to where we are today.
585 B.C.
Philosophy
Aristotle mentioned what would become known as menopause
in his History of Animals noting that the transition began at age 40.
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700 – 480 B.C.
Ancient Greece
The word “menopause” is based on the ancient Greek language.
However, there is little to no data from this period about menopause –
with good reason. At least 50% of women died before the age of 34 and,
to make matters worse, the ancients believed that women were
inferior to men and that her value was based on fertility.
So, understandably, not much attention was paid to
the post-menopause experience.
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1584
The Discoverie of Witchcraft
Reginald Scot’s book asserted that "upon the stopping of their
monthly melancholic flux or issue of blood,"
post-menopausal women were "prone to the accusation of witchcraft".
According to Scot, the lack of bleeding made older women
"likely to command the Devil, due to a build-up of black bile
in their body, resulting in evil thoughts and influences".
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1692
Salem Witch Trials
The majority of women accused of being witches were postmenopausal.
In Salem, the number was 13 out of 16.
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1701
Bloodletting
Thomas Sydenham believed that women were prone to
“hysteric fits” between the ages of 45 and 50.
He prescribed bloodletting to treat menopause in order to “restore menses”
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1710
Calamity
Previously believed to be a natural phenomenon –
menopause began to be viewed as a disease and
perceived as the worst of all “calamities”
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1821
De la ménépausie
Charles Pierre Louis De Gardanne effectively
named menopause when he wrote:
De la ménépausie, ou de l’âge critique des femmes
(“Menopause: The Critical Age of Women”)
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1825 – 1854
Ovariotomies
Encouraged by the first successful ovariotomy performed in Kentucky, Scottish surgeon (and laudanum addict), John Lizars, thought it would make sense to use ovariotomies to treat menopause. He performed 200 of them, killing 89 women in the process.
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1837 (to 1901)
The Victorian Age
Conventional wisdom during this time dictated that a woman’s
physical make up predisposed her to insanity AND that
menopause was a mental illness in need of a cure.
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1844
Samuel Ashwell (London gynecologist)
“It has become too general an opinion that the decline of this function [menstruation] must be attended by illness; but this is surely an error, for there are healthy women who pass over this time without any inconvenience and many whose indisposition is both transient and slight.”
Unfortunately, Dr. Ashwell’s influence was limited.
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1845
Douche Bag
In England, doctors began prescribing douches containing a
cocktail of acetate of lead, morphine and chloroform
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Snake Oil
In the U.S., snake-oil salesmen sold “miraculous cures” for
hot flashes, insomnia and night sweats
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1866
Clitoridectomies
Dr. Isaac Baker Brown –
English gynecologist and surgeon - concluded that clitoridectomies
effectively cured menopause and hysteria 70% of the time.
effectively cured menopause and hysteria 70% of the time.
He also believed in clitoridectomy to treat epilepsy caused by masturbation.
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1870s
Asylums
Lawson Tait, a popular obstetrician, prescribed strong laxatives and
committed women to asylums as prophylactic measures to be
taken against the threat of menopausal “dementia”.
(Dr. Tait also believed that Jack the Ripper was actually a midwife.)
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1890s
Prescriptions
When surgery and institutions failed, opium, wine and cannabis, were prescribed. Other popular prescriptions were powdered ovaries and testicles.
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Ovariin
Merck offered Ovariin for treatment of menopausal symptoms
(made from the pulverized ovaries of cows)
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1929
Estrogen
Estrogen isolated at St. Louis University by
Nobel-Prize winning biochemist Edward Doisy
Nobel-Prize winning biochemist Edward Doisy
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1930
Water-Soluble Estrogen
German-Israeli gynecologist Bernhard Zondeck
discovered water-soluble estrogen in the urine of pregnant mares
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Deficiency Disease
Menopause started being described as a deficiency disease – replenishment therapies included testicular juice and the crushed ovaries of animals
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1933
Emminen
Emminen (estrogen) became commercially available (made from the urine of pregnant women and, ultimately,was too expensive to produce)
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1936
A Woman’s View
Marie Stopes wrote Change of Life in Men and Women blaming the
medical profession for making women think that menopause was a
'revolting, frightening, misleading and injurious state'.
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1938
Synthetic estrogen was developed
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1939
Diethylstilbestrol (DES)
First marketed as a far more potent estrogen than Emminen
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1942
Premarin
Ayerst Laboratories began marketing Premarin
(the most popular form of HRT in America).
Prempro (a combination of Premarin and Provera) would
become the most widely dispersed drug in the U.S.
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1966
Feminine Forever
“All post-menopausal women are castrates,” but, with HRT, a woman’s “breasts and genital organs will not shrivel. She will be much more pleasant to live with and will not become dull and unattractive.”
(From Robert A. Wilson's book, Feminine Forever)
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1969
Dr. David Reuben published a book claiming that while menopausal
women are “not a man”, they are no longer a functional woman.
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1970s
Hormone Deficiency Syndrome
Clinical conditions associated with menopause were identified as Hormone Deficiency Syndrome (hot flashes, osteoporosis, cardiovascular events,
Alzheimer’s disease & vaginal atrophy)
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Estrogen supplements associated with increased risk of
endometrial cancer had a negative impact on HRT’s reputation
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1988
FDA approved HRT for prevention of osteoporosis
(previously prescribed only for the treatment of hot flashes)
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Healthy Forever
A number of observational studies suggested that HRT has
various benefits in the treatment of menopausal symptoms,
and for the prevention of chronic diseases
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1993 - 1994
Heart and Estrogen/Progestin Replacement Study (HERS)
This study found no overall effect of 4.1 years of therapy
with estrogen plus progestin for secondary prevention
of coronary heart disease in postmenopausal women
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1994
Study of Women’s Health Across the Nation (SWAN)
A multi-center, multi-ethnic longitudinal study of the menopausal transition and to observe effects on subsequent health and risk factors for age-related diseases (fractures, depression, subclinical cardiovascular disease, cardiovascular events and physical and cognitive function)
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1996
Million Women Study
Associated HRT with an increased risk of breast cancer
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2002
Women’s Health Initiative (WHI)
Studied the effects of HRT started a
decade or more after menopause
***
THE USE OF HORMONE REPLACEMENT THERAPY PLUMMETS
DUE TO FEAR OF BREAST CANCER AND HEART ATTACKS
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2012
Danish study
Concludes that women treated with long-term HRT early after menopause
“had significantly reduced risk of mortality, heart failure, or
myocardial infarction (heart attack), without any apparent increase of
cancer, venous thromboembolism (DVT) or stroke.
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2021
The North American Menopause Society
“Hormone therapy is an acceptable option for the relatively young (up to age 59 or within 10 years of menopause) and healthy women who are bothered by moderate to severe menopausal symptoms.”
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In the U.S. it's commonplace for physicians to stop talking
to women about sexual wellness after menopause
Women's health and wellness includes sexual health (whether you're sexually active or not), perimenopause, menopause, and post-menopause. Your physician should be initiating the conversations that need to take place around these topics. If you are a woman with a doctor who does not understand or pay attention to the health and wellness issues that are unique to females, it's time to look for a new doctor.
stay informed
stay proactive
stay healthy
Sources:
The Conversation, World Menopause Day: how cultural representations of ‘the change’ are empowering women, Katy Shaw, Professor of Contemporary Writings, Northumbria University, Newcastle, October 14, 2020
The New York Times, Why Is Perimenopause Still Such a Mystery?, Jessica Grose, April 30, 2021
Doctor’s Review, Mad With Menopause, Jackie Rosenhek, February 2014
US National Library of Medicine – National Institute of Health, The Controversial History of Hormone Replacement Therapy, Angelo Cagnacci & Martina Venier, September 2019
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