The Mad,Mad Menopause!!

Having had a full Hysterectomy at the age of 42 this article was quite amusing and so true in parts... Anyone going through the menopause will agree i'm sure



The mad, mad menopause: LOUISE FOXCROFT charts its fascinating, and sometimes gruesome, history...

Hot flushes, forgetfulness, tiredness - they are familiar symptoms for women of a certain age. But while many may believe they're going through a hard time, it's nothing compared with what our predecessors experienced.
The acclaimed physician Edward Tilt was the doctor of choice for Victorian women suffering from gynaecological problems. So it was to his consulting rooms that Mary, a 45-year- old mother struggling with depression, hot flushes and sleeplessness, came for help.
She was married to a publican and had several children. Mary, Dr Tilt recorded in his notes, was 'a tall athletic woman, with a pale face, iron-grey hair, a whimpering voice and apparently always ready to cry'.
Menopause: Just decades ago, 'the Change' was seen as a sign of lunacy
The year was 1855 and Tilt's diagnosis was swift. She was depressed with suicidal tendencies, he concluded, caused by ' cessation' - the menopause.
For the past few months, he recorded: 'She complains of being all atremble, sleepless at night, powerless all day ... she sits alone, doleful and disconsolate, ashamed of herself for being so lazy and still unable to do anything, or forgetful of what it is she ought to do . . . she is much afflicted with suicidal thoughts.'
Tilt prescribed his 'usual mixture before meals' of carbonated soda and various other remedies, including opium, a large bella-donna plaster to be placed at the pit of the stomach and vaginal injections with a solution of acetate of lead.


Further prescriptions included opium, hydochlorate of morphine, chloric ether and distilled water.

Tilt wrote, tellingly, a few months later: 'She has continued in good health, although she has left off the medicines.'

But while the potions Tilt's patients had to endure may seem bizarre, they were nothing compared with what some women went through.

Since the time of the Ancient Greeks, the menopause has been considered shaming.

Unitil the 18th century, it was seen as a natural phenomenon; but over the next 300 years it began to be viewed as a disease, leading to bizarre treatments and extremely dangerous surgery.

The Victorians were deeply suspicious of women's reproductive health.

They thought there was a direct link between the womb and the brain which predisposed women to insanity, particularly during menopause.

The remedy, they concluded, was straightforward: such women should be locked up.

Menopausal women who displayed what was considered to be undue sexual excitement or interest were at best ridiculed and at worst subjected to surgery or a spell in the asylum, diagnosed as suffering with 'climacteric insanity'.

It was believed that the very nature of a woman's physical make-up predisposed her to insanity. Even women who were not mentally ill were likely to offer 'insane interpretations' of their menopausal symptoms, according to George Savage, writing in The Lancet in 1903.

Gruesome history: Louise Foxcroft has written a book about the menopause
The Victorians reasoned that a woman's ovaries were the seat of feminine essence and all that was virtuous in women sprang from them.

But, by the same token, should they become diseased, or - as in menopause - cease to function, then all hell could break loose.

It might be better, some thought, for a woman's troublesome ovaries to be removed: women might then become more biddable, cleaner in mind and body, and more industrious.

The surgical removal of the ovaries, or ovariotomy, was a simple operation, so it was used excessively in attempts to cure mental disorder, especially nymphomania and hysteria.

The term 'hysteria' comes from the Greek, hysterus, meaning womb, and in the 1850s Tilt had called it 'the keystone of mental pathology'.

Some menopausal women came to physicians suffering from 'pent-up sexual longings' which were, they said, much worse than mere pain.

'No sooner does night come on than I am prey to such dreadfully sinful desires that drive me mad,' said one.

Women were supposed only to want to be motherly, and the idea that they could wish to be sexual was terrifying.

The first removal of ovaries in Britain was performed in 1824 by John Lizars, an Edinburgh surgeon and lecturer in anatomy and physiology.

Though his patient survived, the next three did not. By 1855, out of 200 operations, 89 women had died.

Sir Spencer Wells managed to reduce mortality to 11 per cent over the next two decades, thanks to the introduction of anaesthesia in the late 1840s.

He maintained that he performed this surgery to relieve the suffering of women, but some of his colleagues believed the only people who benefited, financially and professionally, were the surgeons.

Isaac Baker Brown, a member of the Obstetrical Society of London, insisted insanity resulted from excessive desire and recommended clitoridectomy - surgical excision of the clitoris.

He claimed this would stop hysteria developing into spinal irritation and on to idiocy, mania and even death.

In 1866, he described the following case history: 'Mrs D was 57 and had four children, with two premature labours. The last child was born 23 years ago.

'For the past year, she has never slept for more than an hour; always waking with a start; feeling frantic and very hot and flushed. She has a constant feeling that she will be lost eternally and of this she is constantly speaking.'

The woman's husband told Baker Brown that she had begun to 'show symptoms of mental derangement' a year earlier and had attempted suicide by trying to jump from a window.

He had his wife confined in an asylum for four months, but she worsened and would wake in the night in a 'frenzy'.

On examination, Baker Brown found her healthy, though she would not 'look him straight in the face'.

On December 14, he performed his 'usual operation'. A week later, she was sleeping better, but 'will not own to being better' and complained of 'her skin being dry, and burning hot'.

Baker Brown begged to differ and, almost wilfully ignoring the hot flushes, recorded merely that 'at times she perspires freely'.

On Boxing Day, her husband and nurse considered her much better, but the patient persisted in being, in her doctor's opinion, 'sulky, saying she is bad, and shall soon die'.

Lawson Tait, an influential physician whose roles included surgeon to Birmingham Hospital for Women and a Fellow of the Obstetrical Societies of London, Dublin and Edinburgh, also considered that menopausal women were at real risk of mental derangement and incurable dementia.

The worst tendency, he said, was for menopausal women to abuse alcohol.

In Tait's opinion, the relief of nearly all menopausal symptoms could be achieved by the use of an occasional drastic purgative and 'removal from home at frequent intervals' - the asylum again.

Purity Movement writers took up the argument that the more badly behaved a woman had been in her youth, the worse affected she would be by the menopause.

The Ladies' Guide In Health And Disease: Girlhood, Maidenhood, Wifehood, Motherhood, published in 1883 by the American surgeon John Kellogg, preached that women who 'transgressed nature's laws' would find the menopause 'a veritable Pandora's box of ills, and may well look forward to it with apprehension and foreboding'.

By the end of the century, however, the idea was beginning to take hold that sex hormones might be involved. A Parisian midwife gave herself liquid made from pigs' ovaries - with beneficial effects.

The prolific British-born French physiologist and neurologist Charles-Edouard Brown-Sequard thought that the ovaries of animals would yield an extract that would help menopausal women.

Over the next 40 years, ovarian hormones were isolated, and as the workings of the endocrine system were revealed, so, too, came new knowledge and new ideas.

In her book, Change Of Life In Men And Women, published in 1936, the scientist and sexual pioneer Marie Stopes laid the blame for fear about the menopause squarely at the feet of the medical profession, which had, she said, emphasised a 'revolting, frightening, misleading and injurious state'.

A ward sister at one of the 'world's most famous hospitals' told Stopes that nearly every case of menopausal difficulty she saw admitted to the hospital was induced by the ghastly things women had read and been told about what was going to happen.

She felt that without this they would have passed through the change with little difficulty.

Stopes was inclined to give what she felt might be 'the most revolutionary' advice of all: not to worry, and to carry on as though nothing special was happening.

In fact, she was of the opinion that things really began to look up after the menopause because so many women had written to her about an increase in their sexual feelings.

One letter began: 'I am a widow with a grown-up family and, since losing my husband a few years ago, I so often have an active sexual feeling, and I wonder at my age (66) if it should be encouraged or repressed, or ... if you could prescribe anything to give me just a little satisfaction at such times...

'I have always thoroughly enjoyed my conjugal rights, but I should be glad to know if it is usual at my time of life to have such strong desires.'
In 1948, Dr Josephine Barnes gave a series of talks on radio about the health of older women.

Dame Josephine, born in 1912, was an obstetrician and gynaecologist, the first Fellow of the Royal College of Obstetricians and Gynaecologists to give birth, and the first woman president of the British Medical Association.

In her radio broadcasts, she discussed blood loss, ovaries, hormonal changes during the menopause and uterine cancers, and sent the head of the Home Service into a tail-spin.

'The inclusion of such a talk represents a lowering of broadcasting standards,' he said.

'It is acutely embarrassing to hear about hot flushes, diseases of the ovary and the possibility of womb removal transmitted . . . at two o'clock in the afternoon.'

But, happily for the Home Service's mostly female afternoon audience, menopausal thinking was proceeding apace.

The long-held idea that the menopause caused women to go mad was replaced with the notion that menopausal women's lost femininity might be restored by hormone treatment.

Menopausal women's bodies, wrote the U.S. gynaecologist Robert Wilson in 1966, were 'a galloping catastrophe' which only oestrogen could repair and make them 'much more pleasant to live with ...not dull and unattractive'.

It turns out that Wilson, according to the New York Times, was funded by the pharmaceutical firm Wyeth, who now claim not to know if Wilson ever worked for them, but whose profits from HRT took off over the next 30 years.

Wyeth placed an advert in the Journal of the American Medical Association in 1975 that claimed: 'Almost any tranquilliser might calm her down, but at her age oestrogen might be what she really needs.'

Adverts such as these provided a powerful push to the idea of the menopause as a disease, but one for which there was a cure. However, it came at a cost. Wilson's son said his mother, who had taken HRT, had died of breast cancer in 1988 after keeping her illness secret to protect her husband's reputation.

Even today, secrecy surrounds the menopause. The taboo remains: women are reluctant to discuss it and many men are embarrassed at the idea of it.

But if we are to really understand it and move on from the Victorians' view of it as something dark and insane, women have to speak up.

Their experiences have to be recorded, published and - not least - believed.
Extracted from Hot Flushes, Cold Science: A History Of The Modern Menopause by Louise Foxcroft (Granta, £14.99). To order a copy (P&P free), call 0845 155 0720.