New book delves into the science, history and meaning of menopause

‘The Slow Moon Climbs' by Susan Mattern, Distinguished Research Professor of History, ponders the evolutionary benefit that renders women’s lives so valuable post-reproduction:

She opens her book with an extraordinary example: that of Hoelun, the mother of the notorious Genghis Khan. Hoelun accomplished far more than simply giving birth to the notorious emperor of the Mongol Empire. Khan has more than 35 million direct male-line descendants. After Hoelan stopped having children she was critical in keeping her brood safe, leading them in a mission of revenge, and helping to turn the Mongols into a people.

Mattern contends that menopause emerged when we evolved away from chimpanzees millions of years ago. “Longevity is what separates humans from chimpanzees and other apes,” explained the 53-year-old historian. On average, we live twice as long as chimpanzees. After menopause, women could care for their grandchildren, nieces and nephews.  They could forage and grow food, producing more than they consumed.  This idea is often called the Grandmother Hypothesis, a concept that emerged in the 1990s, wherein older women are favored by evolution because they enhance human survival.

Yet today, said Mattern, we don’t look kindly on menopause, seeing it primarily as a medical malady to be either stoically borne or treated with hormones, antidepressants and other medications. “That’s just fundamentally wrong,” she contended. “People see the word menopause in the title of my book and they assume it’s a depressing book when in fact it’s full of good news.”

Mattern reports that menopause wasn’t even a concept in the ancient Mediterranean cultures she has spent her professional life studying: those of Mesopotamia, Egypt, Israel, Greece and Rome. “Ancient physicians and writers didn’t write or talk about menopause,” she explained. “There wasn’t a word for it.”  In fact, one ancient Roman physician, Soranus, thought that menstruation, not menopause, was unhealthy for women and rendered them fragile.

It wasn’t until the 18th century that menopause became a mainstream concept. The term itself was coined by a French physician in 1821. It was also referred to as “women’s hell” and the “death of sex.” Sigmund Freud referred to menopausal women as “quarrelsome, vexatious and overbearing.” A 1966 best seller, “Feminine Forever,” called post-menopausal women “castrates.” By the 1920s the first hormones were synthesized in the laboratory, and by 1938 synthetic estrogen had been developed. Menopause was soon “infused with this idea of a deficit of estrogen,” said Mattern. It is still a medicalized “condition” today, although medical nuance has been added with large studies examining the risks and benefits of estrogen alone, or estrogen with progesterone, and even in some cases adding in a dollop of testosterone, all to “treat” menopause.

A wonderful new work full of fresh insights and perspective from a highly accomplished scholar, Mattern's book harnesses the intellectual power of multidisciplinary research with great writing. Congratulations on this important new work.