BOOK: The French Invention of Menopause and the Medicalisation of Women’s Ageing: A History

The largest outcome of the ARC project: Sexual Ageing in the History of Medicine is the monograph by Alison M. Downham Moore, The French Invention of Menopause and the Medicalisation of Women’s Ageing: A History (Oxford: Oxford University Press, 2022). This book is fully OPEN ACCESS in its digital form for downloading as a FREE PDF, thanks to funding from the Australian Research Council. The hard-copy book is available for pre-purchase HERE.

This book is the first major study of the role of menopause in the history of French medicine, explaining why this concept of woman-specific crisis of ageing only began appearing at the end of the eighteenth century, attracting a massive French medical fascination from this time until the early 1930s. It shows how the French neologism la ménopause was the product of the Paris medical faculty in responding both to the symptoms reported by elite women as patients and to the challenge of demographers who first argued that because women were living longer than men, it was not appropriate for doctors worry about their end of menses. But menopause was also propelled by the vitalist commitments and the fascination with hygiene in the medical faculties of Paris and Montpellier in the first half of the nineteenth century, resulting in the idea that older women, despite their longevity, should both place themselves in the care of doctors and inscribe their lives in regimes of self-care and self-management. A continuous theme throughout the book is a consideration of how the integration of menopause into a hygienic pathologisation of women’s reproductive ageing continues to inform our current concepts.

One of the original features of this book is that it considers a relatively overlooked corpus of sources consisting of French medical theses, in which the authors were obliged, by virtue of the pedagogic nature of the genre, to explain how their understanding of their chosen topic reflected a modern scientific and revolutionary approach. Professors in several medical faculties (Paris, Montpellier, Strasbourg) appeared intent on inducting student doctors into a professional identity with the use of thesis topics focused on the scientific critique of women’s irrational fears of the “critical age” generally considered to begin around the age of 45. This form of critique helped to instantiate the authority and professional identity of doctors of women’s health in a competitive market where midwives (sages-femmes), empirics and other kinds of folk medicine practitioners (bonnes-femmes or commères) still vastly outnumbered biomedical doctors, and where the medical specializations of gynaecology, psychiatry and gerontology were being formed and contested. Despite its purported scientific neutrality, menopause, in its discursive elaboration, was the site of a dynamic alchemy between claims to modernity and novelty against the re-use and re-invention of medical tradition.

The book’s methods are grounded in the conceptual history of medicine, an approach that both traces intellectual genealogies through published works, and considers clinical practices, economic pressures and the effect of changing bodily life-ways on the development of medical ideas. It attends to how French medicine reflected wider global developments in the emergence of demography, ethnography, colonial commerce and the effects of industrialisation. However, it also considers internal conceptual continuities with the medical past. Past conceptual continuities were particularly significant in nineteenth-century French medicine on account of its high degree of historical self-consciousness. French doctors writing about menopause saw themselves both as novel innovators in the clinical expression of scientific principles, but also as inheritors of the ancient authorities, Galen and Hippocrates.