Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
16. The History of Menopause with Dr. Renée Sentilles
59 Plays9 months ago
September is Perimenopause Awareness Month! And we are diving into all things perimenopause and menopause.
A Brief History of Menopause in the 20th Century:
Early 20th Century: With advancements in endocrinology, menopause was recognized as a hormonal shift due to declining levels of estrogen. In the 1930s and 40s, estrogen replacement therapy began to be explored as a treatment for menopausal symptoms.
1960s and 1970s: The development of hormone replacement therapy (now called Menopausal Hormone Therapy or MHT) marked a significant change in how menopause was managed. Physicians began prescribing estrogen (and later, progesterone) to treat symptoms like hot flashes and to prevent conditions like osteoporosis.
Feminist Movements: The 1960s-70s women's health movements challenged the medicalization of menopause, encouraging more holistic and natural approaches. Feminists highlighted that menopause was not a disease but a natural phase of life.
In this episode, Dr. Renée Sentilles joins me to discuss the History of Menopause. Dr. Renée Sentilles is Henry Eldridge Bourne Professor of History at Case Western Reserve University, where she has been teaching since 2000. She is the author of two books and various articles, and is currently working on a new book, “In Her Shoes: Getting to the Sole of 20 th Century American Women’s History,” which uses historic shoes engage readers in women’s history.
Follow us on social media:
- Instagram: @drrpope
- TikTok: @vulvadoctor
- Twitter: @drrpope
Want more from Our Womanity?
If you enjoyed this episode of Our Womanity, please subscribe, rate, and leave a review. Your feedback helps us continue to bring you engaging and empowering content.
Recommended
Transcript
Introduction to Dr. Renee Sinteels and Women's Health History
00:00:00
Speaker
Hello, everybody, and welcome back to Arbo Manatee. I have Dr. Renee Sinteels with us again today. She's our local women's historian. She is the Henry Eldridge Bourne Professor of History at Case Western Reserve University, where she's been teaching since 2000. She's the author of two books and various articles and is currently working on another book in her shoes, Getting to the Soul of 20th Century American Women's History. So excited to read that when that comes out and so happy to have her here with us again to talk about historical context of women's health issues.
Historical Context of Menopause and Women's Lifespan
00:00:33
Speaker
And today we are talking about the history of menopause. So welcome Dr. Sentials and thanks for being here again. So take us through with the history of menopause. This is something that I just find really interesting to think about how women have dealt with menopause through the years, how people have thought about it. Well, it's fascinating because
00:00:52
Speaker
Now, women are living half their lives in menopause, or at least a third of their lives in menopause. yeah And one of the things that we realize when we look at menopause as a historical subject is that that really wasn't true for most women. Most women were dying in childbirth really until the 19th century. I shouldn't say most women. If you survive childbirth and get to menopause, good for you. It's not as frequent as it happens now. And then once women hit menopause, they often don't live that many years beyond. And so menopause is a short experience for women, I would say, until the 20th century, really, until you really have a drop in birth rates, which happens by the end of the 19th century.
Impact of 20th Century Contraceptives on Women's Health
00:01:34
Speaker
We go from a woman as an average of seven live births beginning of the 19th century to basically three and a half. And then of course it drops precipitously up to the present. So that changes. So the way we think about menopause has changed. yeah Yeah, because more people are experiencing it now. So basically, if you survived having your seventh child, and maybe from being kind of postpartum to perimenopausal, and then we know what it's like to raise those children, it's not that much time do you think about what you're experiencing or know whether the sleep deprivation is coming from a medical reason or because you have seven kids waking you up through the night, right? And you raise another point which is what's also interesting is so women live to an average of 50 age 55 at the end and I'm talking about white women it's it's a lower number for women of color by the end of the 19th century. That's accounting for that's an average. So that means there are a lot of children who are dying before age five. So there are some women who have quite a bit older than that. But that's about the average age for white women at the end of the 19th century. It's
Menopause as a Historical Disease or Natural Process?
00:02:40
Speaker
much higher now. But what has also changed is the introduction of contraceptive methods that actually work. really starting with the diaphragm 1920s, 30s condoms, and then moving all the way up to the birth control pill in 1960 means that women also have a different relationship to their bodies. And so you get a developing idea among women that biology is not destiny in the same way women would have seen it before. yeah And so there's also a different way of looking at menopause. I mean, that plays into that as well.
00:03:13
Speaker
Okay, so I guess you're saying once they had access to contraception, then they're having fewer children and honestly living longer. That's all kind of happening simultaneously, right? What have you found is kind of the earliest experiences of menopause or how menopause was viewed during that time when people are living longer?
00:03:32
Speaker
Okay, so if you look at menopause now, what you see in feminist writing is a lot of oral histories of women and interviews with women to see how they feel about menopause. And a lot of women are saying, it's great, I stopped worrying about things. And then there are other women who say, oh my God, the hot flashes were debilitating the mind fog.
00:03:50
Speaker
So you're getting a wide range of opinions about menopause. Menopause is also being currently in some ways made a subset of aging. So there's aging and then there's reproductive aging. And so women can go through reproductive aging. That doesn't mean that they've actually become elderly. And so among women themselves, they're talking about this. There's a sense that now we have all of these senses of how women are going through menopause. I can't tell you.
00:04:20
Speaker
how women were experiencing menopause in earlier periods because nobody was really doing that kind of work. Carol Smith Rosenberg, who I mentioned before, who is a great women's historian, has an article on menopause in the 19th century, but she goes to practitioners because doctors are, and medical men and women, yeah are very concerned with female reproduction, all of it. Menstruation, monarchy, loss of fertility, and they really see menopause as a disease.
00:04:50
Speaker
a female disease that ends the fertile life of a woman.
Modern Views on Menopause and Longevity Debates
00:04:54
Speaker
And they don't. And especially natural life of a woman in a way, if you're saying that they're like, not reproduction, then if the reproduction time ends, then it's like their life is over as well. And what's sad about this is we just talked about longevity. In some ways they're right because women's lives are ending.
00:05:10
Speaker
not long after menopause. So it's a very different picture that we see now. So now we're getting this, there was just this article in the New York Times that was, the title was, is delaying menopause the key to longevity? And so they're talking about finding ways to delay menopause. And in fact, the White House with Jill Biden has has put menopause dead center as one of the things that they're most interested in. And so there's a wonderful quote in this article,
00:05:36
Speaker
Renee Wegrenzen of the Advanced Research Projects on Aging says, ovaries are the only organ that we just accept will fail. Why is that? The readers of the article were outraged. All of these people wrote in and they're like,
00:05:51
Speaker
fail. It's not that the organ fails. It's that it's a naturally occurring process. And why do we assume that that they have to continue in the path that they've been on? And that kind of gets at where things are right now. Basically, should medicine intervene?
Hormone Treatments and Societal Pressures
00:06:08
Speaker
Or are we pathologizing a natural shift in women? So interesting. Yeah, it probably would just depend on what your experience is. Like you said, some women um even years ago would say, oh, it's wonderful. I don't have to worry about periods or getting pregnant.
00:06:22
Speaker
And some women are saying I'm miserable. I you know have all these symptoms like insomnia, hot flashes, a sexual desire changes, vaginal vulvar changes. So depending on your experience, I could see it becoming pathology you know from my medical perspective.
00:06:38
Speaker
compared to a natural process that if you don't need that much, then you don't need much intervention, right? But if you're miserable, then you're going to be looking for help somewhere. Maybe that's part of the issue is that there's such a wide variety of experience of menopause, at least now in this day and age. Oh, no, I think there always was, but I also find this really fascinating. And of course, this gets to a lot of things in feminism, but the focus on menopause, which in many ways is welcome to a lot of people because autoimmune diseases go up with menopause, all kinds of other health issues come up after menopause.
00:07:11
Speaker
and we need more attention to women's health. When you read the studies, they make these arguments that virtually every aspect of a woman's health is tied to her ovaries, which gets us back to this like concept that we want to get rid of, which is that women are built around the womb. The whole focus on menopause in a way, even just the language around it gets us where this incredible paradox Yeah, that is so interesting. And earlier in time, I mean, I don't know the exact dates, I'd have to look it up. umm There were these books and these thoughts of, you know, keeping women youthful and sexual with estrogen as soon as they go into menopause. So there was a time when, you know, many, many, I don't know if I can say most, but many women were automatically prescribed estrogen in order to preserve their femininity.
00:08:02
Speaker
for their husbands, right? That was kind of this idea. Am I right about that? That was 1990s, 1980s? Yeah, I'm trying to remember the book. I might have to pull up. That's okay. I think it's actually really interesting because the comments to that article, this comes up again. People are like, oh, people being on those hormone supplements just to remain youthful. And so one of the things about delaying menopause that they're on now is So not just adding estrogen, but actually doing something to the ovaries to keep them from aging. Right. I've heard about actually removing sections of the ovaries and freezing them and so that they could be used when a person goes through menopause to be re implanted. So you have this like own autologous hormone producing
00:08:48
Speaker
So then the question is, are women allowed to age? I mean, if menopause is something that naturally occurs and women are living long beyond menopause, or and of course, there's that which we know is somewhat true, which is women become invisible with menopause and after menopause.
Cultural Implications of Menopause: Ageism and Invisibility
00:09:04
Speaker
They become invisible to doctors as well as becoming invisible on the street. So is it a matter of for women to be visible, do they have to look like they look during their fertile years?
00:09:15
Speaker
yeah is it Yeah, there's a whole age is um sort of framework around that. And definitely for our North American culture, I would say we are, we're pretty ageist, unfortunately, right? We value youth and and the looks of youth. Yeah. And that's so interesting because I haven't really thought of it this way because I spend my days trying to reassure women who are going through menopause, having serious symptoms, really disrupting symptoms that it's okay to use hormones.
00:09:44
Speaker
Because from the women's health initiative in 2002 that came out to kind of scare everybody off of of hormones, I feel like I'm doing so much work in trying to tell people, look, if you are medically eligible, if you are having symptoms that are disrupting your quality of life,
00:10:01
Speaker
do not be afraid. You've been on the birth control bill for years and years. This is, you know, potentially safer depending on your medical background. And so I myself, I can say, have this idea that it's almost a pathology because I see people who are really having symptoms and have been told by the media that estrogen is dangerous. And so I feel like maybe I overcompensate in that area of trying to convince people that it's actually safe for many people and you can't use it. I don't think you're overcompensating because you're talking to people who are miserable, who the estrogen will help. And that message did get out. And I have to say, it having had lots of friends who have gotten onto estrogen, it's like a wonder drug for some people. and So I mean, you're helping people by doing that. These are people coming to you and in misery. Right. like The message is that there are a lot of other women out there who apparently are not miserable. I would love to know, is that is that that true?
00:10:55
Speaker
And then the question of how much of the misery is caused by social dynamics. So how much of it is you know the belief that this is the end of your life. That's the message that's given by society right and that you prolong that life if you just do this. So I mean, one of the things I think we tend to think of biology as more cut and dried and cultural stuffs as more gray. And I think what we'll find is a lot of times biology will change whereas culture will be the entrenched one that doesn't change as easily. So even if we discover there's a way to help women through this change in life without pathologizing it, it doesn't mean society isn't still going to pathologize
Future of Women's Health Research and Cultural Awareness
00:11:38
Speaker
it.
00:11:38
Speaker
Yeah, that's a really good point. Do you think things are changing? I mean, I see women demanding more treatment. You mentioned Jill Biden putting out research initiatives and funding for this. Do you think that things will change you know from here into the future?
00:11:55
Speaker
I mean, so much of what we study about history can tell us about the future in a way. Someone once told me that historians are optimists because we study the past with the hopes that we're going to pull out and go to a better future, I think. And so I, of course, am totally optimistic because things have been building. There's been more funding going into women's medicine and women's health. certainly way more than before. And again, it gets caught in this strange paradox, which is recognizing that women have different physical issues also runs against this idea that men and women are mostly the same. And so, you know, how do we address women's health issues and not strengthen this idea that somehow women are more fragile or more prone to disease? I mean, I think one way would be to say, well, let's look at what's going on menopausely with men.
00:12:45
Speaker
I mean, because I actually think that's fairly, I can't say it's understudied because that might be kind of folded into some of the, you know, Viagra and all of these efforts. yeah But that is an under acknowledged change, I think. So you mean like their midlife and beyond or like what's happening with men? like there's a tend I mean, I think men and women both go through changes in midlife. And right there's a tendency to see women's changes as purely biological and not as much with men. But I think there's biology at work there too.
00:13:14
Speaker
So maybe the issue is not to say that women are so different, but to want more attention on women's health. I do. But without it becoming women in this whole different category yet again.
Conclusion and Reflection on Historical Context
00:13:23
Speaker
Does that make sense? It does. Yeah. No, that's so interesting. And it seems like we have a lot of catching up to do with women's health research in general. And maybe if we get to that point, which I have taken your optimism here.
00:13:35
Speaker
if we get to that point where we catch up, then we will just be looking at aging, right? Like then we won't have to be looking through this lens of like a vulnerable population because it hasn't been studied or because it's been neglected. That's a great point. I guess what I would also say is that we know from history that we have to hold contradictions together in one hand, that we don't have to have this or that. So we'll probably get to the future where we have a better understanding of women and menopause and we're still struggling with We're struggling with our past. Our past always is informing our present. That's how interesting. Well, I really, that's why I love having you on and I appreciate your time again because just having this historical context I think helps us to understand what's happening now and I would love to see that applied across everything just so we can revisit what has happened, how we got here, I think helps us to make better decisions for today and helps us not to repeat things that went forward. We hope so.
00:14:33
Speaker
Thank you so much for your time. Thank you. I appreciate it. I'm sure we'll have you back again. Thank you so much, Rachel. It's a pleasure to be here.