Questioning Menopause Part One

Originally published Oct. 31, 2019

PART ONE: INTRODUCTION

“What do the Chinese classics have to say about menopause?”

I am a lecturer, writer and translator in the field of what I like to call traditional Chinese gynecology, with a small “t,”, in contrast to TCM Gynecology, to signify that my research is focused on the historical version of Chinese medicine and not on its Westernized, scientized and biomedicalized and sanitized contemporary offspring. In this capacity, I get asked frequently about menopause in the Chinese classics, and never have had a good quick answer. It shouldn’t be such a difficult question, but for a number of interesting reasons it is. And hopefully you will agree with me, after you have taken the time to read to the end of this article, that it is worth digging a little deeper, to learn more about this significant transformation in the female body both in the traditional Chinese context and in our own. I hope that my ruminations on this question might carry some meaning for those of us who support women through this change, which means most of us. So I am finally taking the time to straighten out my thoughts here. If you are only interested in the traditional Chinese attitude, skip straight to Part Two. As always, I look forward to your comments, whether in private or in public!

THE CULTURAL CONTEXT FOR “PAUSING THE MOON”

Being a woman in my early fifties, I have a lot of opportunities to explore this topic both personally and in conversations with my friends, colleagues, and students. Like probably most women my age, I have mixed feelings about this multi-year transformation that I am in the middle of experiencing, feeling my body slowly transitioning from one of material fertility to one that exudes a different form of creativity.

I have always loved and whole-heartedly embraced my identity as a mother, gifted as I am with a most incredible daughter, and I adore kids (yes, human and goats) of all ages. I do love being “domestic” and “maternal.” At the same time, I was raised and live in a culture that values youth over old age, productivity over receptivity, expansion over contraction, activity over stillness, and ultimately Yang over Yin, if we look at it in Chinese medicine terms. From this perspective, the loss of this potential, the cessation of material productivity, causes some sadness in most women I know, whether we ever wanted to bear children or not. Of course, I also know that at my age I would be hard pressed to find the energy to bear and breastfeed and raise more children, and I gratefully embrace my quiet predictable life of writing rather than changing diapers. But what does the cessation of monthly female bleeding mean besides the loss of our ability to produce babies?

Any exploration of our attitudes towards the cessation of menstruation obviously has to start with our attitudes towards menstruation. Our dominant modern culture, especially in the United States of America, tends to treat menstruation as a burden, an inconvenience, a shameful and weakening female process that must remain hidden and disguised from the male gaze at all costs. Thus we have tampons to plug things up, advertisements of young ladies frolicking in flowing white dresses or tennis shorts, and also the biomedical and popular practice of treating menstrual problems with medications to suppress menstruation altogether. Related to this, the delay of menarche or, on the other end of the reproductive cycle, the premature cessation of menstruation in female athletes, or any other absence of periodic bleeding in women due to physical or mental exhaustion, inadequate diet or nutrition, or other causes, is mostly not viewed as an important warning sign of a pathology in need of treatment, but as a welcome respite from “female trouble” or “The Curse.” In this light, the age-related physiological changes that gradually cause the female body to stop bleeding every month are welcomed and sometimes even intentionally induced with medication by many of my girlfriends, especially those involved in serious athletic pursuits or just leading very busy lives. Historically, Western attitudes towards menstruation, in popular, scientific, medical, and religious contexts, were surprisingly complex: For many, it was yet another sign of women’s weakness and pollution, as “Eve’s curse,” which justified and demonstrated the view of the female body as a pathological, weaker, and unstable deviation from the perfect male body. Based on women’s affinity with moistness, lethargy, and pollution, the monthly bleeding was seen as a necessary catharsis to eliminate noxious substances that had accumulated over the month. Recognizing the connection between monthly bleeding and female fertility, however, other texts saw it as an elimination of excess blood and fluids, when these were not used to nourish the fetus in pregnancy or the baby through breastmilk, and it was therefore a process that might also, if rarely, occur in over-weight men with lives of excessive inactivity. Quoting a text from 1855, Julie-Marie Strange summarizes the view of British medical texts from this period:

Along with puberty, pregnancy, childbirth, and the menopause, menstruation represented a ‘sexual crisis’, that is, a period of genital and reproductive excitement which intensified the inherent instability of the ‘feminine’ body. Puberty and menopause were referred to respectively as the ‘advent’ and ‘decline’ of femininity, thus rooting womanhood firmly in relation to fertility…Notably, the menopausal woman was compared to ‘those animals who die when once they have transmitted life to others’.(Strange, “I Believe It To Be a Case Depending on Menstruation’: Madness and Menstrual Taboo in British Medical Practice, c. 1840-1930,” in Andrew Shail and Gillian Howie eds., Menstruation: A Cultural History, Palgrave 2005)

Thankfully, my personal views on menstruation and menopause are also, and perhaps more heavily, influenced by my knowledge of traditional Chinese medicine and therefore lecture and write passionately about the medical, cultural, and social importance of valuing women’s regular, abundant, free-flowing monthly bleeding as a powerful symbol of physical abundance, creative potential (both physical and spiritual), lack of stagnation, attunement to cosmic cycles, and balance of yin and yang and qi and blood. From this angle, the disappearance of the monthly flow marks a loss, a change that is the physical manifestation of other, deeper and more hidden physiological changes in the body related to aging and a decline in physical strength.

Before delving more deeply into the Chinese material , let us look at language: Both in Chinese and English, language relates women’s monthly bleeding cycle to the moon, as 月經 yuèjīng in Chinese and as “menstruation” in English, which is derived from the Latin word “mensis,” meaning “moon” or “month” (for more on the relationship between female bleeding and the moon, see my book “Channeling the Moon” and my rumination on “Menstruation and the Moon” on my ImperialTutor.com blog). In this context and without taking the argument too far, what attitude might be expressed in the English term “menopause”?

Obviously, the moon is not an object that ever stops in its cycles, so the implications of the English word "menopause” do sound awfully foreboding and drastic, at least to my moon-loving ears. First off, while derived from Latin roots for “moon/month” and “pause/stop,” this is not an ancient term, the Merriam-Webster dictionary informs us, but a creation that first appeared in Latin medical literature in 1686 and entered the English and other Western languages from the late nineteenth century on. “Pausing the moon” may be a poetic interpretation, but “cessation of the monthlies” is a more accurate representation of the meaning of the term intended by its inventors.

Our modern biomedical and popular attitudes toward this significant transition in a woman’s life become even more interesting when we compare it to the older term “climacteric,” which is a non-gendered word defined in the same dictionary as a “major turning point or critical stage” and specifically as menopause AND andropause! Note the absence of any negative connotations nor limitation to specifically female bodies! One could even argue that “climacteric” sounds like the person has reached their climax, the apex of their development, like the summit of the mountain on a summer hike where a gradual (and perhaps even arduous) ascent is now, after a leisurely cup of tea to enjoy the view from the plateau on top, followed by an equally gradual (but nice and easy) descent that eventually returns us to the baseline from which we started. Incidentally, the innocuous-sounding German term “Wechseljahre” (lit., “years of change”) does not carry a female-specific meaning either and also does not sound like the drastic and unnatural stop of the lunar or monthly cycles implied by the English and biomedical Latin “menopause,” that has now been adopted worldwide along with its related medical views and practices.

In regards to a potential Chinese translation for “menopause,” the only thing to note here is that this term actually has no equivalent in traditional Chinese medical (or other) texts! The closest equivalent is the concept of “a menstrual period that fails to flow through” (月經不通) or similar expressions of blockage and lack of flow/penetration. Nevertheless, these phrases refer to pathological conditions of stopped menstruation, or in other words, the equivalent of the biomedical condition of amenorrhea (derived from Greek and literally meaning “absence of monthly/lunar flow”). These terms obviously refer to conditions that can occur at any point in a healthy adult woman’s life and carry no connotation of aging. In other words, no traditional Chinese term exists to even express the concept of “menopause”! Wrap your head around that fact for a moment, while I am working on the next installment of this story. Stay tuned though, please, because this is not the end, and there is much more to be said!