In many cases, it is not that the medical profession has been unaware of the menopause and its attendent impacts. It just seems that it is not taken seriously enough to warrent treatment and the neglect of thousands of womens' suffering seems willful.
For many Irish people, particularly Irish women, it will not be surprising to learn that indifference towards the menopause rather than ignorance of it has a long history in Ireland.
While browsing through the institutional sections of the online 1911 Census records of the National Archive, I noticed that many routine milestones in the reproductive life of a woman were cited as root causes of mental disease in some female patients diagnosed with illnesses such as "Mania", "Melancholia" and "Dementia".
The so-called Return of Idiots and Lunatics in Institutions (Form I) has some poignant entries, especially when one sees how long patients have suffered with their conditions.
It may be that the classification of mental patients into three narrow categories (Mania, Melancholia, or Dementia) was enforced by the Census rules rather than the prevailing medical system but the extra field provided for "Ascertained or presumed cause of insanity" provides more freedom for respondents.
For most patients no root cause is given for the diagnosis but for others this field includes Previous Attack, Hereditary/Congenital, Epilepsy, Diabetes, Head Injury, Drink, Intemperance, Disappointment in Love/Life, Grief, Puberty, Puerperium, Lactation, Sunstroke, Masturbation, Irregular/bad Living, Venereal Disease, Too much study, Religious excitement/fervour, and Excessive Tea Drinking.
What is remarkable, however, is how many of the underlying causes of insanity are simply biological milestones in the natural life of a woman; menstruation, childbirth, lactation, puerperium and menopause (or one of its synonymous terms "Change of Life", "Amenorrhea", "Climacteric").
While it is true that such events can be traumatic and trigger neuroses in certain individuals, the frequency in these records must be worth examination.
Some examples below come from St. Mary's Hospital, Shanakiel in Cork. Record 72 shows a 72-year-old woman who has been suffering from Mania for 27 years and 2 months due to "Change of Life"
(Row 73 shows a surprise case of Male menopause. Although, I suspect the diagnosis (for 72) was initially written in the wrong row.)Other synonyms for Menopause are listed in the following patient records:
- Patient 384 Change of Life
- Patient 515 Menopause
- Patient 613 Amenorrhea
- Patient 1044 Menopause
- Patient 1115 Change of Life
- Patient 1155/1158 Change of Life
- Patient 1173 Change of Life
The patients of the Portraine Lunatic Asylum show a broad social mix which includes a Protestant governess from Rathgar alongside "paupers" from Baldoyle, all suffering from the same "disease", menopause:
- Patient 21154 Climacteric
- Patient 24272 Climacteric
- Patient 23072 Climacterica
- Patient 22090 Climacteric
- Patient 16945 Menopause
- Patient 13502 Change of Life
But with the current "discovery" of the stresses and torment some women can suffer with this transition, it is illustrative to see how such symptoms left untreated in the past lead to women being diagnosed as mentally ill and incarcerated long-term in Asylums run with brutal regimes..
Links to Institutions (in Census 1911)
Armagh
Antrim
- Holy Well, Co. Antrim
- St. Anne's, Falls Road, Belfast
- St. George's Hospital, Lisburn Road, Belfast
- St. George's Hospital, Lisburn Road, Belfast
Carlow
Clare
Cork
- Skahabeg House, Blackrock, Cork
- St. Mary's Hospital, Shanakiel, Cork
- Youghal Lands, Youghal, Co. Cork
Derry
Donegal
Down
Dublin
- Bloomfield Private Asylum, Donnybrook
- Portraine Demesne, Donabate
- Richmond Women's Asylum, Grangegorman
- St. Patrick's Hospital, Usher's Quay