Menorrhagia and menopause: a historical review

Excessive premenopausal uterine bleeding, whether an exaggeration of catamenial loss or more severe haemorrhage, has until lately been part of traditional climacteric symptomatology, yet it is no longer so. This, and a parallel article, attempt to find out the reasons for the lapse of this symptom. The present paper concentrates on the literature of the 18-19th century, generously quoting selected sources, in an effort to define the context in which this symptom became so prominent, the explanations offered by and the approach of contemporaries to it. The Classical ideas concerning the menses and their cessation, briefly outlined, were challenged during the 18th century by a few individuals who attempted to ascertain the facts for themselves and establish what was the actual course of nature. They were helped in this by the presence of differing cultural subgroups with completely different climacteric experiences. The conviction then arose that medications given upper class women were iatrogenically responsible for the complications they experienced. When menorrhagia continued the lifestyle of these ladies was blamed. Despite all corrections, however, menorrhagia persisted. This review then examines, with varying detail, some of the writings of these two centuries, offering some glimpses into a literature otherwise not easily accessible.