The Slow Moon Climbs: The Science, History, and Meaning of Menopause

by Susan P. Mattern

The first comprehensive look at menopause from prehistory to today



Are the ways we look at menopause all wrong? Historian Susan Mattern says yes, and The Slow Moon Climbs reveals just how wrong we have been. Taking readers from the rainforests of Paraguay to the streets of Tokyo, Mattern draws on historical, scientific, and cultural research to reveal how our perceptions of menopause developed from prehistory to today. For most of human history, people had no word for menopause and did not view it as a medical condition. Rather, in traditional foraging and agrarian societies, it was a transition to another important life stage. This book, then, introduces new ways of understanding life beyond fertility.

Mattern examines the fascinating Grandmother Hypothesis--which argues for the importance of elders in the rearing of future generations--as well as other evolutionary theories that have generated surprising insights about menopause and the place of older people in society. She looks at agricultural communities where households relied on postreproductive women for the family's survival. And she explores the emergence of menopause as a medical condition in the Western world. It was only around 1700 that people began to see menopause as a dangerous pathological disorder linked to upsetting symptoms that rendered women weak and vulnerable. Mattern argues that menopause was another syndrome, like hysterical suffocation or melancholia, that emerged or reemerged in early modern Europe in tandem with the rise of a professional medical class.

The Slow Moon Climbs casts menopause, at last, in the positive light it deserves--not only as an essential life stage, but also as a key factor in the history of human flourishing.

Genres: Nonfiction, Science, Feminism, Health, Womens, History, Medicine

480 pages, Hardcover

First published October 8, 2019

About the author

Susan P. Mattern is a Professor of History at the University of Georgia in Athens, Georgia. She earned her PhD in History at Yale University, 1995.

Her most recent book is "The Prince of Medicine: Galen in the Roman Empire" (Oxford University Press 2013). It is a social-historical biography of the ancient physician Galen, a cultural icon whose works were the basis of western medicine until the Renaissance. She has also written "Galen and the Rhetoric of Healing" (Johns Hopkins University Press, 2008), an analysis of Galen's stories about his patients and a study of his medical practice; and "Rome and the Enemy: Imperial Strategy in the Principate" (University of California, 1999).

She has co-written a textbook, "The Ancient Mediterranean World from the Stone Age to A.D. 600" (Oxford University Press, 2004). After a year of professional development studying social and psychology and transcultural psychiatry, she has begun publishing articles on mental disorders in antiquity. She is also working on a global history of menopause. She teaches graduate and undergraduate classes in  World History and in the history of Greece, Rome, ancient Egypt, marriage, disease, medicine, women, and law at the University of Georgia. 

Reviews

[Lara · Rating 5 out of 5]

I loved everything about this book including the rather dense first section about our paleolithic prehistory. The final section about the history of modern medicine and menopause as a "cultural syndrome" is mind-blowing.

As a nearly-menopausal woman myself, I must say that I feel quite a lot better about it after reading this book.

[Jessica · Rating 4 out of 5]

Written by a historian, I very much enjoyed this exploration of how menopause likely evolved in our species (just us, orcas, and elephants) and how menopause has been experienced across the ages and around the world; what are generally experienced as menopause symptoms in the West is not necessarily how women elsewhere and elsewhen have experienced it. The author takes pains to explain however that this does not mean menopause symptoms are imagined or "all in your head," but that how they are experienced may be influenced by our cultural expectations and how other health symptoms can dovetail with or feed back upon these symptoms, causing a big ol' mess of unknowns. I knocked one star off because I found the second section of the book longer than it needed to be, but the first and third sections were fascinating, and I underlined practically whole pages in the epilogue. Recommended for anyone wanting context for something half of the population will experience, beyond "expect some hot flashes."

[Minna · Rating 4 out of 5]

A fresh take on the long post-reproductive lives in women. Surprisingly Menopause is a rare trait; the vast majority of animals reproduce into old age and die quickly thereafter. Although some whales share this oddity with humans. Turns out menopause is useful and adaptive. Matterns challenges the centrality of hunting and men to the story of human evolution, presenting the plausible Grandmother Hypothesis among others.

Unfortunately this book is overlong with the inclusion of summaries on what feels like every field study available on the topic. These studies mostly have conflicting outcomes, and are often clearly biased, and sometimes seem anecdotal. The more studies Mattern shares, the less reliable they all seem. It makes me question the whole field of anthropology. Was that the point? Put all that stuff in the footnotes next time please!

That aside, Mattern’s ideas feels right. She covers how menopause came to be seen as a disease needing treatment instead of a developmental transition to an important stage in life. She talks about how non western cultures view menopause (as a relief) and how it became a cultural syndrome in the west.

Mattern states:
I have become increasingly impatient with how it is talked about in my society and how this talk unnecessarily demeans a transition and a stage of life that are, by any measure, useful and honorable. We become nonreproductive so we can do other things.

[Eva · Rating 2 out of 5]

Sometimes this book would wander in a direction that would feel off topic or deliver a degree of detail above what was necessary. I'm not sure if it was because this was directed at lay people or just trying to lay groundwork. I just didn't want to hear about Athenian law or Chinese literature for longer than absolutely required in a book about menopause.

[kuusela harry-pekka · Rating 4 out of 5]

A lot of interesting history and statistics (a bit too heavily maybe?) not only on menopause but on family dynamics and human civilisation. For me as a doctor the main takeway interest was the discussion about the relevance of cultural syndromes. The book changed my opinion of ”women should rule the world” into ”mature women should rule the world.”

[Dolors · Rating 4 out of 5]

Interesantíssima aproximació a la menopausa. Des del punt de vista evolutiu - perquè la nostra espècie desenvolupa un període no reproductiu tan ampli -, i des del punt de vista cultural - com es viu i s'entén en diferents cultures i èpoques.

No és un llibre de lectura ràpida. La recerca és força exhaustiva, per tal d'acumular arguments per defensar la seva hipòtesi. Entre altres fets significatius, comenta per exemple que hi ha cultures que no tenen un equivalent per al concepte occidental de menopausa. Una de les informacions que més m'ha impressionat de la recerca.

L'autora planteja la hipòtesi que la menopausa es vol entendre com un síndrome cultural "in the Western World". En defensa la necessitat i el valor, i defensa que l'evolució humana es basa en gran part en aquesta etapa no reproductiva i en els beneficis que les dones de mitjana edat aporten a la Societat.


En parlar dels síndromes culturals, fa un paral.lelisme amb un síndrome cultural coreà anomenat Hwa-byung, que afecta principalment a dones a partir dels 40 anys i baixa educació i nivell socioeconòmic, la descripció del qual m'ha recordat la - dura, però en la meva opinió, molt recomanable - novel.la "La vegetariana" de Han Kang.

[Ellen · Rating 5 out of 5]

The Slow Moon Climbs: The Science, History, and Meaning of Menopause by Susan P. Mattern is a fascinating book from beginning to end. The scope went far beyond menopause, or, at least, led me to think about far more. Parts of the science and history taxed my layman's brain, but I didn't focus on that. I learned what I could, revisited some areas, and accepted that I am not a researcher or historian while moving on. Mattern's ideas about cultural implications are eye-opening, and I hope they spur changes in and the focus of research, as well as notions in the general population that do not advance understanding.
Mattern gives excellent arguments questioning long-accepted ideas of evolution and providing a different perspective.
I think Mattern's ideas about menopause are valuable. I highly recommend reading this and hope that it reaches a larger audience than may be expected with the word menopause being in the title.

[Kristin Butler · Rating 3 out of 5]

Interesting historical perspective and long winded approach to a final hypothesis that menopause is both an adaptive human condition and potentially a cultural “syndrome” (e.g maybe we’re only having hot flashes because the collective unconscious believes that’s what is supposed to happen when we stop bleeding.)

If you are one to medicalize menopause, buy into stereotypes and resist the aging process, you may have a radical epiphany.

If you are less melodramatic about aging, maybe not.

Also, I was hoping for more myth and speculation about the dawning of the Age of Aquarius.

Rising of the Divine Feminine. Gaia. New age of super consciousness.

Alas, less poetry. More super in depth obsessively historical and anthropological research.

I learned a lot. Just not sure I learned a lot about menopause.

[Amanda · Rating 1 out of 5]

i'm disappointed by this book. it wasn't what i was expecting. it's so dense with numbers that i found it boring to read. i abandoned it. i think the information presented would work well in a reference book. it is much too academic to be read with any kind of attention for this perimenopausal mind. put all the info in an alphabetized dictionary of menopause and this might just work, but this is just too dry to bother with for me. i shall return to it as a reference book to look a few things up now and again.

[Ann Douglas · Rating 5 out of 5]

I was inspired to read this book after hearing an interview with the author on the CBC Radio programme Ideas. I was expecting a very different kind of book -- a book that would focus on the evolutionary benefits of menopause -- but the book ended up lot denser and more complicated than that. It was fascinating enough to keep me reading, but only because I'm intensely interested in the subject matter, for both personal and professional reasons.

[JTGlow · Rating 3 out of 5]

Laborious. So many theories. This was well researched and could have used more editing.
Finally, on page 258, "Before I begin the complicated discussion that forms the rest of this chapter, let me try to reduce confusion by summing up the message of this book. Menopause is a developmental transition that has been important to the success of our species in its long prehistory, and also in the shorter, more recent agrarian and modern periods.'

So now you know and you're welcome.

[Allison · Rating 1 out of 5]

This might be a fine college text, but I listened to (chapter one of) the audiobook and felt like someone was reading their field notes: paragraph after paragraph of statistical formulas with no analogies to make them understandable to those of us who managed to escape college without having taken a statistics course. And so many acronyms that when the author finally concludes that, "Obviously, 0.42 is a high PPA," all I could respond was, "Well, obviously" and turned off the book.

[Penni · Rating 4 out of 5]

Much more dense than I expected, and also many times more broad than menopause. It's pretty much a whole history of our species, which is fascinating.

[Catriona Reynolds · Rating 4 out of 5]

Four stars for writing because pretty dry and academic, especially the first two sections. Third section makes it worthwhile.
Five stars for theory and content.

[Alyssa Tuininga · Rating 3 out of 5]

A lot less science and a lot more anthropologolical and cultural study. I found much of it interesting but wanted the science piece.

[Joyce · Rating 4 out of 5]

I would give this book 5 stars on its conclusions. The 4 come from execution. To be fair, it's not her fault. She is an academic and this is what they do. But it is ironic to me that she says she is unsure of how our culture comes to devalue middle-aged women and turn their transition into some sort of odd medical condition when she herself falls for much of the same. Our western civilization values only the material, the physical - what we can measure and quantify. Until we can move beyond that limitation, many things will continue to baffle us. But this book is nonetheless a breath of fresh air and worth digging through the tedious discussions of anthropological theory to get to the meat of the last few chapters.

[Jimbo · Rating 4 out of 5]

I really liked it.

I appreciated the author's modesty and multiple interpretations to the studies and findings.

There were a couple references to capitalism that I'm pretty sure 99% of economist would disagree with, but they were subtle remarks that had almost nothing to do with the topic. It was very surprising that she stated the information such a matter a fact manner considering the modesty in the other areas that I first mentioned.

My favorite part of the book was in the introduction when she told a story of Ganhis Khan's mother and how her impact as a mother lasted well past her reproductive phase in life. Besides being extremely interesting, this story provides an example for an evolutionary benefit for a significant menopausal phase for women.

[Mariana Calderon · Rating 4 out of 5]

This amazing book, among others, discusses the “Grandmother Hypothesis”., according to which, humanity got to where we are thanks to menopause (only killer whales, pilot whales, and humans experience menopause, the rest of the animals remain fertile until they die). Menopause allowed us to care for the children of our descendants and the community (evidence also shows that menopausal women were the most prolific foragers, being crucial for the communities to thrive), and so humanity was able to devote that extra energy to developing agriculture, domesticating animals , creating technologies, etc. Susan P. Mattern’s book is wonderful because it debunks with anthropological evidence what we have been culturally taught about menopause: that it render us "obsolete", expendable, replaceable, etc.
The book also discusses how this natural and normal process, became a "syndrome" and synonymous with disease with the emergence of modern medicine in Europe during the 1700s —dominated at the time by males and completely exclusionary of the female experience— and how modern mainstream culture emphasizes this fallacy pushing us to manage a normal process with synthetic hormones that are really needed in the minority of cases. This is a great read, full of research and analysis. #theslowmoonclimbs #susanpmattern #menopause #thegrandmotherhypothesis #moonwoman

[Andrea Keeler · Rating 3 out of 5]

This book was very disappointing considering how cool this topic is. The flow and organization weren't great and often time it took forever for the author to make a point. Some of the points were a bit cringey coming from a science perspective but this does outline a decent history of menopause while giving a touch of theory.

[Jenine]

Some of the science is over my head. I am enjoying the big picture discussion of humankind over its known existence, including a wry outlook, such as this comment pg 45:
"...catastrophic events that reduce the population by more than a few percentage points are quite rare, although an event of this type seems likely to occur in our near future."

[Lynne · Rating 3 out of 5]

She makes some interesting points, but it got repetitive.

[Erica · Rating 4 out of 5]

3.75 stars

[Emily Mellow · Rating 1 out of 5]

Read 10% before realising how much I disliked it. I guess I just don't care *that* much about how important menopause is. Or, it's not well-written.

[Gwendolyn Berumen · Rating 3 out of 5]

Helpful to think through how menopause has been re/constructed through history and across place

[Natalie · Rating 2 out of 5]

What a waste of time.
The first two sections were full of historical stories that were a little interesting but not helpful to my understanding. The final 20 pages summed up nothing. Nothing was said. I learned nothing.
I gave it two stars because I’m sure a lot of work went into compiling all the data that I found uninteresting and it wasn’t horrible.

[Killian · Rating 5 out of 5]

Very good book, but you probably need an initial interest to get through it (can be dense for someone outside the field of research).

[Jean O'Callaghan · Rating 5 out of 5]

Excellent. Every woman should read this book!