The Slow Moon Climbs: Talking Menopause with Susan Mattern

Cassia Roth

---

Recently, I heard an interview with TV anchor Gayle King on the NPR show On Point about her career as a journalist, her recent interview with R. Kelly, and her experience working in a visual field while aging. One caller mentioned the “menopause pooch,” and congratulated King for redefining what a TV anchor looks like. In response, King described how, at the age of 64, she “feels better than she ever has in her life.” Yes, she has the “menopause pooch,” but she thinks that’s okay. In the interview, King embraced her post-reproductive life in which she has the time and energy to focus on her career. But negativity underpinned the caller’s question. It reinforced for me, a woman in her early thirties, the undesirable connotations often associated with menopause in our culture: you gain weight; men find you less attractive; life ends. You die, old and shriveled and ignored.

My colleague Susan P. Mattern’s recent book The Slow Moon Climbs: The Science, History, and Meaning of Menopause (Princeton, 2019) blows up that negative image. In it, she synthesizes a massive amount of biological, mathematical, historical, and anthropological research to ask: “When did menopause become a medical condition with symptoms and a name?” (265). In doing so, Mattern shows us that menopause is not the problem that modern western culture makes it out to be but rather an ingenious solution — one that allowed our species to conquer the globe.

Mattern organizes the book in a roughly chronological order. “Evolution” explains the evolutionary history of menopause. Two theories have dominated the scientific literature. The first, the “Grandmother Hypothesis” (Chapter 2), views menopause as adaptive in that nature selected for women with a post-reproductive lifespan. These women, by providing food and care for their grandchildren, allowed their daughters to reproduce faster and increased their own inclusive fitness. The second theory views menopause as ephiphenomenal, or a secondary effect of increased life spans. Mattern convincingly argues for the former, claiming that adaptive theories of menopause that invoke kin selection, transfers of resources, and “embodied capital” are correct. The next chapter, “History,” looks at the more “modern” period from roughly 11,000 BCE to today. Mattern centers how a switch to intensive agriculture and property accumulation resulted in patriarchal patterns that are not “natural” to the way humans as a species had organized themselves previously. She also convincingly demonstrates how menopause served as an important way to control fertility in a period when the basic unit of society — the family — had to balance resources to ensure the survival of their kin.

In “Culture,” Mattern gets to the meat of her discussion of how culture defines menopause and, more importantly, how that definition affects women’s experiences. Mattern shows that menopause was not significant in European medicine and culture before 1700. After that, physicians first described it as a retention of blood, then an irritation of nerves, and finally, in the twentieth century, as fluctuating hormones and estrogen deficiency. It also moved from being framed as a finite period of crisis in the nineteenth century to a permanent state of deterioration in the twentieth. Mattern ends by asking us to consider menopausal symptoms as a “cultural syndrome.” Yes, hormonal changes cause real physiological changes such as hot flashes, but how women experience and articulate those changes depend on the cultural context. By reshaping how we view menopause — not as a problem but as an ingenious solution of nature; not as the end of a woman’s useful life but as the beginning of a new period in which reproduction doesn’t define everything — we are not simply changing cultural definitions. We are redefining older women’s roles in society, giving them the respect they deserve. This book changed how I viewed getting older. Recently, I spoke with Susan about it.

Cassia: We know the way science is conducted today often implicitly embeds gender bias into its experimental design. It was still somewhat surprising to me, however, the gendered scientific backlash to the Grandmother Hypothesis. How did you approach explaining the gendered dynamics of this scientific debate without falling into gender essentialism?

Susan: I’m a little slow on the uptake, so it was only after immersing myself in the evolutionary theory for months, or even longer, that I started to see why the debate among anthropologists was so bitter. There are both men and women on each “side” of the debate (they’d probably say it’s too simplistic to reduce it to two sides); for example, Kristen Hawkes has always published together with her colleagues James F. O’Connell and Nicholas Blurton Jones, and more recently with other male colleagues specializing in mathematics and modeling. But the heart of the debate is about the relationship between men and women and the role of male-driven vs. female-driven processes in the adaptations that make us human. The “Man the Hunter” hypothesis placed a male activity — hunting — at the center of human evolution, as well as monogamous marriage and the patriarchal “nuclear” family in which men provide resources and women nurture children. The Grandmother Hypothesis upended all that. In this theory, women and grandmothers are more important providers than men, and the nuclear family isn’t all that important. The “Embodied Capital” hypothesis is a bit of a compromise in that it grants a greater role to monogamous marriage and male providers. Hawkes has argued that “Embodied Capital” started out, when it was first proposed, as a form of “Man the Hunter,” and she’s right, but it’s evolved to look a lot like the Grandmother Hypothesis — emphasizing the productivity of both men and women in midlife, and arguing that both men and women have an evolved post-reproductive life stage.

Cassia: Much of the secondary literature you synthesize and analyze for the book is not historical — you look at mathematics, evolutionary and cultural anthropology, and medicine, to name a few. As a historian, what body of literature did you find most interesting to read and why? Most difficult?

Susan: The reading for the first section, on “Evolution,” was fascinating. If readers wonder why I go on and on about yet another elephant study or describe the Ache of Paraguay in such detail, it’s because I could not tear myself away from that reading and it all seemed so important. At first, it was just wonderful that it was all in English and I didn’t have to struggle with German or ancient Greek — it almost seemed like cheating. After that, I was engrossed in the fun of learning something new. And in the end, it completely changed my perspective on history, which is why the book has a bit of a macro-historical subtext, reorganizing our basic understanding of how humanity’s story has progressed.

Cassia: You are not yet a grandmother (here, I’m not assuming that you will be). But do you think writing this book will change how you approach that stage of your life, if it happens? I know you mentioned your mother read the book (and it’s partly dedicated to her). Has it changed how she feels about this life stage?

Susan: My mom called to tell me she was proud of me for writing the book, and I consider that the high point of my career. I’m not sure whether or how it changed how she sees aging, but my father has said that it made him feel better about aging. That we do not appreciate enough the value of aging and longevity — these are literally the things that make us human — is one of the themes of my book. As for me, I started writing the book when I was approaching menopause and finished it on the other side, and in the meantime I had become convinced that our culture’s understanding of menopause was completely wrong, in all the ways I describe in the book. So it certainly changed how I perceive midlife and post-reproductive life. Even if I never see a dime from the book (which seems likely), at least I have that. And I’m sure it will affect how I see my role as grandmother. Already — and this is in some ways a heavy burden, in other ways it is affirming and even liberating — it’s changed my view of myself as a parent. We don’t just kick our kids out of the nest when they’re 18. We continue to provide for them and help them and transfer resources to them for as long as we are alive — that’s what we really sign up for as parents.

Cassia: As a scholar of fertility control in the nineteenth and twentieth centuries, my research has focused on women of reproductive age controlling when and how to have children. In Chapter 6, you argue that “Menopause was part of a larger picture in which fertility control was crucial to survival and prosperity.” (155) How does including menopause in histories of fertility control expand our historical understandings of all aspects of women’s reproductive and non-reproductive lives?

Susan: One of the hardest things about writing the “History” section of the book was the near-total lack of what I’ll call “Mother-In-Law Studies.” Researchers just have not been interested in the figure of the mother-in-law/grandmother, despite that her role as domestic boss of the peasant farm is so central. At best she’s a hostile caricature in literature produced by men; more often she’s ignored and occasionally scoffed at by researchers (historians, anthropologists, etc.) I wasn’t able to do as much with the mother-in-law as I wanted to, because I didn’t have the time to do all the research myself — it isn’t that kind of book. But I hope I’ve made the case that to understand the peasant economy, we have to understand the mother-in-law, and we have to understand menopause and the role of post-reproductive life in that economy. I’m also hoping that menopause will start being factored into demographic models of agrarian societies.

Cassia: Throughout the book, but particularly in the epilogue, you include your own experiences and understandings of “going through menopause.” Do you think researching and writing the book while you were experiencing menopause (even as you point out your physiological symptoms were mild) changed how you experienced it and the other life changes you outline?

Susan: It’s not necessarily a coincidence that I didn’t experience a full-blown menopausal syndrome while writing a 450-page book that critiques that very construct. I wouldn’t want to make big claims for that — we tend to be affected by the cultural constructs around us even if we’re not very aware of them or if we consciously reject them. But let’s say I’m glad I had a different perspective on menopause than the one our society offers.

---

Featured image caption: Susan P. Mattern’s The Slow Moon Climbs synthesizes a massive amount of biological, mathematical, historical, and anthropological research to ask: “When did menopause become a medical condition with symptoms and a name?” (Courtesy Wikimedia)