00:51:16

Hosts: Anna Reser, Leila McNeill, and Rebecca Ortenberg

Guest: Susan Mattern

Producer: Leila McNeill

Music: Fall asleep under the million stars by Springtide

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The hosts dive into the history of menopause and trace how it became known as a specifically female experience. Dr. Susan Mattern joins in to talk about her new book, The Slow Moon Climbs, and menopause as a cultural syndrome.

Show Notes

“Was Lydia E. Pinkham the Queen of Quackery?” by Rebecca Rego Barry

Feminine Forever by Robert A. Wilson

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

Transcript

Transcription by Julia Pass

Rebecca:         Welcome to episode 28 of the Lady Science Podcast. This podcast is a monthly deep drive on topics centered on women and gender in the history and popular culture of science. With you every month are the editors of Lady Science Magazine.

Anna:  I'm Anna Reser, co-founder and co-editor-in-chief of Lady Science.

Leila:   I'm Leila McNeill, the other founder and editor-in-chief of Lady Science.

Rebecca:         And I'm Rebecca Ortenberg, Lady Science's managing editor.

Rebecca:         And before we get right into the show, just to make an announcement, we are going to be running a series in the magazine about gender, technology, and disability, and that will be running in March, so we're pretty excited about it. And so stay tuned for that. Pitches have been coming in as we're recording this, and I'm pretty excited about them, so stay tuned.

Rebecca:         So to bring us to today, we're gonna be talking about something that all of us go through and that I think women are particularly attuned to because of culture, gestures broadly. But any case, we're talking about aging, and specifically we're going to be talking about menopause. Yeah, so you heard that right. We're gonna be talking about old lady bodies.

Rebecca:         Later in the episode we have a great interview for you with Dr. Susan Mattern, who has written a book about the history of menopause and how aging women have been thought about in different times and places. But to start off our conversation, do you guys happen to know what the exact definition of menopause is?

Leila:   I think, if I could remember the precise scientific language, it means women have outlived their usefulness. Is that correct?

Anna:  It's time to get rid of them.

Rebecca:         It's not correct. Officially, "menopause" refers to the cessation of menstruation. Say that five times fast. The only diagnosis of menopause is that you have gone one year without having your period, so technically you are menopausal on the one day after you have not had your period for one year. Before that, you are premenopausal. After that, you are postmenopausal. It really just refers to that one day, one year after your period stops for the last time.

Rebecca:         But when people talk about menopause, even when they're not just saying it means that women are no longer useful to the world, they're usually not referring to that exact, scientific definition. Usually it involves a collection of symptoms that are sort of out in popular culture—

Anna:  The change, as it were. That seems to be how it's always referred to in period movies.

Leila:   Yeah. I think this is probably the case with a lot of people, that their most common interaction or engagement with menopause is knowing someone who complains about hot flashes.

Rebecca:         Yeah. I also remember in the '90s, my mom had gone through menopause, and suddenly she was talking a lot about—well, not a lot, but sometimes about the various health possibilities of estrogen replacement therapy, which we'll be talking about later, and how she's like, "Yeah, it's supposed to help stop osteoporosis and Alzheimer's disease," which are both things that run in my family. So I feel like my knowledge of it came from that. And we'll be talking, actually, a little bit later about how that became a thing and why it's sort of weird. Yeah.

Anna:  My mom has taken the opposite approach of talking about her symptoms or about any health benefits. She just dunks on me when I have my period now. She's just like, "Damn, I'm glad I don't have to go through that anymore." Thanks. All right. I'm outta here. God, gimme that heating pad. I'm leaving.

Rebecca:         Not gonna lie, I'll probably do that, too. Hell, yeah. That sounds well earned.

Anna:  What we were trying to get at here is that when people say "menopause," they're talking about a collection of symptoms that affect women around the time that they stop menstruating rather than the sort of more technical definition of the actual cessation of menstruation. Menstruation cessation. Good band name.

Rebecca:         I'm imagining now old lady rockers. I'm sorry.

Anna:  This collection or constellation of symptoms is called menopausal syndrome, and it includes the classics that we've been talking about. Your hot flashes, your vertigo, high blood pressure, headaches, insomnia, mood swings. And it's generally thought that these symptoms, especially the sort of super cliché ones like hot flashes, are due to a decrease in the amount of estrogen produced in the body.

Anna:  But here is a fun fact. The word "menopause" did not even exist until the 19th century. And that collection of symptoms that I just described and their connection to women aging and ceasing to menstruate doesn't really come up in medical literature until, actually, the 18th century.

Anna:  So people talk about how women eventually stop menstruating and are no longer allowed—allowed? No longer able to have babies. So you get mentions in the literature of women stopping menstruation and then not being able to have babies anymore, but there's not really a connection to the end of menstruation and this sort of constellation of symptoms until we get to the 18th century.

Leila:   We have spent a lot of time on this show talking about the many insane things that philosophers and scientists and doctors have thought about women's bodies over the centuries, and I believe this all kind of came together in episode eight, so go back and listen to that, Weird Things Men Have Said About Women's Bodies. And they've come up with all sorts of conditions, like green sickness and hysteria, and blamed all sorts of medical maladies on the wandering womb.

Leila:   And a lotta these weird and terrible conditions are in some way connected to a woman's reproductive cycle and generally give the impression that any woman who is not actively making babies is physically broken. And yet for a long time, though, the end of a woman's reproductive years didn't seem to interest them very much. And this is, I guess, another fun fact. Aristotle doesn't even have much to say about it.

Rebecca:         And he had opinions about everything.

Leila:   So from the ancient world to the 17th century, the closest thinkers have come to talking about something like menopausal syndrome is the belief in something called the, quote, "climactic," which is not what I ever learned "climactic" was or referred to. The climactic, which was also called the critical age, was based on this ancient idea that the human body went through seven-year cycles and that men and women were physically and mentally vulnerable at the end of one cycle and the beginning of the next. The seventh of these seven-year cycles was thought to be particularly climactic.

Leila:   Now do some quick math in the back of your napkin. Not if you're driving. Just do it in your head, and you'll realize that the seventh of these seven-year cycles happens when a person turns 49 years old. And that's about the same time that women today experience symptoms of menopausal syndrome. But the climactic wasn't explicitly tied to menstruation, and more importantly, it was thought to be something that both men and women experience. It wasn't at all this gendered experience that we've come to think about today.

Rebecca:         I didn't realize how many times I was gonna make Leila say "the climactic."

Leila:   I enjoyed it. It was fun.

Rebecca:         Anyway, so you might be thinking, "Fine. Men didn't write about menopausal syndrome or anything like that, but frankly, there is a lot about the female experience that men never bothered to write about, so what does that mean?" Another good question is did women ever talk about getting hot flashes and headaches in their 40s and 50s in this period before the 18th century? As far as we can tell, not really. They didn't really talk about this. If they had, you would expect it to come up in recipe books and other kinds of medical writings by women.

Rebecca:         And recipe books are a great source for understanding how women in the past thought about and treated a wide variety of kind of, quote-unquote, "women's issues." And this is kind of how we know that women have always had methods of birth control or had abortions, because you can see writing about it in these recipe books. But they just didn't talk about what we now call menstrual syndrome in any particular way.

Rebecca:         And interestingly, though, all of this changed pretty abruptly in the early 1700s. So in 1710 a Prussian physician named Simon David Titius wrote a dissertation called "On the End of Menstruation as the Time for the Beginning of Various Diseases," which is such a—just come on, dude. Chill. And in the decades that followed, medical professionals of all kinds started to write about complications associated with the end of menstruation.

Rebecca:         And by the middle of that century, almost all gynecological textbooks mentions diseases of aging women. So the ceasing of menstruation was suddenly said to cause seizures, emaciation, scurvy, cancer, and more. And doctors, of course, gave it a lot of horrifying names because doctors are good at that. And the names were things like women's hell, which is my favorite; and green old age, which I feel like must be some kind of reference to green sickness; and death of sex, which I can't tell if that means death of one's genderedness or stopping of having sex, but it could be both. And then they also started using these older terms, like the climactic and the critical age, to refer only to women and specifically to menstruation.

Leila:   Can I just say we're really racking up a fabulous vocabulary list here? Some of these are real cool. Women's hell, death of sex.

Rebecca:         They do make it seem pretty metal, as we were saying.

Anna:  Death of Sex is the first album of Menstruation Cessation. So in 1812 this terrible new disease afflicting old women finally got its name: menopause. And this term was coined by a Parisian doctor named Charles Paul-Louis de Gardanne. My French is atrocious. You can read it in the transcript. At first it was supposed to be a neutral medical term that was meant to sort of sweep away primitive old superstitions about old age, but in the fashion of many things like this in the 19th century, what it ended up really doing was sort of formally medicalizing the aging process for women while completely ignoring that same process for men.

Anna:  As time went on, the list of problems associated with menopausal syndrome continued to grow. Victorian gynecologist Edward Tilt even wrote that women experience a, quote, "loss of feminine grace" and claimed that their features and body became more masculine because their skin became flabby and they grew more stray facial hair. And of course, in good Victorian fashion, doctors tended to blame modern vices and immoral behavior for the symptoms of menopausal syndrome. Aging women were encouraged to avoid such things as dancing, gambling, alcohol, vigorous exercise, of course sexual excitement of any kind.

Leila:   Out of the question.

Anna:  They were told to spend their time instead going on gentle walks and caring for others.

Leila:   Can I just say, though, that going on gentle walks and caring for others should be general life advice across genders, across age? Everyone should enjoy gentle walks and caring for each other.

Rebecca:         It's true. Yeah. Really, the world would be a better place if we all just did more of those two things.

Leila:   Yeah, exactly. Think of how applicable this is to a whole range of problems.

Anna:  I will say, though, that I think the caring for others means like, "You should become the nursemaid of your family [unclear 14:54]."

Leila:   Oh, yeah. No, that's totally what it means.

Rebecca:         I mean, yes. Obviously what it means.

Anna:  Just wanted to point that out.

Leila:   So along with seeking advice from doctors, women also purchased patent medicines and cooked up herbal remedies to calm their symptoms. One of the most famous of those was Lydia Pinkham's vegetable compound, and everyone needs to go look up Lydia Pinkham, and I'll include some links in the show notes because her story is fascinating.

Leila:   Pinkham was a Quaker woman from New England who first began selling her remedies for a variety of, quote-unquote, "female complaints" in the 1870s. Her vegetable compound claimed to be, quote, "a sure cure for prolapsus uteri, or falling of the womb, and all female weaknesses, including leucorrhea, painful menstruation, inflammation, and ulceration of the womb, irregularities, floodings, etc." That is a very long title. Also what are floodings?

Rebecca:         I feel like I have heard that before in Victorian contexts, but I don't know what it is. It sounds terrible.

Leila:   Oh, my God. Pinkham's vegetable compound included black cohosh, which is known to relieve hot flashes, and fenugreek, which nursing mothers still take today to improve milk supply. It also contained unicorn root, life root, and pleurisy root, all preserved in 19% alcohol.

Rebecca:         I feel like so many things in the patent medicine world, the alcohol, I'm sure, was doing a lotta the work here. So we do wanna say that women were going to doctors in the 19th century, suffering from hot flashes and headaches and anxiety around the time that their periods stopped. And doctors weren't making up the symptoms, though of course they chose to categorize the symptoms in a specific way. And, yeah, you don't wanna give the impression that these things are fake or that women were making them up, but the truth is that something happened in the 18th and 19th century in Europe that changed how people thought about aging women's bodies and how aging women themselves thought about their bodies.

Rebecca:         And that really gets me to thinking about other sort of medical conditions—or maybe we should say medicalized conditions—that are real and should be taken seriously but where our understanding of them maybe isn't 100% purely biological. I mean, nothing is 100% purely biological. Everything is a little bit social. But historian Susan Mattern describes menopause as a cultural syndrome for the kinds of reasons that we've been laying out here, where it's something that is at least partially kind of—the idea of it is socially constructed, and we'll be talking some more about that in our interview with her.

Anna:  So if you're a woman in her 50s in the late 19th century who is suffering from really awful hot flashes and headaches, you might pick up a bottle of Lydia Pinkham's vegetable compound. Or maybe you would take an herbal remedy that all the women in your family swore by. If you could afford to go to the doctor, he would probably tell you to go on calming walks or, even more likely, insist that you stop drinking. But if you went to that doctor in the early 20th century, he might suggest a new treatment: eating desiccated cow ovaries.

Leila:   Well, that sounds bananas, but it was actually a very primitive form of treatment that lots of people are familiar with today: estrogen replacement therapy. At the turn of the 20th century, medical researchers became increasingly interested in endocrinology, or the study of hormones. While they weren't completely sure how hormones worked, they knew that they were chemicals produced by specific organs that had certain essential functions, and they also knew that other mammals produced similar hormones.

Leila:   So in 1898, when a woman in Berlin approached her doctor complaining of symptoms of menopause syndrome, he fed her fresh cow ovaries as an experimental therapy. And by that time experiments on animals had led doctors to believe that ovaries produced a hormone that had something to do with the female reproductive system and that menopausal syndrome had something to do with changes in the production of that hormone.

Leila:   Today we know that ovaries produce estrogen and that menopause is associated with a drop in estrogen levels, so they weren't that far off. So the idea of prescribing a woman a kind of estrogen supplement wasn't that crazy, but still, yuck.

Rebecca:         Still wouldn't do it.

Anna:  I mean, did they cook them? I'm sorry. We don’t have to talk about this. I just can't stop thinking about it now.

Rebecca:         There was also a whole debate about whether desiccating them and turning them into a powder they would still work. And some doctors would be like, "No, they have to be fresh," and other doctors would be like, "No, just give the poor woman a powder."

Anna:  Do you stir it into tea? Do you do rails of the—

Rebecca:         Over the next 30 years or so, ovarian therapy, as this was called, became an accepted treatment for women experiencing severe symptoms of menopausal syndrome. So doctors prescribed women fresh or desiccated ovaries from cows, sheep, and other farm animals, I think because the farm animals were easily accessible and nearby and stuff.

Rebecca:         And to be fair, doctors weren't throwing dried reproductive organs at every woman over 50 who walked into their office. That would be rude. This was a treatment that doctors used in rare circumstances when other treatments didn't work and a patient's symptoms were debilitating in a pretty severe way. But it was an option. It was on the table as something, and thankfully in order for estrogen replacement to continue to work, women didn't have to eat cow organs forever because estrogen was isolated in 1929 and synthetic estrogen was developed in 1938.

Rebecca:         So by this point, ovarian therapy had been renamed hormonal therapy, and doctors were a little more confident that it actually worked. It also now didn't involve so much of the eating of cow ovaries. But they continued to use the treatment cautiously. Doctors saw the drop in estrogen and the symptoms associated with it as a normal process, and they worried that overprescribing estrogen would in the long run just prolong menopausal syndrome and delay the body's adjustment to changed hormone levels. So this was really only if a woman was like, "I literally haven't slept for a week" or like, "I can't get outta bed because of my headaches."

Anna:  In case you thought that we were going to end on a note where doctors are being reasonable about women's bodies, boy, have I got a story for you. So in 1963, a Brooklyn-based gynecologist named Robert Wilson published an article in the Journal of American Geriatric Society arguing that untreated menopause was dangerous and left women at risk for hypertension, high cholesterol, osteoporosis, arthritis, and severe depression.

Anna:  He naturally also said that it robbed women of their femininity and left them shells of their former selves. According to Wilson, postmenopausal women experienced life, quote, "through a gray vail, and they live as docile, harmless creatures, missing most of life's values." End quote.

Anna:  As soon as you hit 50, you're the walking dead if you're a woman.

Rebecca:         Yep. Yep. You are useless to society and also sad.

Anna:  And it's unpleasant, and I don't wanna look at you.

Leila:   See, I can experience most of these things on my own without menopause. Severe depression, high cholesterol, hot flashes, headaches. Will that make my transition with the change easier?

Anna:  That sounds, I'm sure, like the 19th-century doctors that we talked about earlier. But unlike Victorian doctors, who had little to offer women who had been so tragically unsexed by menopause, Dr. Wilson had a cure. He would give them estrogen replacement therapy. Throwing caution to the wind, he encouraged women to begin taking estrogen as they approached menopause and to continue taking it indefinitely.

Anna:  So in both the 1963 article and in a 1966 follow-up book that he titled Feminine Forever, Wilson further described menopause as a, quote, "deficiency disease like diabetes that had to be cured with estrogen replacement therapy." This book sold 100,000 copies in seven months, and magazines like Time and Newsweek also published articles about Wilson's cure for menopause. Between 1963 and 1975, estrogen sales quadrupled.

Leila:   You know, putting in a timeline here when this guy's stuff was coming out and being publicized really is putting into perspective some of the things my family has said about menopause, clearly influenced by this during that time.

Rebecca:         Yeah, 100%. Yeah. It's one of those things where you're like, "Oh, this is where all these things that seem like common knowledge come from."

Leila:   "That's why you said that." Today doctors and patients are a little more cautious about estrogen replacement therapy. Studies since 1975 have sometimes linked its long-term use for postmenopausal women to cancer and heart disease. Other studies have shown that it can slow the effects of osteoporosis, and it is still seen as a good way to manage severe symptoms of menopausal syndrome. But regardless of a person's specific medical needs, it's hard to escape the fact that when it comes down to women and only women, people seem to think that old age is something that needs to be cured.

Rebecca:         Yeah. It's like men get osteoporosis, too. I'm just gonna throw that out. One of the things that does seem to be generally accepted is that estrogen replacement therapy is good for combating osteoporosis, and osteoporosis is a serious medical problem. But it's not just women that get osteoporosis, and yet all of this is about that.

Anna:  I think Wilson's "death of femininity" thing is probably more lastingly influential, even, than his idea of curing menopause because I think that the tide is turning on the idea of curing menopause, but I do think that there is still this very kind of tenacious idea that old women are not feminine and they can never recover their femininity and that once you hit 50, it's just a downward slope into nothingness. And for women, if you're not feminine, then you don't have any cultural capital as a woman.

Leila:   Well, because it's like women go through this stage of getting into their late 30s and 40s. Men may not want to bone you anymore, so you've kind of lost a little bit of your usefulness, but you might at least still be able to produce offspring, so you still have some usefulness. But then when that's completely gone, no one wants to screw you anymore and you can't produce kids? Get out of here.

Rebecca:         And women literally do talk about how sometimes, for some women, there's a moment where sort of they get up and they go through their day and they realize that they were kind of wildly invisible. That is, I think, something that aging women talk about sometimes. It's like, "Oh, my God. I just no longer exist to the people around me." And, I mean, there are times when that sounds great to me, not gonna lie, but that is mostly coming from a place of, yeah, it can be exhausting being noticed all the time as a woman.

Anna:  Right. So yeah. You get, for the first half of your life, way too much unwanted attention, and then for the second half of your life, you're just dead to everyone around you until you're actually dead.

Leila:   You are covered in a gray veil.

Rebecca:         On that note, shall we turn to our interview to talk more about why all of this is a problem but also where it came from?

Rebecca:         And now we're excited to welcome Dr. Susan Mattern on the podcast. Dr. Mattern is a Distinguished Research Professor in the history department at the University of Georgia and the author of The Slow Moon Climbs: The Science, History, and Meaning of Menopause. In The Slow Moon Climbs, Dr. Mattern looks at menopause from prehistory to the present and argues that menopause is an essential life stage that has been integral to the flourishing of the human species. So welcome to the podcast.

S. Mattern:      I'm happy to be here. Thank you.

Leila:   So in your book, you describe menopause syndrome as a, quote-unquote, "cultural syndrome" because it has been experienced differently by different societies across time and space. And today we've been spending some time talking about the different ways menopause has been understood throughout history, too. Can you explain a little bit more about what you mean by menopause being a cultural syndrome?

S. Mattern:      Yeah. I can explain that. So the main reason I think I tried to talk about menopause as a cultural syndrome is that it really looks like a cultural syndrome and kinda walks and quacks like a cultural syndrome in terms of there's been some very sophisticated research by this discipline, people called transcultural psychiatrists, into these kinds of syndromes that are specific to specific cultures. And in some ways they are specific to the cultures that formed them, but in other ways, they do have a lotta things in common, and you can sorta describe them as a class of phenomena.

S. Mattern:      And menopausal syndrome really has all of the markers of this class of phenomena. So for example, just about all of these symptoms that are commonly associated with menopause or that scientists associate with menopause when they give you, for example, a checklist of symptoms and say, "Check off this or that if you've experienced it." So when researchers talk about what they think are the symptoms of menopause, there's a huge number of them, as you probably know, but they're all in a certain category.

S. Mattern:      And that is the category of symptoms that overlap with the autonomic nervous system arousal. That is, when we get anxious or when we have any kind of fight/flight kind of response, even if it's sort of an unconscious response, our bodies tend to respond in certain ways. And some of those ways are sleep problems, cognitive issues, pain of almost any kind, heat and chilling sensations, palpitations, gastric problems. There's a huge range of things that our body does in that situation.

S. Mattern:      Now when we have an idea or a concept of a disease that has these symptoms—which are also very general symptoms; they're not really specific to anything, they're typical of a lot of things—what tends to happen is that we focus on those symptoms we think are most significant. So we have this concept of a disease that has X as a symptom. Maybe it's dizziness, for example, for a lot of [unclear 31:46] syndromes. And then when we feel dizzy, we think, "Oh, I've got X." It makes us anxious, which makes us then feel more dizzy because it's one of these.

S. Mattern:      So and even though this sounds kind of simplistic, our brains are so good at picking up on sometimes really unconscious cues and generating these syndromes so we'll pay more attention to that symptom, it will get worse, we'll pay more attention to it. And through this kind of feedback loop, we can generate certain kinds of very specific phenomena.

S. Mattern:      And when we think about it, that really explains a lot about menopause. It explains why it's such a prominent thing in modern Western cultures. Because of its position in modern Western medicine, it's been exported to a lot of other places, but when we look at premodern societies, we often don't really see a concept of menopause. Or even if we do, it's quite different from what we're talking about, the experience that we think of as menopause.

S. Mattern:      One very striking feature that menopause has in common with a lot of these sort of anxiety-type cultural syndromes is the hot flash, that a lot of these other syndromes have these kinda fits or spells or sometimes what they think of as seizures. A panic attack or panic disorder in Western psychiatry is an example of one of these kinds of problems where you have this rapidly escalating, sudden-onset episode with rapidly escalating symptoms that then sort of goes away.

S. Mattern:      I got really, really interested in the hot flash, and I was writing the book like, "What is a hot flash, and what do we think a hot flash is?" Because nobody ever defined it for me, to be honest. And so I read what medical researchers think a hot flash is, and it's very interesting why they think that's what it is and sorta the history of the literature on it.

S. Mattern:      There is this sort of scientific tradition about what a hot flash is, and it's very similar to what we see, for example, with panic disorder or what we see in a lot of other cultural syndromes. So in fact, if you have a hot flash as described in medical literature, you might qualify for a panic attack by DSM criteria. So there's a lotta similarities in those two phenomena. Because I have some experience researching cultural syndromes for other reasons and I've written other analyses of cultural syndromes, the more that I looked at menopause—and I was interested in where does this concept come from and how did it develop and so on—the more I sorta felt like, "Well, this is really another example." And I didn't actually start out tryin' to make that argument, but that's kinda where I ended up

Rebecca:         In putting together the larger episode around this, yeah, that was one of my interesting discoveries in looking at the various research. In the Western world, menopause seems to sort of appear in a certain time and place.

S. Mattern:      Yeah. It's a very specific time. Yes. It's not there, and then suddenly it's there, and it's a big change from within a few years.

Rebecca:         Yeah. So the other thing that you talk about in your book is kind of the ancient people and prehistorical people and aging and the fact that for most mammals and most animals, even, it's unusual to have females or any gender live past reproductive age. So it's pretty unusual that human females live for quite a good span of time postmenopause. Yeah. Can you talk a little bit about that and sort of the grandmother hypothesis?

S. Mattern:      It is very interesting, isn't it? And so this is obviously not my specialty, so when I was writing this part of the book, I was reading other people's theories and ideas. And sorta the grandmother, if you will, of the grandmother hypothesis, her name is Kristen Hawkes, and she works at the University of Utah. So that's really her idea. And I talk about the grandmother hypothesis, and I also talk about some other sort of evolutionary theories of human life history and of aging and menopause, and I try to put them all together in the end. I don't know how successful that is, but in any case.

S. Mattern:      So why do we age? This is a question that's sort of a classic question in evolutionary biology. It's not really easy to explain because nature should select against something like that, right? It should select for health and survival and long life and reproduction. And to some extent it does, but for various reasons, sort of in the mid-20th century theorists started coming up with pretty good explanations of why it is that organisms are. However, according to these classical theories of senescence, we really shouldn't live beyond our ability to reproduce. There really shouldn't be a lot of selection for living beyond when we can reproduce those genes because once we're not reproducing anymore, our genes are free to run rampant and accumulate all kinds of problems and so on because they're not gonna be reproduced.

S. Mattern:      So and there was even sort of a nickname for this idea. It's called the wall of death hypothesis. There's a lot of recognition that there are factors that can reduce that sort of wall of death effect. And when we look at the real world, especially among mammals, who tend to take care of babies after they're born, we see that most mammals do—it's hard to calculate, and we haven't really had the statistical tools to figure out how are we defining post-reproductive life, but most mammals seem to have a small post-reproductive life span so that there'd be a period of the end of their life when maybe they're not gonna have another baby, but they'll still live a little bit longer than the next birth interval. And the reason for that is probably investment in the next generation, so their investment in their offspring probably explains that a little bit.

S. Mattern:      However, just in 2011, 2013, a team of researchers developed a new way to measure post-reproductive life span. It's hard if you think about it. How long does an animal live? Well, some lions live this number of years, and some lions live a lot longer because there's always a lot of variation in longevity. How do we know if that lion has outlived its reproductive life and so on? It's not actually that easy to answer these questions, but people knew there's something going on, right? There's something going on with humans.

S. Mattern:      However, there's now a new way to do this, and it's called post-reproductive representation, and it's a measure of basically how many adult females in a population at any time will be post-reproductive. So it measures not only the length of post-reproductive life span, but how common it is and how much of a feature it is of that animal. By this measure, most animals have a very small post-reproductive life span, or they don't have one, including a lot of mammals. Including chimpanzees don't seem to have any post-reproductive life span to speak of. They continue to have offspring until they're old and won't stop, basically, until they die. But humans have a huge post-reproductive representation compared to other animals.

S. Mattern:      So even excluding all modern populations, just looking at populations that don't have modernization, don't have modern medicine, or whether it's looking at records from societies before modernization, looking at those societies, we see that humans rarely, rarely see a post-reproductive representation less than 30%. That means that 30% of adult women are post-reproductive in the population, which is huge. I mean, that's not wall of death. That demands some kind of evolutionary explanation. The only other animals that—there's two species of toothed whales. One is orcas, the killer whales, that you get that most people are familiar with. And orcas have been very extensively studied, and they appear to have also a very substantial post-reproductive life span for females, not for males. Males die much younger in that species. Humans are kind of unique in this respect.

S. Mattern:      And then the question becomes how do we explain why this occurs? We seem to have a long, naturally occurring post-reproductive life span that's probably adaptive. It probably arose because it was useful in some way. It's not really possible to argue that it's just an artifact of modernity anymore. It is a natural part of our lives, and it's kind of hard to explain away except as something useful.

S. Mattern:      The sort of most interesting ways to explain this have to do with transfers of resources. So I talked about classical senescence theory talks about tradeoffs that the human body has to make. So we trade off growth against maintenance against reproduction, and that balance kind of explains why we age and why we die. But there's a fourth factor. So people thinking about menopause added a fourth factor to the theory, which is transfers. That is, if we are transferring resources from older generations to younger generations, it changes the math completely, very substantially, so that post-reproductive life can evolve in those circumstances 'cause it's so helpful to have older people who are not reproducing, who are not producing more competitors for those resources—who are just producing and not reproducing, that is. That's so helpful in that kind of species where you're doing those resource transfers. Models show that you can get post-reproductive life span that way. So we think that's what happened.

Leila:   One of the fascinating things about the grandmother thesis for me, anyway, is that it really contradicts this popular idea that women in particular outlive their usefulness.

S. Mattern:      Oh, yes. Yeah. I mean, and that was always kind of unlikely, right? Yeah. So what I talk about in the book, and this is what most anthropologists believe, is—and especially in the last couple years since we've had these new ways of measuring post-reproductive life span that are so convincing—is that, yeah, we have it because it's useful. Post-reproductive life span is something that's unique to humans that has been a tremendous advantage in our history and is part of this sort of group of traits that makes us especially adaptable to all kinds of circumstances, and it's one reason why we've been able to colonize almost every ecological niche.

S. Mattern:      For example, when we have this post-reproductive life span, it's part of a strategy that means that we can invest a lot in children, that childhoods can be longer, we can invest in skill-intensive strategies, we have more adults to children, we live longer. It's part of this whole complex. As a result, we can accumulate skills. We can practice. We have expertise. We have culture. We can teach that expertise to younger generations as part of that. It's a kind of resource transfer. So basically if we think of ourselves as this exceptionally smart, technological, cultural, adaptive kind of animal, that's because of menopause.

S. Mattern:      And the other thing that it does is it allows us to reproduce very quickly because what we think happened is grandmothers are helping their daughters to care for their grandchildren, and that means the daughters can have babies much more quickly. And it makes for a very flexible strategy. So when there's an opportunity, when conditions are good, human populations can grow extremely fast, and especially in the modern period, we see evidence of this.

S. Mattern:      But it also explains certain aspects of our prehistory, is that human populations have a possibility to boom in very favorable circumstances, which makes it easier when there's a crash. When something bad happens that wipes out either a whole population or a large part of a population, we can recover that much faster. And that's one reason, again, why we've been such a successful kind of animal so far.

Leila:   I wanna ask a little bit more about this idea of population. And one of the things that you talk about is what the history of menopause can teach us about that distinction between fertility control and social programs like eugenics. So can you explain that difference there and what exactly the history of menopausal women can teach us about that distinction?

S. Mattern:      Yeah. So fertility control means being able to make decisions about reproduction, so being able to limit reproduction, for example, if you want to. So in our society, it's a very important part of reproductive freedom, right, the ability to not reproduce when you don't want to reproduce or when it's not the right circumstances and so on. And this is something that's been an important part of our history in particular since the turn to agriculture. And when we had agricultural societies that are land-limited societies, fertility control is important to wellbeing because it's very easy to have too many heirs, more than your resources can support.

S. Mattern:      And so throughout sort of premodern history, agricultural societies usually have a huge number of really ingenious ways to manage that problem, the problem of either too many heirs or too many daughters or the strategies of marriage, keeping property in the family, and all of these things. So all of these are very closely linked together, and so fertility control has been part of our history for a long time. And sometimes it's something on the individual level, where a woman or a couple wanna control their fertility for some reason. Sometimes it's a family thing, where the family's making decisions about its resources, or it can also be a state thing. It can be coercive. We've had some ghastly episodes in our history where governments have forced fertility control on populations for one reason or another.

S. Mattern:      But fertility control is a more broad concept, right? And it's something that we need as a species because we evolved to be this boom and bust species, right? We evolved to be a vast reproducing, colonizing species, but at the same time, because we have menopause and because we have post-reproductive life phase, we can have a very flexible reproductive strategy. So when things aren't so good, we have the capability of using that non-reproductive part of our population to invest in resource or invest in training. We do these long-term strategic things, and we do have a large part of the adult population that's not reproducing. And that allows us to be more flexible. But fertility control especially, as I said, whenever land is limited and resources are limited, it's been a very important part of our history.

S. Mattern:      Now eugenics was a kind of catch-all term for a bunch of sort of ideas and ideologies that arose in the early 20th century and really remained popular through the mid to even, in some places, late 20th century. Fortunately are not something that we talk about today. We now pretty much agree this was a bad idea. But in any case, eugenics is the idea that some kinds of people should not reproduce and that should be prevented from reproducing. In the United States, over the course of the 20th century, at one point most states had eugenics laws on their books at some point over the course of the 20th century, so something that's very widely practiced as part of US policy.

S. Mattern:      And these kinds of laws mostly targeted poor people, ethnic minorities, gay people, people perceived as mentally ill, with forced sterilization, sometimes even castration. Bad, bad things. And this was done quite a lot, so we know of about 60,000 cases of these kinds of mandatory sterilization episodes. And that's probably a vast underestimate of what really happened. It was especially popular in California. Obviously this kind of eugenics thinking was a big part of Nazi ideology. Mostly when we think eugenics, we mostly think Hitler. However, it's something that was much more broadly part of Western culture and also part of United States culture for a while.

S. Mattern:      So as you can see, that's quite different from the idea of fertility control. It's a very broad concept. It's a tool that we used, and it can be a very good thing, and in some ways, depending on circumstances, it can be a response to constraining circumstances. And it can be done in different ways, and some of them are not fun to talk about, like infanticide. You can see that eugenics is a very specific kind of historical phenomenon, fortunately mostly limited to the 20th century, although who knows? Maybe it will come back.

Leila:   I mean, we are living in these times, so.

Rebecca:         Yeah. It's one of those—yeah. Yeah. I wanna get back to this idea of writing a big world history. So can you talk a little bit about what that experience was like and some of kind of the challenges and benefits of taking that approach? 'Cause it seems like such a big task.

S. Mattern:      It does seem like a big task. I can see how it does. However, well, to me it's mostly the decision to do it because you spend most of your professional life feeling like, "Oh, I need to have all the languages, and I need to have all this expertise that I don't have." And then at some point you realize, "Well, nobody else is gonna do it. And so if anybody's gonna write on a big subject like this, and I think somebody has to, I guess it might as well be me."

S. Mattern:      And I get that people read the book and it's pretty densely argued and it seems like a giant task. And of course it was, and I spent years on the research and so on. But to me it seemed easy 'cause I didn't have to read Ancient Greek. I wasn't reading a lot of German. I had to learn some math and some evolutionary theory. And I had to learn a lotta things, but learning's fun, and to me it was easy and fun.

S. Mattern:      I loved reading the scientific articles. Again, they're all in English. The elephant studies, the whale studies. It was all just so fascinating. It was something new. So to me it was exciting and fun and, compared to what I usually do, relatively easy. And I just was really grateful that I had the time to invest in trying to answer these big questions that I think a lotta people have, but most people don't have the time. They're not paid to do this for eight or 10 hours a day. So yeah. So to me this was a fun project.

Rebecca:         Yeah. It does feel, in a refreshing way, very counter to the more traditional academic you get narrower and narrower and narrower in your expertise as things go on.

S. Mattern:      Right, it can happen. Yeah. But it doesn't have to.

Leila:   So do you have any new research on the horizon, or are you gonna be doing more with this work, or what's next for you?

S. Mattern:      Oh. Well, what an interesting question. Thank you for asking. Well, I have a backlog of chapters and stuff that I owe, so I'm still working my way through that. When I'm doing a book, I put everything else on the back burner 'cause otherwise I won't get it done. I'm terrible at multitasking.

S. Mattern:      But, well, I mean, this is gonna sound boring, but I wanna do a big article on shepherds, comparative shepherding. I have sheep at home, so I think a lot about livestock and about domestication, domesticated animals and how we care for them, and this sort of turn to—and I talk about the turn to agriculture. The turn to agriculture and pastoralism. What that means and what it means to be a shepherd. And historically they're always these really fascinating sort of marginal characters just on the edges of civilization, sort of between free and slave, between sort of citizen and bandit. So they're just really interesting characters. So I thought, "I'm just gonna indulge my curiosity and write about shepherds for a bit."

S. Mattern:      And then I might go back and write about the origins of property. And people don't like the second part of it—book's in three parts, and people don't like the second part as much as the other two parts, but to me this was the most interesting part 'cause I study premodern societies for a living, and this project kinda transformed how I see premodern societies in a general, sort of on a big-picture way. And it was sorta the realization that property changed everything, that for most of our history as a species, property was just not a thing.

S. Mattern:      And what happened when property was basically invented? What happened? It changed everything about us just as profoundly as modernization did, maybe more profoundly 'cause modernization is still this property-based system in most of the ways that we do it. So I'm really interested in that question of how and why do we develop this idea, what is it in its earliest stages, and what did that transformation mean. And so that takes me all the way back to the Neolithic. I'd probably go back to the Neolithic Mediterranean just 'cause that's the place where I can most competently look at the materials. Just yeah. That's my next big ambitious project, would be something like that.

Leila:   That sounds fascinating to me. I especially like this idea of these marginal shepherds living between being citizens and bandits. That sounds cool.

S. Mattern:      Yeah, shepherds are really interesting. Whenever you hear the shepherds abiding in the fields. Do you ever think about the Christmas stories about the shepherds? What are they doing out there in the fields? Keeping watches their flock by night. They're sleeping with the sheep. So they're really these sort of half-wild kind of people.

Leila:   Yeah. Well, we wish you luck in your future research.

S. Mattern:      Oh, thank you.

Leila:   And if it ever crosses paths with Lady Science again, we hope that you'll be back on the show. We really appreciate you taking the time to talk with us about your book, and for listeners out there, we do have a review of this book on our website. So be sure you check that out, and we'll link to it in the show notes. And we will also link to the book so that you can buy it yourself. Yeah. Thank you so much for being on the show today.

S. Mattern:      Thank you. It was a pleasure.

Leila:   That's gonna do it for us today. If you liked this episode, please leave us a rating and a review on Apple Podcasts so that new listeners can find us. Questions about any of the segments today? Tweet us at @ladyxscience or #ladyscipod. For show notes, episode transcripts, to sign up for our monthly newsletter, pitch us an idea, and more, visit ladyscience.com.

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