One of the first Anglophone books on the female climacteric was by Edward Tilt, an English physician, who—like many of his colleagues—had been trained and had practiced in France, in the late 1830s and the 1840s, and imported the idea from there. Tilt described it first in the later chapters of On the Preservation of the Health of Women at the Critical Periods of Life (1851), a small guide for women, as well as in a series of articles. A subsequent, larger book, directed to the medical community, The Change of Life in Health and Disease: A Practical Treatise on the Nervous and Other Affections Incidental to Women at the Decline of Life (1857), was dedicated to the topic entirely. Here, alongside terms such as climacteric and change of life, Tilt introduced the French physicians’ term la ménopause (from the Greek for “month” or “monthlies” and “cessation”), coined by Charles-Pierre-Louis de Gardanne some forty years earlier, originally as ménespausie, to replace the unwieldy expression cessation des menstrues.
Unlike climacteric, the reference to menstruation linked menopause firmly to the female body. Reversing Halford’s findings, Tilt described a change of life that was “insensibly” worked out in men, but “in woman the passage is often perilous and the result is more marked.” He argued that physicians needed to pay more attention to this “crisis,” which he attributed to ovarian “involution” or shrinkage. Tilt’s menopausal patients, presented in numerous case studies, suffered from headaches, felt “giddy and stupid,” feared going mad or losing their memory, and were melancholy and bad-tempered. He compared their condition to hysteria and called it “pseudo-narcotism.”
British literature increasingly used the expression female climacteric from about the mid-1860s, and menopause entered English-language dictionaries in the late 1880s, although it did not become current until the following decade. The new standing of the female climacteric was epitomized in the New York physician Andrew Currier’s The Menopause (1897); an explicit attempt to update Tilt’s work, it was the first monograph by an American physician on the topic.
The menopause diagnosis alleviated suffering and made middle-aged women clinically visible as individuals who deserved relief and support. But like many other medical concepts, it also served important social purposes. By linking women’s bodily functions and social roles, reproductive capacity and domesticity, it naturalized a woman’s role as a wife and mother and rationalized the idea that her place was in the home.