The history of female reproductive health is an intimate one. Courtship, sex and childbirth can be uncovered in the historical record through midwifery guides, childbearing manuals, broadside ballots and the letters and diaries of the elite. The history of menstruation, on the other hand, largely remains a blind spot. “Even though it’s woven into the fabric of our everyday lives,” says Professor Mary Fissell, “menstruation wasn’t considered sufficiently important to be recorded in history.”
With very little source material available on this often intensely personal history, individual experiences of menstruation in the past have largely been lost or left a mystery. What we do know is that periods were less regular in pre-modern times than today, due to the fact that many women would have been malnourished. Menstrual regularity was also impacted by the fact that most women spent a larger part of their reproductive life either pregnant or breastfeeding, compared to today.
The records that do survive are largely prescriptive medical texts that reveal ideas about fertility and menstruation from the time. “In the 16th and 17th centuries, people’s understanding of the way in which the female body worked was very different to ours today,” comments Fissell. While today we understand that women are most fertile towards the middle of their menstrual cycle, early modern physicians believed women were the most fertile right after the end of menstruation.
During the pre-modern era, medical professionals also widely subscribed to humoral theory, which dated back to ancient Greece. This stated that the human body contained a mix of four humours: black bile, yellow bile, blood and phlegm – each with their own qualities. Every person had their own particular makeup of humours, the balance of which dictated their health.
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Women were thought to have a humoral composition that made them naturally colder and wetter than men, who were typically associated with being hotter and drier. To a largely agrarian society, this helped explain why women carried children, rather than men. Planting a seed in cold, wet ground would allow it flourish; unlike hot, dry ground where it would likely not take root.
Humoral theory also helped explain why women menstruated. When food was digested, it was thought to be broken down by the body into the four humours. “Since men were hotter, it was believed they could, in a sense, cook their food more completely and convert a greater proportion of it into humours,” explains Fissell. However, due to their cool countenance, women could not digest their food completely, resulting in leftover “plethora”.
“According to physicians, this excess had to leave the body somehow, else it would stagnate and cause problems,” says Fissell. “That’s why women menstruated each month – to get rid of this plethora.” When a woman became pregnant, it was thought that the plethora was instead used to feed the foetus, and could transform into breast milk to provide for the baby post-birth.
“While humoral theory doesn’t equate with current scientific knowledge,” says Fissell, “the pre-modern understanding was based on what could be understood from what could be seen, and so it explained the lived experience of the body pretty well.”
How did women deal with periods?
While medical texts tell us how menstruation was explained by medical specialists in the past, there’s a large silence surrounding the guidance that ordinary women were given on how to deal with their periods from family members or community figures. “I don’t think women were encouraged to be familiar with the interiors of their bodies at this time,” suggests Fissell. “As far as we know, it didn’t seem to be part of their universe.”
It’s likely that most advice was passed on through female friends and family members when a woman was young, and wasn’t put to paper. But what was printed told a different story. “What we see in print is a collection of misogynistic ideas about menstruation,” says Fissell. “I think we have to read it as a deep-rooted fear of the female reproductive body. It was a product of ignorance, where men knew very little about the female body and so told stories that had very little grounding in reality.”
As such, advice was often questionable. Pre-modern commentators warned how a woman on her period should not look in a mirror because it might crack, or that she if she walked on grass, it would die.
But for most women, it wasn’t possible to hide away for several days a month. With unpractical guidance and a lack of modern amenities, how did women deal with menstruation? Instead of underwear as we might recognise it today, women in the 16th and 17th centuries wore shifts – long linen undershirts worn night and day. If a woman was in a better economic situation, she might have been able to change her shift twice a week and have it cleaned by a local laundress. But this wasn’t common.
“Shifts were like a second skin, meaning that women at the time didn’t wear pants,” says Fissell. “This makes it puzzling how they managed their periods, but I think we can hypothesise. I’ve always assumed women used a combination of straps and absorbent natural materials like hay and straw, or even fabric for those who could afford it.”
How women dealt with the day-to-day practicalities of dealing with their period is rarely discussed in contemporary written sources, but enters the world of artefacts even less.
“If there is any physical evidence of early sanitary products, it hasn’t been understood as such,” says Fissell. “Silence doesn’t mean absence, but we haven’t found anything conclusive.”
The first sanitary products?
Sanitary towels, as we might recognise them today, didn’t come about until the late 19th to early 20th century. Industrialised weaving and spinning meant that fabric became cheaper, bringing about the emergence of cloth towels for women.
While the evidential absence of sanitary products poses a difficulty for historians, there’s a similar silence surrounding medication for period pains. One hypothesis suggests that they did exist but, like women’s experiences of menstruation, were simply not written about. Instead, it was likely that remedies were simply shared from one woman to another.
“The sources we have tell you what a women could have expected from her period,” says Fissell. “It’s a shame we can’t find out more about individual experiences but, unfortunately, it’s as close as we can get. How did women cope? It’s a complete mystery.”
Mary E Fissell is professor in the Department of the History of Medicine at the Johns Hopkins University. She was talking to Ellie Cawthorne on an episode of the HistoryExtra podcast
Listen | Professor Mary Fissell unearths the history of women’s reproductive health in the pre-modern Atlantic world, including menstruation, fertility and childbirth: