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Fantastically Wrong: The Theory of the Wandering Wombs That Drove Women to Madness

I don’t have a womb, but I know women who do. All the time, they say to me, “Sorry that I’m out of sorts, my womb just started moving around my torso yesterday!” I tell them that they should probably see a doctor--or at least a sorcerer--immediately.

Fantastically WrongIt's OK to be wrong, even fantastically so. Because when it comes to understanding our world, mistakes mean progress. From folklore to pure science, these are history’s most bizarre theories.Sounds crazy, but in Ancient Greece, this conversation would have actually come up frequently, only it would have been in Greek instead of English. You see, for the Greeks, there was no ailment more dangerous for a woman than her womb spontaneously wandering around her abdominal cavity. It was an ailment that none other than the great philosopher Plato, as well as Hippocrates, the father of modern medicine , described at length.

Greek physicians were positively obsessed with the womb. For them, it was the key to explaining why women were so different from men, both physically and mentally. For Hippocrates and his followers, these differences could be explained by a “wandering womb.” The physician Aretaeus of Cappadocia went so far as to consider the womb “ an animal within an animal ,” an organ that “moved of itself hither and thither in the flanks.”

The womb could head upward and downward, and left and right to collide with the liver or spleen--movements, argued Aretaeus, that manifest as various maladies in women. If it moved up, for instance, the womb caused sluggishness, lack of strength, and vertigo, “and the woman is pained in the veins on each side of the head.” Should the womb descend, there would be a “strong sense of choking, loss of speech and sensibility” and, most dramatically, “a very sudden incredible death.”

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Luckily, the womb had a weakness. “It delights also in fragrant smells,” Aretaeus added, “and advances towards them; and it has an aversion to foetid smells, and flees from them.” And yeah, you guessed it: To cure a wandering womb, physicians could lure it back into position with pleasant scents applied to the vagina, or drive it away from the upper body and back down where it belongs by having the afflicted sniff foul scents.

There was a Greek dissenter, though, by the name of Soranus. This physician, writes Helen King in her essay " Once Upon a Text: Hysteria From Hippocrates ," argued that the womb was not mobile, and that the success of scent therapies was not due to an animalistic organ reacting violently to odors, but to such aromas causing relaxation or constriction of muscles.

How men could get all of the symptoms of a wandering womb--the headaches and vertigo and, of course, very sudden incredible death--without owning an actual womb, is quite problematic for the theory. But for the Greeks, the womb was clearly the seat of a woman’s wily ways, and very much a weakness (Aristotle held that a woman was a “deformed” or “mutilated” male). The womb was a rather more intimate version of the Achilles’ heel, if you will.

And how’s this for a shocker: The looming threat of a wandering womb was used to assert power over women, argues King. One prescription, for example, was for women to be pregnant as often as possible to keep the ostensibly bored womb occupied, and therefore in its rightful place. Physicians would also prescribe consistent sex.

The Romans, thankfully, distanced themselves from the notion of a truly wandering womb, with the physician Galen noting that while it may seem to be moving, it’s actually the tension of the membranes that hold it in place that pull it up slightly. The problem, he claimed, was the “suffocation” of the womb by a buildup of menstrual blood or, even worse, the female version of “seed” that mixed with male sperm. Retained seed would proceed to rot and produce vapors that corrupt the other organs.

After the fall of the Roman Empire, a Byzantine physician by the name of Paul of Aegina proposed an imaginative cure: Make the lady sneeze and, no joke, shout at her. And when the original Greek writings on womb movement, the Gynaikeia , eventually trickled into the Islamic world, physicians there adopted both Aretaeus’ concept of a wandering organ and also rolled in Galen’s idea of suffocation, greatly expanding on the causes of, and cures for, malignant womb vapors.

All of this knowledge, and I use that term loosely, arrived in Italy in the 12th century, and for the next several hundred years, much emphasis was put on scent therapy and sneezing (hey, sneezing may stop your heart, but it does wonders for the womb--OK, sneezing doesn’t actually stop your heart, and it does nothing for the womb). And by the 1500s, argues King, “the hysteria tradition was complete.” While wombs were no longer thought to wander, they were very much to blame for the ostensible irrationality of women. Over the course of several thousand years, the womb had become less and less of a way to explain physical ailments, and more and more of a way to explain psychological dysfunction.

In the 1700s, the theorized cause of hysteria began to shift from the womb to the brain. But this didn’t stop the emergence of the widespread female hysteria commotion in the 19th century , in which countless cures for haywire wombs were peddled on the population, including hypnosis and vibrating devices (not a joke) and blasting a woman’s abdomen with jets of water (sadly, also not a joke). And consider those women of Victorian literature, who were so overcome with emotion--and not at all the suffocating corsets--that they collapsed after announcing they had “a touch of the vapors.” Yes, those same vapors. And how to awaken these women? Smelling salts. Yes, those same foul odors of Hippocratic medicine .

Then along comes Sigmund Freud, who says, Whoa, let’s everyone just settle down . Men get so-called hysteria as well. Freud, in fact, attested to experiencing as much himself, and his study of male hysteria indeed eventually informed his famous Oedipus complex . Most importantly, Freud made it abundantly clear that psychological disorders come from the brain, not from a malfunctioning womb.

Today, what the ancient Greeks or Romans or Arabs would consider to be hysteria is in fact a wide range of psychological disorders, from schizophrenia to panic attacks. (The theory lingers in the word “hysteria” itself: It’s derived from the Greek for “womb.”) And the womb, that organ that so befuddled the physicians of yesteryear, is now much more widely appreciated as that thing that, you know, gave birth to all of us. Unless you're Zeus, and you give birth out of your head . Such are the mysteries of male childbirth, I suppose.

References:

King, H., et al. (1993) Hysteria Beyond Freud . "Once Upon a Text: Hysteria From Hippocrates." University of California Press

Tasca, C., et al. (2012) Women and Hysteria in the History of Mental Health. Clinical Practice and Epidemiology in Mental Health. 2012; 8: 110–119 .

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Wandering wombs and hysteria: the tortuous history of women and pain

Women face an uphill battle to have painful symptoms taken seriously by doctors. Gabrielle Jackson found out the hard way.

It wasn't in a doctors office or a hospital that Jackson learnt for the first time that her long list of painful symptoms were all typical of endometriosis.

She was sitting in a university lecture.

"I cried and I cried and I cried. For most of my life I'd doubted myself, feeling second-rate, weak and flaky," she writes.

What happened next is detailed in her book Pain and Prejudice, where she describes being diagnosed with two chronic inflammatory diseases, endometriosis and adenomyosis, in her early 20s.

Jackson's experience is not unusual. In fact chronic pain is common: it's estimated that nearly one in five Australians lives with it in some form.

But Jackson says women in particular struggle to receive a diagnosis.

It's a problem that's been around for a very long time.

Pain as punishment

For much of history, pain has been seen as an intrinsic part of womanhood.

According to the Abrahamic religions, the first woman ever was dealt pain in childbirth as punishment for disobeying God, when she and Adam dared to take a bite out of an apple plucked from the tree of knowledge.

Social and behavioural scientist Kate Young says institutions like religion, government and education have always played a big part in how we understand women's bodies.

"Women's sexuality has been constructed as volatile and in need of control," she says.

Physicians in Ancient Greece were among the first to describe and systematically categorise various diseases and medical conditions.

Chief among them was Hippocrates, inventor of the "Hippocratic Oath" to do no harm to patients, and widely considered the father of medicine.

He popularised the idea of the "wandering womb", a belief that the medical afflictions suffered by women were the fault of her uterus dislodging itself from her pelvic region and wandering freely around her body.

Hippocrates named one of these afflictions after the Greek word for uterus, hystera.

"The idea was that if they weren't having children, which is what they were 'biologically destined' to do, that must be why they were getting sick,'' Young says.

"The uterus wasn't being used for what it was meant to be so it was wandering around their body."

A hysterical woman was seen as difficult, irrational and dysfunctional, and certainly not fit for public life.

Over time, as scientific understanding of human anatomy developed, the wandering womb theory fell out of favour.

Hysteria, however, persisted in medical textbooks well into the 20th century.

During the 18th century industrial revolution, it was re-framed as a disease of the nervous system.

The transition from agriculture to industry brought with it a pace of life that was seen as incompatible with the inherent frailty of femininity.

Women in pain were victims of a rapidly changing civilisation.

Asylums in the society

In the 19th century, much of a sick woman's fate was determined by her wealth (or more often, the wealth of her husband).

"For wealthy women, the frailty became fashionable, an idle wife was proof of her husband's success,'' writes Jackson.

Poor women were more likely to be locked away in asylums for the insane.

The problem at this time was often framed as either an excess or deficiency in female sexual desire, and as such, treatments often appeared at odds with one another.

Some physicians sought to induce orgasms in their patients, others opted to remove the clitoris altogether.

Other treatments included hypnosis, and traditional blood-letting with leeches.

A persisting pain gap

These days, women's pain is better understood.

Many of those "mad" and "hysterical" women of history were likely suffering from conditions we now know as endometriosis, epilepsy, anorexia and chronic fatigue syndrome.

Hysteria has been demoted from a legitimate medical condition to an admonishment, usually levelled at a woman seen to be behaving in an overly emotional manner.

But the pain gap between men and women lingers.

"Women wait longer for pain medication than men, are more likely to have their physical symptoms ascribed to mental health issues [and] suffer from illnesses ignored or denied by the medical profession," writes Jackson.

Ms Young says there is still a strong cultural belief in western society that pain is normal for women.

Her research into endometriosis revealed that medical professionals often prioritise a woman's fertility over easing her pain symptoms.

"We know that the treatment goals of clinicians and women often conflict," she says.

"Women often privilege symptomatic relief, and want to be able to go about their everyday lives.

"Clinicians instead privilege fertility.

"One of the reasons for that is probably to do with their training, and might go back to the fact that we haven't incorporated women's perspectives and knowledge about their bodies into science and medicine.

Mice, men and difficult women

GP and ambassador for Chronic Pain Australia, Caroline West, agrees that a dearth of good research into women and their bodies had compounded the problem.

"It's in part the fault of the medical profession in not realising that there are clear gender differences in terms of how the body functions,'' she says.

"When it comes to chronic pain research there's definitely been a strong gender bias.

"The irony is that the majority living with chronic pain are women yet 80 per cent of the research is done on men or male mice.

"It's ridiculous to think that you could just study men and expect to have the answers about women's pain."

Jackson points out in her book that PubMed has nearly five times as many clinical trials on male sexual pleasure as it has on female sexual pain.

Young says while it's not the job of women to close the gaps in pain research, improvements in women's healthcare are often the result of them demanding better.

"The women who didn't take no for an answer, who came back and said to a doctor and said "this isn't good enough", they're often framed as the difficult women," she says.

"I love difficult women. I think they are challenging a long history of male-centred medicine.

"Every time they go back to their doctor and say 'I want more from you', I think they are challenging that... and that's so powerful."

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Beware the Wandering Wombs of Hysterical Women

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From ancient Greek physician Hippocrates to the infamous doctor Isaac Baker Brown of the 19th century, the pains and ailments of women were thought to be because of a ‘wandering womb’, better known as ‘hysteria’.

Hysteria, of the Greek translation 'hysterika,' which meant 'that which proceeds from the uterus’ was the generalized term given to women who suffered discomfort of every manner, ranging from mental illness to sexual deviancy, the lack of sexual desire, and even migraines.

Throughout history, medical practitioners have been in a constant struggle with their own codes of morality and treatment. This resulted in the creation of several techniques and machines, which inevitably resulted in the clinical and uncomfortable act of pelvic massage, and even masturbation. Still, the treatments never provided a cure and no matter what physicians did, the problems of a dissatisfied and uncomfortable woman remained.

In certain times in history, hysteria became known as the precursor to a complete demonic possession, resulting in priests having to perform exorcisms and root out potential witches in the area. The belief of hysteria as a symptom continued into European medicine and was extended to encompass several more symptoms with every passing century.

It was only in the early 20th century that hysteria became phased out due to its over-generalized use and diagnosis. Even though hysteria is no longer relevant in the modern era, a disorder of a ‘ wandering womb ’ still exists in the form of endometriosis.

Though the diagnosis and symptoms are not the same, endometriosis is when the lining and cells of a uterus begin to expand and grow in regions where it shouldn’t. Endometriosis, by modern clinical definition, is literally a wandering womb.

How could hysteria have lasted for so long? To answer this, one will need to study its history in detail.

Women under hysteria as depicted in 1880. (Damiens.rf / Public Domain )

The Early History of Wandering Wombs

Its most notable appearances were in the writings of Hippocrates in his Hippocratic Corpus . In his earliest writings, hysteria was a disease of the womb , treatable with massage and exercise.

It was generally believed that the uterus could move within and throughout the body, depending on the health of the woman. According to Hippocratic physicians of the time, the womb itself was like an animal, and it moved to find cold and moist places within the body due to a lack of male seed irrigation.

The result of the womb’s vagabond nature was to create emotional and physical torment until the womb itself had found comfort. This resulted in women having fainting spells, menstrual pain, and a loss of verbal coherence. One treatment prescribed by Hippocratic physicians was to place sweet smells by the vaginal regions and foul salts by the nose in order to lure the uterus back to the woman’s lower groin.

However, by the 1st century AD, the philosophers Celsus and Saronus felt that the remedy for hysteria needed further additions to its treatment. Along with genital massage with sweet oil, exercise and relaxation were now added to the remedies of hysteria.

Diagnosing Hysteria

The definitions of hysteria remained similar in its multifaceted explanations for hundreds of years. Most symptoms included congestion of bodily fluids, nervousness, insomnia, sensations of heaviness in abdomen, muscle spasms, shortness of breath, loss of appetite for food or sex, being demanding, causing trouble, and deficiency of sexual gratification.

By the European Middle Ages, according to contemporary scholar Rachel Maines, the name of 'hysteria' was changed to the ‘suffocation of the uterus’. The diagnosis remained the same and so did the attitudes.

In later documents nearing the 11 th century AD, marriage and masturbation to orgasm became the untold cure for the symptom even though most medieval doctors were hesitant to prescribe this method in fear of being asked to perform it on their female patients. Most though would prefer for women to have their husbands or midwives perform the treatment.

Water massages as a treatment for hysteria 1860. (Laurascudder / Public Domain )

During the 12 th century in Europe, most medical physicians relied on the Greek Classics from Plato and Hippocrates in order to diagnose most ailments. Additional diagnosis of hysteria would now include "the retaining of blood or of corrupt and venomous uterine humors that should be purged in the same way that men are purged of seed that comes from their testicles next to the penis”, as stated by the physician Trotula. However, in the years to come, the fear of the devil would become instrumental in the extreme treatments for hysteria when the previous methods did not work.

Hysteria and Possession

The 13th century Europe was no different in their definitions of hysteria, only now recommending that widows and nuns partake in the treatment of hysteria to balance the fluids and emotional stability of such individuals. The preferred treatments, however, was still married intercourse , as well as vaginal massaging techniques. However, if these methods did not work, the alternative and most extreme explanations would be of the supernatural torment of demons.

It was a widely held belief that if hysteria was not treatable by methods of the older ways, then the symptoms were the beginnings of a demonic possession caused by a hexing witch. The most desirable victims for the alleged demons were young women suffering from depression, single women, women who were viewed as difficult, and elderly women.

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Demonic possession as a result of hysteria, 1858. (Fæ / Public Domain )

The notion of demon possession came from the misunderstanding of mental illnesses which existed during the time. Because of this, most physicians assumed that the traits for demon-possessed women, or demoniacs, were consistent: convulsions, increased intelligence accompanied by clairvoyance and spontaneous tremors, amnesia, and extreme emotional unbalance. Once this was diagnosed, the popular assumption was that there was another witch that had caused the possession of the suffering patient and would need to be found in order to reverse it.

By medieval canon law , any women suffering from either hysteria or demonic possessions were considered blameless of their actions. Thus, rather than stand trial, hysterical female criminals, or in the extreme cases, the ' possessed ' were to be sent to priests in order to have exorcisms performed . Alas, if the exorcism did not work to calm the women, it would mean they were unsavable and the priests feared being taken by the demon possessions themselves.

It wasn’t until the late 17th century when the belief of these unusual ‘possessions’ was phased out, and the possibility of seeing these troubles as mental illnesses became more present in the medical world.

Hysteria and Mental Health

In the 17th century, hysteria emerged as one of the most common female diseases that could be treated by medical practitioners. However, what was changing was attitudes about mental health . During this time, the medical thoughts on hysteria were being studied as a psychological brain disorder, rather than a wandering womb.

The French physician, Philippe Pinel , one of the first physicians to develop more humane psychological study of patients, believed that the disease hysteria, and to some extent nymphomania, were mental instabilities caused by sexual frustrations. Though the diagnosis began to change, the cures remained the same. Pinel also believed in the form of vaginal massage in order to bring balance to the brain.

Hysteria was believed to be caused by nymphomania and other mental instabilities. (robertwaghorn / Public Domain )

During the 18th century, the symptoms of hysteria would be broadened to also include hypochondriac men. However, for the most part, it was still considered a woman’s disease since most practitioners felt that it was now, not only connected with a woman's mental state but also deeply connected to female sexual organs simultaneously.

Female Hysteria in the 19th Century

During the 19 th century, for women, the western world was plagued with a plethora of fears not only consisting of catching hysteria but also with the concerns of uncurable sexual diseases such as syphilis . With such fears that were prevalent in 19 th century society, so were the extreme treatment methods for such conditions. During the 19 th century, the desires for pleasure and the self would be seen as terrible.

Though in previous years, hysteria was considered uniquely feminine and directly connected to their sexual organs, the practitioners of the time now felt that hysteria was a more negative extreme state rendering “…women difficult, narcissistic, impressionable, suggestible, egocentric, and labile; not to mention idle, self-indulgent and deceitful, craving for sympathy, who had an unnatural desire for privacy and independence…” (Donkin, 1892)

Physicians carried a fear that they were promoting the notion of sexual debauchery by having their work compared to masturbation. Due to this, during the 19th century, there was an extreme treatment, though not very popular with most physicians of the time, to perform clitoridectomy (the circumcision of the clitoris ) in order to prevent female masturbation, and therefore isolating the problems most women had with the alleged symptom of hysteria.

Gynecology or 1822, to treat hysteria doctors often performed the procedure of a clitoridectomy. (Morgoth666 / Public Domain )

Such 19 th century gynecologists such as Isaac Baker Brown (1812-1873), who was also president of the Medical Society of London, believed that the clitoris was utterly responsible for hysteria, epilepsy , and manic depression. In his opinion, if one were to surgically remove what he considered the ‘unnatural irritation’ called the clitoris, the issues which all women faced would be gone.

During this time, there was a widespread belief which most doctors of the time had that the mental and emotional disorders were directly connected to the female reproductive organs , and by simply removing them, it would make a woman compliant and trustworthy. However, by 1867, this fell out of practice.

In the second half of the 19th century, however, newer and more technical methods for treating hysteria would separate the sexual aspect of the disease and keep the physicians free from the lewd act of vaginal massage. This would come in the form of medical vibrators, and as scholar Rachel Maines would explore in her studies, there was a market that could be indefinitely exploited.

As a scholar, Rachel Maines theorized that medical practitioners from the early 19th century until the early 20th century practiced the techniques of medical masturbation upon female patients until they reached a sexual climax , in the most clinical and most non-romantic way.

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A 1918 ad with several models of mechanical vibrators, developed to treat hysteria. (PawelMM / Public Domain )

More often than not, most husbands and family members of the patient would be in the same room as a medical doctor would vaginally massage her to orgasm. This has been documented to take hours at a time and be very uncomfortable to watch.

As mentioned prior, due to the sexually perverse nature of the act, medical doctors desperately tried to recommend the technique to the patient’s husband or midwife to perform, rather than directly performing the treatment themselves. With the problems of symptoms continually returning to patients, another technique was promoted by way of mechanical automation.

Main's notion was that this tool was not only a better alternative to medical practitioners performing vaginal massage but also was a very marketable tool in terms of medical revenue: “Hysterical women represented a large and lucrative market for physicians. These patients never recovered nor died of their condition but continued to require treatment.” (Rachel Maines, 1999)

Though, even with Maine’s hypothesis, many other scholars believe this to be a skewed interpretation of the facts. Other scholars have chosen to keep the history of the vibrator and the history of hysteria as two separate and competing theories which exist in academia today.

Hysteria Redefined for the Modern Age

By the early 20th century, the number of women suffering from hysteria drastically declined due to its overgeneralized diagnosis. In the 21st century, hysteria was no longer recognized as an illness at all.

Within several hundred years, the definitions of wandering womb and hysteria seemed to stay somewhat consistent. Through time, more symptoms were added to the disease to explain further mental disorders which could not be accounted for.

However, the theme and treatment seemed to remain the same until the turn of the century. Only then was the disease hysteria phased out for further scientific and more specific definitions for ailments. Although it can be argued that advances in medical technology and thinking were the reasons for the social maturing, it may be potentially due to women attaining more rights than they had before.

Top image: Hysteria was a term used to diagnosis wandering womb a female medical condition branded by ancient Greeks. Source: rodjulian / Adobe Stock

By B.B. Wagner

Griffith. 2014. The Mysterious Case of the Wandering Womb . The University of Melbourne. [Online] Available at: https://blogs.unimelb.edu.au/sciencecommunication/2014/10/17/the-mysterious-case-of-the-wandering-womb/

Maek, H. 2009. Of Wandering Wombs and Wrongs of Women: Evolving Conceptions of Hysteria in the Age of Reason . University of Regina. [Online] Available at: https://ejournals.library.ualberta.ca/index.php/ESC/article/download/20152/15580

Maines, R. 1999. The Technology of Orgasm: “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction . The Johns Hopkins University Press.

Mayo Clinic Staff. Date Unknown. Endometriosis . Mayo Clinic. [Online] Available at: https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656

Rudnick, L. and Heru, A. 2017. The ‘secret’ source of ‘female hysteria’: the role that syphilis played in the construction of female sexuality and psychoanalysis in the late nineteenth and early twentieth centuries . Sage journals. [Online] Available at: https://journals.sagepub.com/doi/full/10.1177/0957154X17691472

Spanos, N. and Gottlieb, J. 1979. Demonic possession, mesmerism, and hysteria: A social psychological perspective on their historical interrelations . Journal of Abnormal Psychology. [Online] Available at: https://psycnet.apa.org/doiLanding?doi=10.1037%2F0021-843X.88.5.527

Tasca, C., Rapetti, M., Carta, M., and Fadda, B. 2012. Women And Hysteria In The History of Mental Health . Clinical Practice and Epidemiology in Mental Health. [Online] Available at: https://www.researchgate.net/publication/232746123_Women_And_Hysteria_In_The_History_Of_Mental_Health

Ussher, J. 2013. Diagnosing difficult women and pathologizing femininity: Gender bias in psychiatric nosology . University of Western Sydney, Australia. Feminism and Psychology. [Online] Available at: https://journals.sagepub.com/doi/abs/10.1177/0959353512467968

B.B. Wagner is currently working on a master’s degree in Anthropology with a focus in Pre-contact America. Wagner is a storyteller, a sword fighter, and a fan of humanity’s past. He is also knowledgeable about topics on Ice Age America... Read More

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Hysteria, Witches, and The Wandering Uterus: A Brief History

Or, why i teach "the yellow wallpaper".

I teach “The Yellow Wallpaper” because I believe it can save people. That is one reason. There are more. I have taught Charlotte Perkins Gilman’s 1891 story for nearly two decades and this past fall was no different. Then again, this past fall was entirely different.

In our undergraduate seminar at the School of the Art Institute of Chicago, we discussed “The Yellow Wallpaper” in the context of the nearly 4,000-year history of the medical diagnosis of hysteria. Hysteria, from the Greek hystera or womb. We explored this wastebasket diagnosis that has been a dump-site for all that could be imagined to be wrong with women from around 1900 BCE until the 1950s. The diagnosis was not only prevalent in the West among mainly white women but had its pre-history in Ancient Egypt, and was found in the Far East and Middle East too.

The course is titled “The Wandering Uterus: Journeys through Gender, Race, and Medicine” and gets its name from one of the ancient “causes” of hysteria. The uterus was believed to wander around the body like an animal, hungry for semen. If it wandered the wrong direction and made its way to the throat there would be choking, coughing or loss of voice, if it got stuck in the the rib cage, there would be chest pain or shortness of breath, and so on. Most any symptom that belonged to a female body could be attributed to that wandering uterus. “Treatments,” including vaginal fumigations, bitter potions, balms, and pessaries made of wool, were used to bring that uterus back to its proper place. “Genital massage,” performed by a skilled physician or midwife, was often mentioned in medical writings. The triad of marriage, intercourse, and pregnancy was the ultimate treatment for the semen-hungry womb. The uterus was a troublemaker and was best sated when pregnant.

“The Yellow Wallpaper” was conceived thousands of years later, in the Victorian era, when the diagnosis of hysteria hit its heyday. Medical attention veered from the hungry uterus and was placed on a woman’s so-called weaker nervous system. Nineteenth-century physician Russell Thacher Trail approximated that three-quarters of all medical practice was devoted to the “diseases of women,” and therefore physicians must be grateful to “frail women” (read frail white women of certain means) for being an economic godsend to the medical profession.

It was believed that hysteria, also known as neurasthenia, could be set off by a plethora of bad habits including reading novels (which caused erotic fantasies), masturbation, and homosexual or bisexual tendencies resulting in any number of symptoms such as seductive behaviors, contractures, functional paralysis, irrationality, and general troublemaking of various kinds. There are pages and pages of medical writings outing hysterics as great liars who willingly deceive. The same old “treatments” were enlisted—genital massage by an approved provider, marriage and intercourse—but some new ones included ovariectomies and cauterization of the clitoris.

It is no accident that such a diagnosis took off just as some of these same women were fighting to gain access to universities and various professions in the US and Europe. A decrease in marriages and falling birth rates coincided with this medical diagnosis criticizing the New Woman and her focus on intellectual, artistic, or activist pursuits instead of motherhood. Such was the downfall of Gilman’s narrator in “The Yellow Wallpaper.”

Good chance you read the story in school, but in case you didn’t or have forgotten, here is a synopsis. Following the birth of her first child, the narrator says she feels sick, but her physician husband has dismissed her complaints as a “temporary nervous condition—a slight hysterical tendency.” He has rented a country house and has put her to rest in the former nursery. She explains,

So I take phosphates or phosphites—whichever it is, and tonics, and journeys, and air, and exercise, and am absolutely forbidden to “work” until I am well again.

Personally, I disagree with their ideas.

Personally, I believe that congenial work, with excitement and change, would do me good.

But what is one to do?

The narrator’s work is that of a writer. She sneaks paragraphs here and there when she is not being observed by her husband or his sister who is “a perfect and enthusiastic housekeeper, and hopes for no better profession.” The story documents the narrator’s frustrations with her so-called treatment and her husband’s resolve that she only needs to exercise more will and self-control in order to get better. “‘Bless her little heart!’ said he with a big hug, ‘she shall be as sick as she pleases.'”

We witness the narrator’s steady decline as she becomes increasingly obsessed with the room’s ghastly wallpaper: “the bloated curves and flourishes—a kind of ‘debased Romanesque’ with delirium tremens— go waddling up and down in isolated columns of fatuity.” Gilman—a prolific writer of fiction, poetry and profound and progressive books, including Women and Economics, a woman who drew large crowds as she made the national lecture circuit in her day—is masterful at showing us how things fall apart for her protagonist. In the final scene of the story, the narrator creeps along the edges of the former nursery amidst shreds of wallpaper, stepping over her crumpled husband who has fainted upon discovering his wife in such a state.

A number of 19th-century practitioners gained fame as hysteria doctors. S. Weir Mitchell, a prominent Philadelphia physician, was one of them. He championed what he called “the rest cure.” Sick women were put to bed, ordered not to move a muscle and instructed to eschew intellectual or creative work of any kind, fed four ounces of milk every two hours, and oftentimes required to defecate and urinate into a bed-pan while prone. Mitchell was so renowned he had his own Christmas calendar.

Mitchell was Charlotte Perkins Gilman’s physician. His rest cure was prescribed to some of the great minds of the time, including Edith Wharton and Virginia Woolf. Scores of white women artists and writers were diagnosed as hysterics in a period when rebelliousness, shamelessness, ambition, and “over education” were considered to be likely causes. Too much energy going up to the brain instead of staying in the reproductive organs and helping the female body do what it was supposed to do. As Mitchell wrote, “The woman’s desire to be on a level of competition with man and to assume his duties is, I am sure, making mischief, for it is my belief that no length of generations of change in her education and modes of activity will ever really alter her characteristics.”

Transgressing prescribed roles would make women sick. British suffragettes, for instance, were “treated” as hysterics in prison. Outspoken proponents for women’s rights were often characterized as the “shrieking sisterhood.” In our seminar discussion, we made the comparison to the numbers of African American men diagnosed as schizophrenics at a State Hospital for the Criminally Insane in Ionia, Michigan in the 1960s and 70s as documented in psychiatrist Jonathan Metzl’s powerful book The Protest Psychosis: How Schizophrenia Became a Black Disease . A diagnosis can be a weapon used as a way to control and discipline the rebellion of an entire demographic.

As we discussed “The Yellow Wallpaper” and its historical context, I could see that Allie was becoming more and more outraged. She looked as if she might bolt from her classroom seat. Her hand shot up, “Would you believe that my high school English teacher told us, ‘If this woman had followed her husband’s instructions, she wouldn’t have gone crazy?!'”

If I’d had a mouth full of something, I would have done a spit take. In all my years of teaching the story, I cannot remember ever hearing this jaw-dropping explanation. But Allie opened the flood gates. Bec raised her hand, “We read it in eighth grade. We were all concerned and confused, especially the girls. And disturbed by the ending. No one understood what was wrong with the woman. The story didn’t seem to make any sense.”

Max added, “In my A.P. Psychology class, our teacher asked us to use the DSM 4 to diagnose the woman in “The Yellow Wallpaper.” I remember a number of student guesses, like Major Depressive Disorder, General Anxiety Disorder, as well as OCD, Schizophrenia, and Bipolar with Schizotypal tendencies.”

Noëlle said she remembered a fellow high school student describing the narrator as “animalistic” and the teacher writing it on the board. There was no discussion of what “hysteria” actually meant.

Keeta encountered the story in a college literature seminar titled “Going Mad.” Class discussion focused on the insane and unreliable narrator. “A missed opportunity for me to learn about something very real and current, and in some ways I feel wronged by that,” Keeta said. They explained that they had a similar feeling when watching the film Beloved in middle school. “Here’s your heritage, and it’s dumped in your lap, and you have no idea why this enslaved woman killed her child. If you had more information about the history of slavery and reproductive resistance, then you would be able to make better sense of what you were seeing.”

Cristina hadn’t read “The Yellow Wallpaper” before but said, “In the fourth grade in my all-girls Catholic school in Bogotá, my religion teacher told the class that we should only show our bodies to our husbands and doctors. Meaning they are the only ones that can touch our bodies. I think there is some connection here, no?”

I am always moved by the associations students make between the history of hysteria and their own lives and circumstances. We discussed how it is startling to learn about nearly four millennia of this female double bind, of medical writings opining cold, deprived, frail, wanting, evil, sexually excessive, irrational, and deceptive women while asserting the necessity of disciplining their misbehaviors with various “treatments.”

“What about Hillary?” Bec chimed in.

This wasn’t just any fall semester. There couldn’t have been a more appropriate time to consider the history of hysteria than September 2016, the week following Hillary Clinton’s collapse from pneumonia at the 9/11 ceremonies, an event that tipped #HillarysHealth into a national obsession. Rudolph Giuliani said that she looked sick and encouraged people to google “Hillary Clinton illness.” Trump focused on her coughing or “hacking” as if the uterus were still making its perambulations up to the throat.

For many months, Hillary had been pathologized as the shrill shrew who was too loud and outspoken, on the one hand, and the weak sick one who didn’t have the strength or stamina to be president on the other. We discussed journalist Gail Collins’ assessment of the various levels of sexism afoot in the campaign. On the topic of Hillary’s health, Collins wrote, “this is nuts, but not necessarily sexist.” We, in the Wandering Uterus, wholeheartedly disagreed. But, back in September, we did not understand how deeply entrenched these sinister mythologies had already become.

We returned to the Middle Ages to help us understand what we were witnessing unfold during the campaign. By way of the church, the myth flourished that women were evil. Lust and carnal pleasures were the problem with women who were, by nature, lascivious and deceptive. Female sexuality, once again, was the problem. So-called witches were accused of making men impotent; their penises would “disappear” and it was claimed that witches would keep said penises in a nest in a tree. Unholy spirits were the cause of bewitchment, a condition that sounded a lot like earlier descriptions of hysteria. Its “treatment” led to the death of thousands of women. In their 1973 groundbreaking treatise, Witches, Midwives, and Nurses , Barbara Ehrenreich and Deirdre English argue that the first accusations of witchcraft in Europe grew out of church-affiliated male doctors’ anxieties about competition from female healers. The violence promoted by the church allowed for the rise of the European medical profession.

In class, we continued to discuss the construction of she-devil, foul-mouthed Crooked Hillary who extremists berated with hashtags like #Hillabeast and #Godhilla and #Witch Hillary. How could we not compare the campaign season to the witch-hunts when folks at rallies started chanting “hang her in the streets” in addition to the by-then familiar “lock her up.” In short order, we witnessed a shift from the maligned diagnosis of a single individual to an all-out mass hysterical witch-hunt against a woman who dared to run for presidential office. We discussed the brilliant literary critic Elaine Showalter whose book Hystories , written in the 1990s, focuses on end-of-the-millennium mass hysterias. Prior to the existence of social media, Showalter presciently wrote, “hysterical epidemics. . . continue to do damage: in distracting us from the real problems and crises of modern society, in undermining a respect for evidence and truth, and in helping support an atmosphere of conspiracy and suspicion.”

We discussed the fact that social media had allowed for this rapid circulation of Hillary mythologies. I explained that the witch-hunts in Early Modern Europe happened to correspond to the invention of the social media of their day. First published in 1486, Malleus Maleficarum or The Hammer of Witches by Reverends Heinrich Kramer and James Sprenger became the ubiquitous manual that spread the church’s methods of identifying witches through questioning and torture in large part by means of the contemporaneous invention of the printing press. For nearly two centuries, this witch handbook was reprinted again and again, disseminating sentences that would later inspire the anti-Hillary playbook, “She is an imperfect animal who always deceives.” “When a woman thinks alone, she thinks evil.”

By midterm presentations, we talked about the ways in which hysteria had gone viral with other women candidates, like Zephyr Teachout, a law professor and activist running for Congress, who found herself on the receiving end of attack ads that featured a close-up of her face with a red-lettered CRAZY stamped on it.

Upon closer investigation, this form of political slander was not limited to the current election season or the US. In Poland, women who marched against a recent abortion ban were called feminazis, prostitutes, whores, witches, and crazy women. While in 2013, Russian news reports suggested that members of the band Pussy Riot were “witches in a global satanic conspiracy in cahoots with the Secretary of State Hillary Clinton.” That should have been a clue to what would follow.

During the weeks running up to the election we veered from the topic of hysteria and discussed the history of gynecology and enslaved women as experimental subjects, sexual anatomy and disorders of sexual development, and queer and trans health care, but we still began each class by sharing recent developments from the campaign trail: Muslim registries, pussy grabbing/sexual assault, and bullying. We discussed Trump’s remarks that soldiers living with PTSD are not “strong enough,” echoing medical and military attitudes from the previous century that associated male hysteria with WWI and “shell shock.”

The Sunday before the election, I was invited by students belonging to the school feminist group, Maverick, to meet at the Hull-House Museum. We sat on the floor of Jane Addams’ bedroom which houses her 1931 Nobel Peace Prize as well as her thick FBI file, evidence of the one-time moniker “most dangerous woman in America.” We talked about the founding of the Settlement House, that Addams knew that “meaningful work” was important for this first generation of white women that had received a college education. At the Hull-House, Addams and other young women residents worked together with some of the poorest immigrants to improve living conditions, to promote child labor laws, to build playgrounds. They celebrated various immigrant traditions over large shared meals and Italian opera and Greek tragedy.

I told the group that Charlotte Perkins Gilman visited the Hull-House on a number of occasions. It was at the Hull-House that she developed some of her ideas about women and economics, about group kitchens and shared domestic responsibilities. I told them how amazed I was to learn that, as a young woman, Addams, as well as a number of Hull-House residents, had also been under the care of the famed Dr. Mitchell.

I read them excerpts of Addams’ writings during WWI when she was blacklisted for her promotion of peace; her health failed, and she hit the depths of depression. Remarking on her colleagues’ suffering, she wrote: “The large number of deaths among the older pacifists in all the warring nations can probably be traced in some measure to the peculiar strain which such maladjustment implies. More than the normal amount of nervous energy must be consumed in holding one’s own in a hostile world.”

When our class met two days following the election, we talked about deportations, anti-Muslim hate crimes, LGBTQ vulnerabilities, and climate change. A number of us confessed that we were physically ill as we watched the returns come in. I mentioned one friend who wrote me that he felt as though he were drinking poison. Two other friends were struck down by bouts of diarrhea and dry heaves on election night. When they went to their doctor, she said that she had seen an inordinate number of sick people. Something was going around.

For many of these students, the election results were just an added stress to that of a long-time civil war back home, to having undocumented family, to losses from gun violence, or to being targeted when walking down the street because of race and/or gender presentation and/or sexuality and age. For some of us, this next administration would be yet another thing to get through. For more of us, we were only beginning to understand that our democracy and our rights were fragile things.

I didn’t tell them that I was waking up each morning feeling nauseated, my belly distended. I knew I was clenching my gut as if I had been sucker-punched. This clenching plus many surges of adrenaline had set off an old familiar pain in my gallbladder area. A friend told me about his neck pain. Another said her hip pain had returned. I was reminded of Showalter again: “We must accept the interdependence between mind and body and recognize hysterical syndromes as a psychopathology of everyday life before we can dismantle their stigmatizing mythologies.” Who could ever claim that mind-derived illness is not true illness? Pain is not fiction.

The readings for the class immediately following the election included Billye Avery on her creation of the National Black Women’s Health Project. She wrote about the importance of really listening to each other, that issues like infant mortality are not medical problems, they are social problems. We also discussed an excerpt from Audre Lorde’s Cancer Journals , words that were remarkably fresh some 30 years later: “I’ve got to look at all my options carefully, even the ones I find distasteful. I know I can broaden the definition of winning to the point where I can’t lose. . . We all have to die at least once. Making that death useful would be winning for me. I wasn’t supposed to exist anyway, not in any meaningful way in this fucked-up whiteboys’ world. . . Battling racism and battling heterosexism and battling apartheid share the same urgency inside me as battling cancer.” We took heart in Lorde’s reference to, “The African way of perceiving life, as experience to be lived rather than as a problem to be solved.”

Our syllabus continued to portend current events even though it had been composed back in August before the start of the semester. At the escalation of the Standing Rock water protectors’ protests, we discussed Andrea Smith’s “Better Dead than Pregnant,” in her book Conquest: Sexual Violence and American Indian Genocide , about how the violation of indigenous women’s reproductive rights is intimately connected to “government and corporate takeovers of Indian land.” We discussed Katsi Cook’s “The Mother’s Milk Project” and the notion of the mother’s body as “first environment” in First Nations cultures, which led environmental health activists to the understanding that “the right to a non-toxic environment is also a basic reproductive right.”

The week the students were to begin their final presentations, we discussed the Comet Ping Pong Pizza conspiracy, that a man actually stormed a DC pizza parlor with an assault weapon because of fake news claiming that this establishment was the locus of Hillary’s child sex slave ring. I would not have been surprised if the fake news writers had taken inspiration from the Malleus Maleficarum and reported that the parlor also served Hillary the blood of unbaptized children.

Emma said she was tired of Facebook and where was the best place to get news?

A good deal of the election’s fake news had been dependent on the power of a nearly 4,000-year-old fictional diagnosis. Both news and medical diagnosis masqueraded as truth, but they were far from it. How to make sense of this fake diagnosis in relation to the idea that illness can be born from our guts and hearts and minds? Is there anything truer? And yet, psychosomatic illness continues to be deemed an illegitimate fiction.

We know that the social toxins of living in a racist, misogynist, homophobic, and otherwise economically unjust society can literally make us sick, and that sickness is no less real than one brought on by polluted air or water. In actuality, both social and environmental toxins are inextricably intertwined as the very people subject to systemic social toxins (oppression, poverty) are usually the same folks impacted by the most extreme environmental toxins. And the people who point fingers and label others “hysterical” are the ones least directly impacted by said toxins.

Then there are the lies leveled at fiction. What of the fake criticism students had encountered during their former studies of “The Yellow Wallpaper”? Our histories provide us with scant access to the so-called hysteric’s words or thoughts. But Gilman was outspoken about her experience. She wrote about it in letters, in diaries, in the ubiquitous “The Yellow Wallpaper” and in a gem of a 1913 essay titled “Why I Wrote ‘The Yellow Wallpaper.'” In this 500-word piece , required reading for anybody assigning”The Yellow Wallpaper,” Gilman describes her experience with a “noted specialist in nervous diseases,” who, following her rest cure, sent her home with the advice to “‘live as domestic a life as far as possible,’ to ‘have but two hours intellectual life a day,’ and ‘never to touch pen, brush, or pencil again’ as long as I lived.” She obeyed his directions for some months, “and came so near the borderline of utter mental ruin that I could see over.” Then she went back to work—”work, the normal life of every human being; in which is joy and growth and service”—and she ultimately recovered “some measure of power” leading to decades of prolific writing and lecturing. She explains that she sent her story to the noted specialist and heard nothing back. The essay ends,

But the best result is this. Many years later I was told that the great specialist had admitted to friends of his that he had altered his treatment of neurasthenia since reading”The Yellow Wallpaper.”

It was not intended to drive people crazy, but to save people from being driven crazy, and it worked.

I teach “The Yellow Wallpaper” because it is necessary to know and to revisit. I teach “The Yellow Wallpaper” because a deep consideration of this story in relation to its historical and medical context teaches us how much more we can learn about every other narrative we think we already know, be it fact or fiction. I teach this story because I believe it can save people.

The semester is over and New Year’s Day 2017 has passed. I am struck with a nasty flu that lingers for weeks. There is a pulling pressure in my head, a stuck feeling in my ears, unpredictable flushes. I can’t focus. I can barely write the sentences required to finish the letters of recommendations that are due.

Surfing online scratches some productivity itch. Like an obsessed survivalist chipmunk, I stock up on nuts and canned goods and vitamins that will line basement shelves. I donate to a hodgepodge of organizations and causes. . . NRDC, Standing Rock, IRC, African Wildlife Foundation, and more. I sign online petitions as quickly as they enter my inbox. I cough my way through calls to my members of Congress, imploring them to reject various cabinet picks. I come across an article about the surge of visits to therapists for “post-election stress disorder” and “post-election depression syndrome.” The fever continues and still there is that loss of appetite, all laced with a deep sense of foreboding. I sleep through President Obama’s farewell speech.

I wake up the next morning from a fever-induced delirium and am convinced that it is of the utmost importance to locate PVC-free window film. Once the right product is identified, I will affix these decorative wallpaper-like opaque sheets to the bottom sashes in the kitchen so that pedestrians on the nearby sidewalk cannot see in. Suddenly, I must have more privacy. But I want privacy and light. I look at various patterns. One pattern is called “atomic energy.” It is lovely but would probably prove monotonous. I finally land on “rhythm” for its non-descript pattern. In the end, I decide that the wood blinds that are already there work just fine.

I blow my nose and steam my head through more news of Russian election intervention and continued nasty tweets, this time aimed at civil rights legend John Lewis. As Inauguration Day inches closer, I lie on the couch under a blanket, looking out my Chicago window at the rain that should be snow.

A friend on the phone tells me that a fever is the releasing of anger. I feel semi-human. I am haunting my own couch. I leave the house only twice in 17 days to see Frank, the acupuncturist, who tells me that he is treating scores of people with the same upper respiratory thing. He has seen an uptick in ailments since the election. Maybe things will be better after the inauguration, he says hopefully, maybe the anticipation is worse.

I hear myself say aloud to my body, “Please work with me here.”

I read about Jan Chamberlin, a member of the Mormon Tabernacle Choir who refuses to sing at the inauguration. A CNN anchor says that her comparison of Trump to Hitler sounds “kind of hysterical. . . ”

I recall one student from a few years ago. She raised her hand and said that the diagnosis of hysteria was like being called a “crazy girl.” “I am called that all the time,” she said. I was confused. Crazy girl? But as she continued on about that label, many of her classmates nodded emphatically. “If I get upset about something said in conversation or on social media,” she said, “I’m dismissed as ‘crazy girl.'”

Class projects are piled on the floor of my office. There is Max’s poem about the horrifying beating he experienced as a teenager, a hate crime at a mall witnessed by his boyfriend and dismissed by the police. There is Virginia’s small book that she made for her teenage nieces, advice for being a young Latinx person in this country. There is Sylvie’s project, an artist’s book collaboration with her dead mother’s journal writing. Noëlle’s educational coloring book for kids with diabetes that she made with her eight-year-old brother as adviser. I imagine that most, if not all, of these amazing young people would have qualified at one time or another as hysterics because of gender presentation and/or sexuality, and their artistic, scholarly, or activist pursuits. Me too. We are all part of a long history, members of tribes that have been, at times, misinterpreted, misunderstood, or worse.

The misunderstandings have not stopped. Each semester that I teach this class, a few students share stories of bodily symptoms, their own or a family member’s, that could not be explained by organic causes according to conventional Western medicine. Inevitably they were told by a healthcare provider that the problem is all in their heads. These stories contribute to conversations about the power of the mind and how many great ideas and possibilities arise from the very “irrational” place that has been and continues to be so often undervalued.

That is another reason I teach “The Yellow Wallpaper.”   Gilman’s text reminds us that we must defy Mitchell’s treatment; we must use our minds, our critical faculties, and our imaginations more than ever to question and to act.

The fever has lifted, but I still cancel my trip to DC. Standing in the cold for hours would be a bad idea given what my body has been through. I know I must rest. But I can finally focus again. And write. I am so grateful. As Gilman says, “work, the normal life of every human being; in which is joy and growth and service.”

I refuse to tune in for the inauguration. I cannot bear to watch it by myself. After it is over, I read the transcript of the apocalyptic “carnage” speech and witness comparison photos between the last inauguration and this one, proving the small number of people in attendance, a fact that will become the focus of more lies. These “alternative facts” are aided and abetted by Trump’s adviser Kellyanne Conway who will be increasingly subject to strikingly familiar misogynist bitch and witch-based attacks of her own. Hysteria is a bipartisan weapon.

The following day, I watch videos and livestream of millions of participants assembled for Women’s Marches all over the world. A proliferation of photos collect online in a blink. My stomach releases a bit.

From my couch, I work on my syllabi for spring semester while reading Hannah Arendt on tyranny, Michel Foucault on defending society, and bell hooks on love. I am not teaching “The Yellow Wallpaper” this semester. But it will be on my syllabus next fall. And the following fall. And again. And again.

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Terri Kapsalis

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Women have long been seen as at the mercy of their biology.

In the ancient medical world it was believed that a 'wandering womb' caused suffocation and death. Menstruation and pregnancy were thought to make women the weaker sex, both physically and mentally. By the late nineteenth century, it was deemed scientifically proven that women’s biology made them less rational than men, unfit to participate in many areas of public life.

Rising above these attitudes, a century ago, women began securing the right to vote in the UK. Around the same time, nursing was formalised as a predominantly female profession. Since then, nurses have taken a leading role in challenging assumptions of women’s health.

Yet myths and misconceptions remain widespread. Social changes continue to alter women’s biology, as they start periods earlier and live longer beyond the menopause. What is ‘normal’ for women? And why has women’s health long been considered 'dirty' nursing'?

Did you know: Gynaecology is a Greek term literally meaning 'the study of women'. And hysteria is derived from 'hystera' meaning womb. This linguistic association between women’s health and hysteria is still in use today in the term hysterectomy.

Decisions about women’s health have historically been made by men.

For the Victorians, the menstrual cycle was considered a disease. Women found all sorts of ways to find out more about their periods and learnt from female relatives. Some would even source secret texts on women’s health, often disguised in the dust jacket of more ‘acceptable’ reading material.

How did nursing change this? As the role of women in health care grew, so did an understanding about women’s health and biological cycles. Nurses became advocates for women, in a position to air previously hidden topics. 

The introduction of the contraceptive pill in 1961 changed when and how much women bleed. It helped move away from medically assumed norms to cycle lengths and flows unique to the individual. More and more women were able to better predict the symptoms of their own biology.

Women today have more control over their periods than ever. Bolder attitudes have seen campaigns to abolish the ‘tampon tax’ and charities working to ensure all women get access to menstrual supplies. Nurses play an important part in this changing atmosphere. As more non-surgical options have become available for women, like mirena coils and hysteroscopy, nurses have been at the  forefront of embracing and delivering these treatments.

Nursing today focuses on the holistic management of menopause. This can include managing lifestyle changes and advising on prescribed medication such as Hormone Replacement Therapy. Because the effects of menopause are so complex, Clinical Nurse Specialists (CNS) are key at this advanced level of practice. Taking time to understand individual patient concerns and providing tailored support are crucial nursing skills.

A Victorian woman going through the menopause was often considered to be emotionally unstable. During this 'climacteric period', she may well have been prescribed leeching or bloodletting from the ankle. Her doctor would have advised against reading novels, going to parties and dancing. For a 45 – 50 year old Victorian woman, an onslaught of instability and madness was considered inevitable. 

In the Victorian age men were also diagnosed with climacteric insanity, as something that was defined as a broad spectrum of 'changes' in life. But men were not diagnosed as frequently as women. Today, the possibility of 'man periods' or the 'male menopause' are widely discussed, as hormone fluctuations in men are also recognized.

Hidden loss

Pregnancy loss is more common than is discussed.

Even today, some causes of miscarriage are not known. Plenty of preventative measures have been tried and tested by women all over the world for centuries. Ancient Egyptian women were known for placing protective amulets in the vulva and women of Ancient Greece would avoid bitter foods. Practically any action taken by a woman in the Middle Ages could be seen to prompt a miscarriage, making her choices wholly responsible for the outcomes of her pregnancy.

In the nineteenth century, anything from exercise, worry, even failure to meet the demands of home life was blamed. Whilst these beliefs are centuries past, the idea of miscarriage as being the ‘fault’ of the woman still exists. Stigma around miscarriage and ectopic pregnancy continues

Nurses are breaking this stigma.

The focus has shifted from the physical health of women to their emotional health. Specialist nurses within Early Pregnancy Units are leading on assessing, scanning and undertaking treatments. Counselling and strong links with support groups and charities are all part of providing expert care for their patients.

"By allowing my own experience to be reported I hope…that I might contribute in a small way to a future climate in which these matters are respected as entirely personal – rather than pored over and speculated about as they are now.”

In 1895, Dublin nurse Alice Beatty took her surgeon, Charles Cullingworth, to court.

Cullingworth operated on Beatty for 'ovarian disease', but removed both her ovaries rather than the one she had consented to. Beatty, engaged to be married and keen to start a family, claimed damages for a wrongly performed operation. She lost the case.

Victorian surgery, prescribed and performed by men, was often extreme. Hysterectomy was the treatment of choice for cervical cancer, even when death rates were high. Consent and the social and psychological effects on women were barely acknowledged. 

With the advent of new procedures, such as endometrial ablation, hysterectomy is no longer the only option. Now, Clinical Nurse Specialists (CNS) are essential in delivering and supporting these new treatments and at the same time, ensuring the rights and wishes of their patients are met. 

Gynaecological cancers are complex and the nursing role is expanding. Nurses take the majority of smear tests. They have a large role in the diagnosis of cervical cancer, from screening through to colposcopy, as well as spotting cancer reoccurrence. A CNS remains with their patient for the whole journey, from diagnosis, treatment and managing the long term effects. Unlike Alice Beatty, women now have increasing opportunities to take more control over their own care.

We all need to speak more openly about intimate health issues.

Women's biology has long been subject to speculation, comment and often control by others. It is now time for menstruation and menopause to be understood and celebrated as a normal part of female biology. 

In a field previously dominated by the perspectives of male doctors and physicians, all nurses now have a responsibility to advocate for women today. It is up to healthcare workers to recognise that each woman is different and that ‘normal’ means healthy.

Perhaps for the nurse, it is the ‘dirty’ nature of gynaecology which makes the role so unique, helping to transform a woman’s experience.

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THE WANDERING WOMB

By Mary Lefkowitz

The New Yorker , February 26, 1996 P. 194

MEDICAL NOTES about gynecology in ancient times. For women, certainly, anatomy is destiny. Not so much because of what they lack as because of what they possess, which is to say wombs, vaginas, breasts: the female reproductive system is a weakness of both the body and the mind. That, at any rate, is how men seem to have thought of it for millennia. At the beginning of this century, male educators argued that women would injure their wombs if they studied Greek or mathematics. Ancient doctors believed that the womb could move about in a woman's body, putting pressure on other organs and so causing serious illness, and even death... Tells about Egyptian beliefs of 1900 B.C.: a woman who was unwell was said to be "womby"... How could such diseases of the womb be cured? According to 4th century Hippocratic doctors, there were two viable courses of treatment. One was sexual intercourse, especially if it resulted in pregnancy. The other course of treatment involved medication... Tells about various treatments, including sweet-scented vaginal suppositories, fumigations or vapors, animal excrement, and human excrement mixed with beer froth. Greek doctors prescribed cow or goat dung or bird droppings, often in combination with fragrant wine or rose oil (Cures derived from animal excrement are used today: a form of estrogen used in hormone-replacement therapy is extracted from the urine of pregnant mares... Even today, when wombs have stopped wandering, medicine tends to pathologize the vagaries of the female reproductive system, from menarche to menopause. Women of ancient times themselves looked back with nostalgia on the carefree years of their childhood. Who could blame them for dreading, in sickness and in health, the prospect of their womb-dominated years?

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Magical and Medical Approaches to the Wandering Womb in the Ancient Greek World

Earlier and shorter versions of this paper were given at the University of Zaragoza (September 2005), as the Dennis A. George Lecture in Hellenic Culture at Tulane University (April 2006), at the Institute for Advanced Studies, Hebrew University (July 2006), University of Southern California (February 2007), Columbia University (December 2007), William and Clark University (April 2008) and Bryn Mawr College (November 2008). I am grateful to my various hosts and for the questions and critiques I received at each venue. Different sections and versions of this paper have benefited from conversations with and the comments of Ann Hanson, Lesley Dean Jones, Brooke Holmes, Roy Kotansky and Heinrich von Staden. Some of the material treated in the third section appeared previously in a truncated and less developed form in Faraone 2007 and Faraone 2011. I completed writing this essay in the autumn of 2008 at the Institute for Advanced Study in Princeton on a fellowship supported by a grant from the Andrew W. Mellon Foundation as well as the Hetty Goldman Membership Fund. I am thankful to the staff and faculty of the School of Historical Studies for making my stay especially rewarding. Any errors that remain are, of course, my own.

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Christopher A. Faraone; Magical and Medical Approaches to the Wandering Womb in the Ancient Greek World. Classical Antiquity 1 April 2011; 30 (1): 1–32. doi: https://doi.org/10.1525/CA.2011.30.1.1

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The idea that the womb moved freely about a woman's body causing spasmodic disease enjoyed great popularity among the ancient Greeks, beginning in the classical period with Plato and the Hippocratic writers and continuing on into the Roman and Byzantine periods. Armed with sophisticated analyses of the medical tradition and new texts pertaining to the magical, this essay describes how both approaches to the wandering womb develop side by side in mutual influence from the late classical period onwards. Of special interest will be the tendency in both traditions to imagine both demons and errant wombs as wild animals and to use fumigations to control both. It concludes with a discussion of the historical development of and consequences for the idea that women alone possessed an internal organ that was variously interpreted as a mechanically defective body-part, a sentient and passionate animal, and then finally a demon with malicious intent, who bites and poisons the female body. It also argues against the hypothesis or assumption that midwives or wet-nurses were the original source for the idea of the wandering womb, suggesting that the syndrome never fit comfortably into the category of gynecological illness, because the womb was not the site of disease, but rather a cause of spasmodic disease in other areas of the body.

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Hippocrates and the concept of the "Wandering Womb"

Born around the year 460 BC , Hippocrates is known as one of the most remarkable physicians of all times. The ancient Greek patients had several choices when they were severely ill. But many patients turn directly to the gods, typically Asclepius, the God of medicine. Many asclepieia (healing temples) were built and from the 5th century BC onwards, and people would come to the temples hoping for a cure or a dream containing some sort of a cure. Hippocrates insisted on medicine being practiced according to natural sciences and anatomy hence physical observations of symptoms and natural treatments. But the persistent notion of the woman inhabited by a "wandering womb", "an animal within an animal" and the coexistence of Goddesses unable to control their drives and their mind contributed to the idea that women were driven to madness for anatomical and mental reasons. But with the birth of a rationalized medicine, what would be the impact on the representation of the image of the Woman in the city-state and how would that translate into the medical field ?

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This paper compares the cases of female ailments recorded in the Epidaurian Miracles Cures (iamata) with the theory and therapeutics of the Hippocratic gynecological texts as a means of testing the extent of the assumptions shared between temple and Hippocratic medicine. I argue that where temple and Hippocratic practice hold common ground, it is readily explicable through widely circulating and historically rooted cultural presuppositions regarding female physiology and pathology, rather than through scientific borrowings. Rather than representing complementary outlets of medical care in which Asklepios specialized in " hopeless " cases, I suggest that the iamata permit us to observe a process in which parallel medical traditions branched out from a common cultural substratum, and that more nuance is required in framing the relationship between Greek naturalist and religious medicine.

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The aim of this research was to study in depth the story of Asclepius, the ancient Greekmythical god of healing and medicine. The need for health preservation led humans to develop medicine initially as magic, then as an art, and nowadays as a science. The purpose of this study was to identify the elements that led to the recognition of Asclepius-Asklepios by the ancient Greeks as the god of medicine. A thorough review-analysis of Ancient and international bibliography was performed. The study led to the conclusion that the main element of Asclepius prevalence was the establishment of worship sites (Asclepieia). There were more than 300 of these Asclepios temples in the whole Ancient Greek world. According to a series of practices that were performed in these sacred institutions, these Asclepieia could be theorized as the first hospitals in Europe.

Christopher Faraone

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Biljana Ljujic

This article reassesses the consensus concerning the relation between Hippocratic-inspired medical practice and temple healing in Greek antiquity. This consensus holds that Hippocratic medicine and the temple cures effected in Asklēpieia were not perceived as oppositional or contradictory therapeutic outlets but instead as complementary “sectors of care.” After reviewing the status quaestionis and challenging some of the conclusions drawn from the evidence available, this article suggests a fresh approach which emphasizes the negotiation of subjectivity and agency in the constellation of patient, physician, and institution as a primary comparative heuristic. I demonstrate the appeal of this approach by interpreting some of the only “patient-centered” narratives left to us from antiquity: the iamata from Epidauros and the Hieroi Logoi of Aelius Aristides.

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Rashid Bhikha

In recognition of his contribution to the medical field, Hippocrates is universally known as the "Father of Medicine". He transformed medicine from superstition and magic to a scientific and evidencebased system. The core focus of Hippocratic medicine is an individualistic approach based on "Vis Medicatrix Naturae"the healing power of nature, which acknowledges the uniqueness of each individual, as well as the effects of lifestyle in health and disease. More significantly, Hippocrates hypothesised thehumoral theory. Furthermore, he advised on the importance of professionalism and medical ethics with respect to bedside manner, benevolence, and conduct. This led to the origin of the Hippocratic oath as we know it today. Ultimately, there is no era of medicine which is unmarked by Hippocrates. He laid the foundation of what is the essence of medical science today, including rationalism, ethics, patient care, observation skills and clinical experience. This paper focuses on the acknowledgement of Hippocrates, highlighting his contributions in medicine to this day.

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Lesley Bolton

In recognition of his contribution to the medical field, Hippocrates is universally known as the “Father of Medicine”. The Medicine of Hippocrates has been practised for more than 2500 years under various names across the world. Hippocrates conceptualised philosophical principles of medicine including Vis Medicatrix Naturae (healing power of nature), Humours, Temperament and Lifestyle Factors. More significantly, he is known for transforming the practice of medicine that included superstition and magic, to a scientific system based on the principle of cause and effect, with holism, professionalism, and medical ethics with respect to bedside manner, benevolence, and conduct. This led to the Medicine of Hippocrates being known as A Science of Medicine and the Art of Care. Whilst the technological advancements of Western medicine have made excellent progress in diagnostics, with pathological and imaging technology and also in surgical procedures, the side-effects associated with Western medication, is a major concern within the context of the Medicine of Hippocrates.

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PMS and the Wandering Womb

Research questions the prudence of attributing negative moods to the menstrual cycle.

"The idea that any emotionality in women can be firstly attributed to their reproductive function -- we're skeptical about that," Dr. Sarah Romans told me, skeptical said with audible restraint.

She and eight other researchers at the medical school at the University of Toronto published a review last week in the journal Gender Medicine that looked at all of the clinical research they could find to date on PMS with prospective data. Their conclusion was that the articles, in aggregate, "failed to provide clear evidence in support of the existence of a specific premenstrual negative mood syndrome."

Romans isn't saying that the mood symptoms we attribute to PMS aren't real and common. But she is saying that those symptoms are culturally over-attributed to the menstrual cycle, to the detriment of the medical community and those experiencing them -- and as a broader issue of gender equality.

The Diagnostic and Statistical Manual of Mental Disorders, which is the definitive text of U.S. psychiatrists, defines and outlines a diagnosis called premenstrual dysphoric disorder (PMDD). It's often casually defined as a severe version of PMS, which itself is not included in the DSM as a diagnosis. PMDD is characterized by physical and behavioral symptoms in the second half of the menstrual cycle.

"I do believe that PMDD exists," Dr. Romans told me. "I think we still don't know the prevalence. There was a good study recently that measured the prevalence rate down from 3-9 percent to around 1.5 percent." Still, "it's doing any woman a disservice to not let her have access to some of the effective treatments for PMDD." She describes how effective anti-depressant SSRIs like sertraline (Zoloft) can be, immediately, for PMDD.

Romans specifies, "Our interest was really in the wider premenstrual syndrome construct. I think most would assume that PMS is much more firmly evidence-based than in fact it is."

In their paper they note that the menstrual cycle has "historically been the focus of myth and misinformation, leading to ideas that constrain women's activities." An association between negative mood and the menstrual cycle has a long history, first noted in the scientific literature in 1931 by gynecologist Robert Frank and psychoanalyst Karen Horney. Long before that there was the wandering womb -- the notion, in the teachings of Hippocrates, that illness was due to the uterus moving around the body like a wild beast. The word hysteria is even derived from the Greek hystera , meaning uterus.

A broad mood-somatic premenstrual syndrome (PMS) was actively promoted by Katharina Dalton in the United Kingdom during the post-World War II years; she implicated progesterone deficiency as its cause. During the 1960s, PMS gradually supplanted Frank's earlier term of "premenstrual tension," and PMS continues to be the common term in the developed world. However, the definition of PMS, whether referring to mood alone or mood plus physical symptoms (e.g. bloating), is not clear when the term is used in both the scientific literature and in lay discussions.

The University of Toronto team systematically reviewed all the major English-language research that included daily mood reports that had been collected prospectively for at least one full menstrual cycle. There ended up being 41 that they considered large enough to be valid.

According to their review process, 15 studies (36.6 percent) "found no association" between mood and the phase of one's menstrual cycle. Another 17 (41.5 percent) "found an association of negative mood in the premenstrual phase, combined with another phase of the menstrual cycle." Six (13.5 percent) found an association between "negative mood and the premenstrual phase." The remaining 4 studies (8.5 percent) found an association between negative mood and a non-premenstrual phase. So, of the published research, several large studies have found associations between various phases of the menstrual cycle and moods. But they vary as to which phase. And sometimes no relationship exists at all.

The review doesn't discount the organic nature of cyclic moods, but it does suggest that hormonal fluctuations related to the menstrual cycle aren't definitively or regularly to blame. And "when there is a menstrual cycle tie-up," Romans explains, "it's actually perimenstrual -- the premenstrual (3-5 days before menstruation) and the menstrual phases together -- not purely premenstrual."

Romans' team is working on more research that compares menstrual cycle with other social and health variables in terms of what most determines mood, under the hypothesis that it's heavily weighted toward the latter. "The menstrual cycle signal was very small in terms of explaining the negative moods we were studying," she explains.

"I think this can be seen as the modern day equivalent of the old wandering womb notion," she told me, "that women are hysterical because of their reproductive system. And when a woman's upset, it's still often one of the first thoughts people have -- maybe she's premenstrual -- rather than 'Is her physical health bad? Is she under a lot of stress? Is she lacking social support?'"

"I go beyond that in my own thinking, which is that the whole PMS notion serves to keep women non-irritable, sweet, and compliant the rest of the time. There is a range of paradoxes -- world-turned-upside-down events -- like festivals, Mardi Gras, where people are socially prescribed to behave out of role. In Europe in medieval times there'd be one day a year where the lord would serve his own servants and workers, and then the rest of the time it's the other way, servant obeying the master. And these kinds of rituals serve to embed the normal behavior. I think PMS is a bit like that. 'We'll let you be cranky and bad-tempered now, but just for one or two days. The rest of the time you've got to be like a true woman.' Of course that's pretty feminist and hard to get data for, but at times I think it explains quite a lot."

Gender biases color the discussion in both directions, if unconsciously, but at least this study can inform more research on how we can keep everyone in the best mood possible, firstly by not overlooking pathology out of cultural expectation.

"PMS has been called a culture-bound syndrome in North America, and there are huge cultural differences in terms of how readily that explanation is reached for."  There aren't, to her knowledge, cultures where a notion of PMS isn't a consideration, but there are many where the basics of the cycle are being re-evaluated.

"There's an anthropologist called Beverly Strassman who studied African tribes and has made the point that monthly menstruation is a very modern phenomenon. Women used to have later menarche, more pregnancies, longer periods of breast-feeding -- so in all they'd probably have half the number of menstrual cycles. Compared to modern women who have around 400 cycles during an active reproductive life. So there are important basic questions that remain unanswered. Is it healthy to have monthly menses? We really don't know."

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The wandering womb : a cultural history of outrageous beliefs about women

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The Palgrave Handbook of Critical Menstruation Studies [Internet].

Chapter 22 the womb wanders not: enhancing endometriosis education in a culture of menstrual misinformation.

Heather C. Guidone .

Affiliations

Published online: July 25, 2020.

Embedded in the centuries-old assertion that the womb was a nomadic entity wandering about the body causing hysteria and distress, persistent menstrual misinformation and misconceptions remain prevalent wherein pain disorders like endometriosis are concerned. Affecting an estimated 176 million individuals worldwide, endometriosis is a major cause of non-menstrual pain, dyspareunia, painful menses and reduced quality of life among individuals of all races and socioeconomic backgrounds. Wide-ranging symptoms may be dismissed as routine by both patients and practitioners alike due to lack of disease literacy, and lengthy diagnostic delays can exacerbate the negative impact of endometriosis on the physical, psychological, emotional and social well-being of those affected. This chapter identifies some of these challenges and explores how obstacles to best practice can be reduced in part through adoption of early educational campaigns which incorporate endometriosis as a major component of menstrual health education.

• The Endometriosis Enigma

Described as “a riddle wrapped in a mystery inside an enigma” (Ballweg 1995 , 275; Wilson 1987 , 1), endometriosis is defined by the presence of endometrial- like tissue found in the extra-uterine environment (Johnson and Hummelshoj for the World Endometriosis Society Montpellier Consortium 2013 ). The disease elicits a sustained inflammatory response accompanied by angiogenesis, adhesions, fibrosis, scarring, and neuronal infiltration (Giudice 2010 ). The gold standard for confirmation of diagnosis is laparoscopy (D’Hooghe et al. 2019 ).

Characterized by marked distortion of pelvic anatomy (Kennedy et al. 2005 ), development of endometriomas and high association with comorbidities (Parazzini et al. 2017 ), endometriosis can result in significantly reduced quality of life. Although considered ‘benign,’ the disease may also be associated with higher risks of certain malignancies and shared characteristics with the neoplastic process (Matalliotakis et al. 2018 ; He et al. 2018 ).

Endometriosis is estimated to affect nearly 176 million individuals globally (Adamson, Kennedy, and Hummelshoj 2010 ), and ranks high among the most frequent causes of chronic pelvic pain (van Aken et al. 2017 ). A leading contributor to infertility, gynecologic hospitalization, and hysterectomy (Yeung et al. 2011 ; McLeod and Retzloff 2010 ; Ozkan et al. 2008 ), systemic influences of the disease can significantly impair physical, mental, emotional, and social health (Marinho et al. 2018 ). Definitive cause remains elusive, as does universal cure or prevention, and much of the discourse surrounding etiology and treatments remains ardently debated. Endometriosis imposes a staggering healthcare burden on society, with associated costs soaring into the billions (Soliman, Coyne, et al. 2017 ).

The complexities of this multidimensional condition remain poorly elucidated in current scientific works and little progress has been made toward deciphering endometriosis. Although research seems omnipresent, much of it is redundant in nature and the few qualitative studies conducted on the realities of living with the disease lack rigor (Moradi et al. 2014 ).

Though classically viewed as a ‘disease of menstruation,’ a uterus and routine menses are not de rigueur to diagnosis. The condition has been documented in post-hysterectomy/postmenopausal individuals (Ozyurek, Yoldemir, and Kalkan 2018 ; Soliman, Du, et al. 2017 ), rare cis males (Makiyan 2017 , et al.), gender diverse people (Cook and Hopton 2017 ; Yergens 2016 ) and the human fetus (Schuster and Mackeen 2015 ; Signorile et al. 2010 , 2012 ). Nevertheless, many continue to link the condition to simply ‘painful periods’ despite its profound impact far and apart from menses.

Comprehensive review of treatments for endometriosis, and the ensuing debates encompassing each, is outside the scope of this writing. However, timely diagnosis and multidisciplinary, integrative treatment are necessary to effectively manage the condition—yet universal access to quality care remains limited in many settings, due in large part to dismissal of symptomology. In brief:

Laparoscopic excision is one of the most effective therapeutic options (Donnellan, Fulcher, and Rindos 2018 ; Franck et al. 2018 ; Pundir et al. 2017 ), affording biopsy-proven diagnosis and subsequent removal of lesions at the time of the surgical encounter. However, accuracy of diagnosis and treatment depends on ability of the surgeon to adequately identify the tissue in all affected areas.

Secondary to surgery are medical therapies. No drugs for endometriosis are curative; all have potential side effects (Rafique and Decherney 2017 ) and similar clinical efficacy in temporary reduction of pain. Menstrual suppression—which does not treat endometriosis, only symptoms—further supports the perception that menstruation is ‘unhealthy’ and requires pharmaceutical intervention.

Despite over 100,000 hysterectomies being performed annually as of this writing for a primary diagnosis of endometriosis and approximately 12% of individuals with the disease eventually undergoing hysterectomy as ‘treatment,’ there is an approximate 15% probability of persistent pain after hysterectomy, which may be due to incomplete disease removal, and a 3–5% risk of worsening pain or new symptom development (Rizk et al. 2014 ). Nor is menopause protective, with an estimated 2–4% of the endometriosis population being postmenopausal (Suchońska et al. 2018 ). In fact, postmenopausal endometriosis has demonstrated a predisposition to malignant change, greater tendency for extrapelvic spread, and development into constrictive and/or obstructive lesions (Tan and Almaria 2018 ).

Derived from the misogynist, antediluvian belief that painful menstruation was ‘ordained by nature as punishment for failing to conceive’ (Strange 2000 , 616), pregnancy has long been suggested as a treatment or even cure for endometriosis. Nonetheless, pregnancy is not a ‘treatment’ option in any current clinical guidelines (Young, Fisher, and Kirkman 2016 ), nor does it prevent or defer progression of endometriosis (Setúbal et al. 2014 ). Moreover, the disease is linked to infertility, miscarriage, and potential complications in obstetrical outcomes (Shmueli et al. 2017 ) and ectopic pregnancy (Jacob, Kalder, and Kostev 2017 ).

Finally, adjuncts like pain management and pelvic physical therapy are also often recommended post-surgically to address secondary pain generators common with endometriosis that is, pelvic floor dysfunction. Other alternative and complementary measures may also be considered.

Defying Dogma: ‘Killer Cramps’ Are Not Normal

Classic presentations of endometriosis include but are not limited to abdominopelvic pain, infertility, dyschezia, dyspareunia, dysuria, physiologic dysfunction, and significantly reduced quality of life. Extrapelvic disease, while less common (Chamié et al. 2018 ), may manifest in a variety of ways for example, catamenial pneumothorax. Among the most widely recognized of endometriosis symptoms is incapacitating menstrual cramping (‘dysmenorrhea’).

Indeed, menstrual pain without pelvic abnormality (“primary dysmenorrhea”) is among the most common of gynecological disorders. Though accurate prevalence of dysmenorrhea is difficult to establish, it is estimated to impact up to 93% of adolescents (De Sanctis et al. 2015 ) and between 45 and 95% of all people with periods. When interviewed by Writer Olivia Goldhill ( 2016 ) for her heralded Quartz article on the lack of research into dysmenorrhea, Professor John Guillebaud went on record stating “period cramping can be almost as bad as having a heart attack.” Though some have questioned the notion that any degree of menstrual pain is “normal” (Dusenbery 2018 , 221), primary dysmenorrhea generally maintains a good prognosis.

Conversely, severe pain failing to respond to intervention (“secondary dysmenorrhea”) is typically associated with conditions like endometriosis and warrants timely intervention (Bernardi et al. 2017 ). Moreover, a link between dysmenorrhea and the future development of chronic pelvic pain has been suggested (Hardi, Evans, and Craigie 2014 ), though symptoms are routinely misdiagnosed or otherwise dismissed (Bullo 2018 ). As a result, those suffering may be disparaged as ‘menstrual moaners’ or portrayed as simply unable to ‘cope with normal pain’ (Ballard, Lowton, and Wright 2006 )—yet nearly 70% of adolescents with intractable dysmenorrhea or pelvic pain that fails to respond to initial therapy will later be diagnosed with endometriosis (Highfield et al. 2006 ).

Delays in the diagnosis of causative gynepathologies persist at the individual and medical level. To that end, healthcare professionals must engage patients in conversations which remain sensitive to cultural context, perceptions, and attitudes, yet draw out possible menstrual issues early so individuals are treated in timely and effective ways that harmonize with their specific needs.

• Embodied Experience

A widespread lack of public education about pelvic pain and menstrual-related disorders persists. As a result, endometriosis remains under-diagnosed, inadequately treated and frequently marginalized. Inappropriate diagnostic tests, poor history taking, provision of temporary analgesics or hormonal suppression to merely treat symptoms—but not the disease itself–creates confusion in diagnosis, postponement in diagnostic confirmation and mismanagement (Riazi et al. 2014 ). Only a minority of studies adds to the contextual information required to understand what it means to actually struggle with endometriosis.

Misinformation about the disease remains ubiquitous, saturating the healthcare and public sectors. Affected individuals may delay seeking care for their symptoms, believing them to be a part of ‘normal’ menstruation, and healthcare workers may in turn dismiss their pain as “imaginary” (Bloski and Pierson 2008 ). To that end, healthcare encounters have been expressed as double-edged, both destructive and constructive; affecting not only the perception of the individual’s physical condition, but her self-esteem, body, and sexuality (Grundström et al. 2018 ) as well. As a result, those with the condition must often become ‘expert’ or ‘lead’ patients; that is, those who are proactive with respect to their health and possess knowledge of their disease and symptoms in order to effectively direct and manage their own care.

Individuals with the endometriosis from all backgrounds have long described journeys characterized by ignorance, disbelief, and lack of knowledge on the part of their doctors and the public. Encountering attitudes that they ‘exaggerated or imagined their symptoms or [have] low pain thresholds’ and further insinuation that “psychological factors or former abuse enhanced the symptoms” (Grundström et al. 2018 , 8) may compound feelings of vulnerability and anxiety. Many “feel angry and frustrated when they [have] experiences with doctors who misdiagnosed, did not diagnose, delayed diagnosis of endometriosis, or just generally did not listen to their concerns, symptoms, and experiences” (Moradi et al. 2014 ). Not surprisingly, some people with endometriosis may resort to maladaptive coping strategies as a result (Zarbo et al. 2018 ).

Clark ( 2012 , 83) has described the impact endometriosis may have on a woman’s sense of identity: “self-doubt plagued many . . . where they questioned their perception of the severity of the symptoms and ultimately their own sanity; mainly due to not being believed by medical practitioners and other lay people.” Yet as Culley et al. demonstrated ( 2013 ), the distress so commonly experienced by those with endometriosis is in fact related in large part to dissatisfaction with care for the disease. The authors correctly suggest the negative social and psychological impacts of the condition could be improved by a number of strategies; not least of which include practitioner education efforts and raising awareness via education through schools and support groups.

Pandora’s Jar: The Impact of the Wandering Womb and Hysteria on Endometriosis

From Greek hysterikos (‘of the womb’), assumptions on the ‘wandering’ uterus have long influenced attitudes about women’s health. Since the genesis of gynecology arose from the mythical first woman, Pandora, the womb was believed to have ‘no natural home.’ Identification of Pandora’s jar ( pithos ) as a uterus has been widely represented in Hippocratic gynecology and Western art; its subsequent opening brought forth ‘a range of evils including disease’ (King 1998 , 2, 47–48, 58).

Anxiety, sense of suffocation, tremors, convulsions, or paralysis and more have been attributed to the ‘migratory uterus’ (Tasca et al. 2012 ). Hippocrates remains largely credited for grouping such issues under the single designation of “ hysteria ,” though King ( 1998 ) challenges such ascription (227, 237). Nonetheless, early physicians suggested that ‘hysteria’ could be counted among the ‘… symptoms of menstruation.’ Some advised that women who frequently displayed nervous or hysterical symptoms in relation to menses ‘ought to be incarcerated for their own safety and the good of society’ (Strange 2000 , 616); a tenuous correlation might even be drawn to today’s menstrual huts.

Nezhat, Nezhat, and Nezhat ( 2012 ) further suggest there is irrefutable evidence that “hysteria, the now discredited mystery disorder presumed for centuries to be psychological in origin, was most likely endometriosis in the majority of cases …” and as Jones ( 2015 ) proposes, discourse about the disease is “at least related to if not influenced by the social forces that shaped a diagnosis of hysteria” (1084).

Though ‘hysteria’ has been largely abandoned in modern nomenclature, the legacy of its impact persists. Today, symptoms of endometriosis may dismissed not as hysteria but ‘somatization’ (Pope et al. 2015 ). Women’s pain is routinely under-treated, labeled inappropriately as having a sexually transmitted infection, told their symptoms are ‘in their head’ (Whelan 2007 ) or too often, simply not heard (Moradi et al. 2014 ).

Endometriosis also remains tethered to psychological profiling, with those suffering routinely described as high risk for anxiety, depressive symptoms, and other psychiatric disorders. In fact, however, it has been demonstrated that the presence of pain—versus endometriosis per se—is associated with such psychological and emotional distress (Vitale et al. 2017 ). Whelan ( 2007 ) further asserts what those with the endometriosis well know: “[c]ertainly, medical experts’ ways of representing endometriosis often undermine the credibility of patient accounts . . . patients have often been represented in the medical literature as nervous, irrational women who exaggerate their symptoms” (958). Indeed, endometriosis is very much a corporeal condition with no regard for race, religious, sexual, socioeconomic, or mental health status.

• Sampson and the Itinerant Uterine Tissue

Reminiscent of the migrating womb, much of the dogma guiding endometriosis treatment and research today is rooted in the archaic supposition that the disease is caused by normal endometrium that has ‘roamed’ to distant sites. Just as the uterus does not wander, however, nor do fragments of entirely normal uterine tissue simply meander idly hither and yon resulting in endometriosis.

The premise of the condition arising from wholly normal albeit peripatetic endometrium sustains a century-old concept based on the works of Dr. John Sampson ( 1927 ). Essentially, he considered endometriosis lesions to be comprised of ordinary endometrial cells; in fact, while somewhat resembling native endometrium, they are not identical (Ahn et al. 2016 )—an important distinction. An abundance of differential invasive, adhesive, and proliferative behaviors have been demonstrated in the eutopic and ectopic counterparts of endometrial stromal cells in patients with the disease (Delbandi et al. 2013 ), and the tissue is functionally dissimilar (Zanatta et al. 2010 ).

Contrary to Sampson’s Theory, there is also evidence of endometriosis in cis males (Rei, Williams, and Feloney 2018 , et al.), the human fetus (Signorile et al. 2009 , 2010 , 2012 ), females who have never menstruated (Suginami 1991 ; Houston 1984 ), and premenarcheal girls (Gogac et al. 2012 ; Marsh and Laufer 2005 ). The premise of ‘retrograde periods’ also fails to account for extrapelvic endometriosis in most cases. Moreover, though reflux menses is very common among people with periods, not all develop endometriosis; the incidence of disease is small compared to the occurrence of backflow experienced by most menstruators (Ahn et al. 2015 ). Similarly, as Redwine ( 1988 ) confirmed decades ago, endometriosis lacks the characteristics of an autotransplant (Khazali 2018 ).

Undeniably, pathogenesis remains rife with contention. Differing theories on varied mechanisms abound; stem cells, genetic polymorphisms, dysfunctional immune response, and an aberrant peritoneal environment have all been suggested in the establishment of endometriosis (Sourial, Tempest, and Hapangama 2014 ). The evidence also favors embryologic origins, with additional cellular and molecular mechanisms involved (Signorile et al. 2009 , 2010 , 2012 ; Redwine 1988 ). Nevertheless, no unifying theory to date accounts for all of described manifestations of endometriosis (Burney and Giudice 2012 ).

• Unremitting Misinformation, Menstrual Taboos, and Diagnostic Delay

Much of society’s derogatory view of menstruating individuals, including within the political sphere (‘ blood coming out of her wherever   … ’), remains virtually unchanged, and the very normal physiological process of menstruation remains linked to unfavorable attitudes in all cultures (Chrisler et al. 2015 ). Periods are still considered taboo in many parts of the world, with persistent knowledge gaps resulting in part from poor puberty guidance (Chandra-Mouli and Patel 2017 ). Research on menstrual cycle-related risk factors is lacking (Harlow and Ephross 1995 ), and the media continues to reinforce misconceptions around social captivity, restrictions, professional inefficiency, physical, and mental discomfort (Yagnik 2012 ) related to menses. Menstrual bleeding continues to be portrayed as “messy, inconvenient, and [an] unnecessary phenomenon to be controlled or possibly eliminated” (McMillan and Jenkins 2016 , 1). Yet, with a nod to Bobel and Kissling ( 2011 ): “menstruation matters:” menstrual history is a key component in a comprehensive women’s health assessment and an increasingly important variable in disease research (McCartney 2016 ).

For many, persistent taboos and perpetuation of ‘period shaming’ come at a high price: menstrual pain specifically, such as that often accompanying endometriosis, is routinely dismissed. Hence, the path to diagnosis is largely dependant upon the individual’s own “knowledge and experience of painful menstruation and other symptoms and whether they know other people who have been diagnosed” (Clark 2012 , 85).

Delayed diagnosis serves as a high source of stress responsible for an important psychological impact on individuals with endometriosis. Average diagnostic delays worldwide hover around 7.5 years (Bullo 2019 ) or even longer, with continued resistance to timely intervention and referrals. Indeed, several clinicians consider themselves inadequately trained to understand and provide psychosocial care for patients with the disease (Zarbo et al. 2018 ). Conversely, earlier diagnosis and efficient intervention decreases productivity loss, quality of life impairment, and healthcare consumption, consequently reducing total costs to patients and society alike (Klein et al. 2014 ).

Studies reveal a relationship between ambivalent sexism and more negative attitudes toward menstruation, which may also lead to reticence to report menstrual cycle-related symptoms (Marván, Vázquez-Toboada, and Chrisler 2014 ). Others may deliberately conceal concerns for fear of stigmatization, further leading to diagnostic delay (Riazi et al. 2014 ). Still others may seek to reduce stigma associated with menstruation through ‘menstrual etiquette’ (Seear 2009 ), perpetuating social rules and normative expectations of menstruating persons and fearing that disclosure would result in embarrassment or perception that they are ‘weak’ (Culley et al. 2013 ). The literature further suggests some patients may simply fail to seek timely medical help due to their own inability to identify symptoms as ‘abnormal’—a failing of our menstrual education system.

To navigate the experiences of menstruation, endometriosis, and other episodes related to pain or vaginal bleeding, individuals “require factual and supportive information that enables them to differentiate between healthy and abnormal bleeding, to understand and take care of their bodies or those of dependents who may require assisted care, and to seek health advice appropriately” (Sommer et al. 2017 , 2). Yet, menstrual teachings remain hampered by deficient cycles of misinformation. Education and perception are primarily communicated by mothers, sisters, or friends who themselves may lack accurate understanding (Cooper and Barthalow 2007 ), with resulting poor body literacy regarding reproductive anatomy, female hormones and their functions, effect of hormones on the menstrual cycle, ovulation, and conception (Ayoola, Zandee, and Adams 2016 ).

Likewise, menstrual health education programs in school and community settings remain deficient, particularly in low income settings, with many girls viewing school education about menstruation as “ inaccurate, negative, and late ” (Herbert et al. 2017 , 14).

• Conquering the Prevailing Ethos of Menstrual Shaming to Effect Positive Change

The perpetuation of menstrual shaming (for example, ‘The Curse’) has led to a prevailing ethos of generational taboos and lack of body literacy. There are consequences for such persistent bias, poor information systems, and practices; the resulting lack of education leads to delayed diagnosis and quality treatment of endometriosis and other gynepathologies with subsequent impact on fertility, loss of libido and pleasurable sex, chronic pain, diminished quality of life, loss of sense of self, body-negative thoughts, and more.

While disease knowledge has evolved, the deeply entrenched cultural norms surrounding both endometriosis and menstruation must continue to be challenged. Existing gaps must be bridged in order to eliminate the enduring barriers that persist. How and when girls learn about menses and its associated changes can impact response to the menstrual event and is critical to their knowledge, autonomy, and empowerment. Hence, it is necessary to overcome persistent myths, increase authoritative awareness of endometriosis, and articulate effective strategies to develop more robust literacy on the condition than presently exists.

Cooper and Barthalow ( 2007 ) previously established the need for menstrual education in schools, with the topic being offered even before menarche in order to better prepare girls for the experience and continuing throughout their educational career so that students can build upon their basic knowledge of the many themes involved with menstrual health. A three-pronged approach has been suggested (Subasinghe et al. 2016 ) to better inform individuals about dysmenorrhea specifically: having the school nurse provide educational leaflets to increase familiarity with the condition; encouraging health professionals to be more proactive in asking patients about the topic so that young menstruators with dysmenorrhea may be more likely to disclose their pain and symptoms; and finally, joint promotion by health professionals and schools of reliable, authoritative websites, and resources for additional guidance.

Oni and Tshitangano ( 2015 ) previously proposed that school health teams may also consider screening students for menstrual disorders in order to help diagnose underlying pathological causes and attend such issues accordingly. Similar findings on the need for adolescent education on the effective management of dysmenorrhea suggest that extending the educational program to parents and school leaders is beneficial as well (Wong 2011 ).

• The Endo What? Documentary team School Nurse Initiative ( https://www.endowhat.com/school-nurse-initiative ), founded by Shannon Cohn, is a collaborative effort to provide endometriosis education and awareness among school nurses and their students and
• The New Zealand model and the first of its kind in the world, developed over two decades ago by Deborah Bush, MNZM, QSM, Dip Tchg. LSB, Chief Executive of Endometriosis New Zealand ( http://www.nzendo.org.nz/how-we-help/all-about-me ). Both efforts have served to educate countless individuals.

Building on the examples above, clinicians and the public alike will benefit from better understanding of endometriosis, thereby improving patient experiences and leading to improved outcomes. We must incorporate correct disease information along with ethical, social, cultural, economic, and diversity perspectives in emerging menstrual education curriculum.

In order to ensure appropriate intervention and reduce costly, unproven protocols, like-minded collaborators from practitioner, allied and mental health and others need to engage in associated efforts. There must be an emphasis placed on optimal pathways, evaluation of modern concepts, and cross-collaborative strategies. It is imperative that all individuals know when, where and how to obtain help when symptoms of menstrual-related disorders first arise, and it is vital that the public, including but not limited to, legislators, hospital administrators, gynecologists, and subspecialists become involved in these efforts.

Moreover, in that mothers often traditionally teach their daughters, we must rectify misperceptions and offer instruction on menstrual practices and disorders like endometriosis by providing compulsory education at school, in clinics, and kinship settings in order to encourage story-telling narratives and break the legacy of silence, misinformation, and fear. We must better elucidate the parameters of normal versus abnormal bleeding, pain, and related symptomology in order to recognize disorder and pain signaling throughout the cycle.

To address difficulties faced by low resource and medically underserved communities, use of participatory/community-based efforts, integrated messaging during clinic visits, and use of Information Technology (IT) and digital health tools where applicable can improve access to healthcare services and information in ways that enhance patient knowledge and self-management, thereby positively impacting health outcomes.

Through stakeholder partnerships, we can foster new menstrual educational programs to produce high-quality educational materials and afford better outcomes for all. A strong public health agenda for menstrual/endometriosis education must include a collaborative interface among public health, community and non-healthcare sectors.

Endometriosis has the propensity to take away so many of an affected individual’s choices: when and whether to engage in sex, when or if to pursue fertility, whether or not to undergo invasive procedures or to choose oft-ineffective menstrual suppressives that alter her cycle and more. We must strive toward early recognition and diagnosis, better understanding of pathophysiology and pain mechanisms, increased translational research and dissemination of authoritative facts on a widespread basis, starting with menstrual education among youth.

The current deficiency in quality menstrual education leads to confusion, inaccurate beliefs about and negative views on menstruation and related conditions. Though steps forward have been made, many individuals lack understanding of what constitutes menstrual dysfunction and when, where and how to seek care. It is imperative that patients and health professionals alike become better educated on the clinical characteristics of endometriosis, not least general practitioners and school nurses, who play crucial roles in early diagnosis. This is achievable through menstrual education programs that incorporate the disease as a leading cause of pain. Outlining optimal care pathways, encouraging timely recognition, improving research priorities, accepting modern concepts and emphasizing appropriate, cross-collaborative strategies to optimize outcomes can transform endometriosis care and reduce the role of ‘menstrual silence’ in its diagnosis and treatment.

Embarking on robust educational programs which begin in the primary setting and are shared across varied resources will enhance literacy on painful menstruation and gynepathologies, thereby affording access to better, earlier care and improving the lives of the millions suffering. By revitalizing menstrual communication and key conversations, we can put an end to the secrecy, silence, shame, and pain.

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• Signorile, P. G., F. Baldi, R. Bussani, et al. 2010. “New Evidence of the Presence of Endometriosis in the Human Fetus.” Reproductive BioMedicine Online 21 (1): 142–47. [ PubMed : 20471320 ] [ CrossRef ]
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• Strange, J. M. 2000. “Menstrual Fictions: Languages of Medicine and Menstruation, c. 1850–1930.” Women’s History Review 9 (3): 607–28.
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• Yeung, P. Jr., K. Sinervo, W. Winer, and R. B. Jr. Albee. 2011. “Complete Laparoscopic Excision of Endometriosis in Teenagers: Is Postoperative Hormonal Suppression Necessary?” Fertility and Sterility 95, no. 6 (May): 1909–12, 1912.e1. [ PubMed : 21420081 ]
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• Zarbo, C., A. Brugnera, L. Frigerio, C. Malandrino, M. Rabboni, E. Bondi, and A. Compare. 2018. “Behavioral, Cognitive, and Emotional Coping Strategies of Women with Endometriosis: A Critical Narrative Review.” Archives of Women’s Mental Health 21, no. 1 (February): 1–13. [ PubMed : 28932912 ]

The vernacular of endometriosis is rooted in classic scholarship and the topic of menstruation itself is often cited as an example of biological reductionism: the medicalization of women and standardization of bodies (Rodríguez and Gallardo 2017 ). Hence, the author acknowledges that the terms “women” and “women’s health” are enforcers of hetero-cisnormativity, gender binarism and gender essentialism. For the purposes of this chapter, incorporation of such terms is intended only as a theoretical framework, inclusive of all bodies who struggle with endometriosis and have suffered from the bias, negligence, misdiagnosis and medical misogyny which so often characterize the disease; such use is not intended to trivialize, equate or otherwise limit the scope of the condition to only lived experiences of those essentialized categories of “females.” Furthermore, although often associated with the disease, “menstruation” is not synonymous with “endometriosis.” Much of what is communicated about endometriosis, particularly in the scientific literature and media, reflects a stagnant belief system that perpetually confounds the diagnostic and treatment processes. Whilst medical knowledge, clinical experience and therapies are ever-evolving, the condition remains fundamentally mired in outdated assumptions that invariably lead to poor health outcomes. If we are to achieve real progress, we must strive towards an ideology which is truly reflective of modern concepts in order to elevate the condition to the priority public health platform it well deserves. To that end, though not intended as exhaustive or all-encompassing, the author has endeavored to incorporate the most current, authoritative facts about endometriosis herein—some of which run contrary to public doctrine.

Open Access This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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• Cite this Page Guidone HC. The Womb Wanders Not: Enhancing Endometriosis Education in a Culture of Menstrual Misinformation. 2020 Jul 25. In: Bobel C, Winkler IT, Fahs B, et al., editors. The Palgrave Handbook of Critical Menstruation Studies [Internet]. Singapore: Palgrave Macmillan; 2020. Chapter 22. doi: 10.1007/978-981-15-0614-7_22
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• Defying Dogma: ‘Killer Cramps’ Are Not Normal
• Pandora’s Jar: The Impact of the Wandering Womb and Hysteria on Endometriosis

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• [Endometriosis - new clinical guidelines for better and equal care in Sweden]. [Lakartidningen. 2020] [Endometriosis - new clinical guidelines for better and equal care in Sweden]. Björk E, Gustavsson M, Palmstierna M, Valentin A, Olovsson M, Melin AS. Lakartidningen. 2020 Jun 2; 117. Epub 2020 Jun 2.
• Review Revisiting the wandering womb: Oxytocin in endometriosis and bipolar disorder. [Horm Behav. 2017] Review Revisiting the wandering womb: Oxytocin in endometriosis and bipolar disorder. Dinsdale NL, Crespi BJ. Horm Behav. 2017 Nov; 96:69-83. Epub 2017 Sep 19.
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• April 28, 2017

The word “hysteria” conjures up an array of images, none of which probably include a nomadic uterus wandering aimlessly around the female body. Yet that is precisely what medical practitioners in the past believed was the cause behind this mysterious disorder. The very word “hysteria” comes from the Greek word hystera, meaning “womb,” and arises from medical misunderstandings of basic female anatomy.

Today, hysteria is regarded as a physical expression of a mental conflict and can affect anyone regardless of age or gender. [1] Centuries ago, however, it was attributed only to women, and believed to be physiological (not psychological) in nature.

The womb continued to hold a mystical place in medical text for centuries, and was often used to explain away an array of female complaints. The 17th-century physician William Harvey, famed for his theories on the circulation of the blood around the heart, perpetuated the belief that women were slaves to their own biology. He described the uterus as “insatiable, ferocious, animal-like,” and drew parallels between “bitches in heat and hysterical women.” [5] When a woman named Mary Glover accused her neighbor Elizabeth Jackson of cursing her in 1602, the physician Edward Jorden argued that the erratic behavior that drove Mary to make such an accusation was actually caused by noxious vapors in her womb, which he believed were slowly suffocating her. (The courts disagreed and Elizabeth Jackson was executed for witchcraft shortly thereafter.)

So what could be done for hysteria in the past?

Today, wombs are no longer thought to wander; however, medicine still tends to pathologize the vagaries of the female reproductive system. [6] Over the course of several thousand years, the womb has become less of a way to explain physician ailments, and more of a way to explain psychological disfunction—often being cited as the reason behind irrationality and mood swings in women. Has the ever-elusive hysteria brought on by roving uteri simply been replaced by the equally intangible yet mysterious PMS? I’ll let you decide.

You can now pre-order my book THE BUTCHERING ART by clicking here . THE BUTCHERING ART follows the story of Joseph Lister as he attempts to revolutionize the brutal world of Victorian surgery through antisepsis. Pre-orders are incredibly helpful to new authors. Info on how to order foreign editions coming soon. Your support is greatly appreciated. 

1. Mark J Adair, “Plato’s View of the ‘Wandering Uterus,’” The Classical Journal 91:2 (1996), p. 153. 2. G. S. Rousseau, “‘A Strange Pathology:’ Hysteria in the Early Modern World, 1500-1800” in Hysteria Beyond Freud (1993), p.104. Originally qtd in Heather Meek, “Of Wandering Wombs and Wrongs of Women: Evolving Concepts of Hysteria in the Age of Reason,” English Studies in Canada 35:2-3 (June/September 2009), p.109. 3. Quoted in Matt Simon, “Fantastically Wrong: The Theory of the Wandering Wombs that Drove Women to Madness,” Wired (7 May 2014). 4. Robert K. Ritner, “A Uterine Amulet in the Oriental Institute Collection,” Journal of Near Eastern Studies 45:3 (Jul. 1984), pp.209-221. For more on the fascinating subject of magical amulets, see Tom Blaen, Medical Jewels, Magical Gems: Precious Stones in Early Modern Britain (2012). 5. Rousseau, “A Strange Pathology,” p. 132. 6. Mary Lefkowitz, “Medical Notes: The Wandering Womb,” The New Yorker (26 February 1996).

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The Wandering Womb: Essays in Search of Home (Juniper Prize for Creative Nonfiction) Kindle Edition

Even as a fourth-generation Jewish Texan, S. L. Wisenberg has always felt the ghost of Europe dogging her steps, making her feel uneasy in her body and in the world. At age six, she’s sure that she hears Nazis at her bedroom window and knows that after they take her away, she’ll die without her asthma meds. In her late twenties, she infiltrates sorority rush at her alma mater, curious about whether she’ll get a bid now. Later in life, she makes her first and only trip to the mikvah while healing from a breast biopsy (benign this time), prompting an exploration of misogyny, shame, and woman-fear in rabbinical tradition.

With wit, verve, blood, scars, and a solid dose of self-deprecation, Wisenberg wanders across the expanse of continents and combs through history books and family records in her search for home and meaning. Her travels take her from Selma, Alabama, where her Eastern European Jewish ancestors once settled, to Vienna, where she tours Freud’s home and figures out what women really want, and she visits Auschwitz, which—disappointingly—leaves no emotional mark.

• Print length 246 pages
• Language English
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• Publisher University of Massachusetts Press
• Publication date March 31, 2023
• File size 1170 KB
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Editorial Reviews

"Wisenberg is an affecting guide through the nuances, joys, and complications of contemporary Jewish womanhood; The Wandering Womb both celebrates those identities and mourns the past pains that they reflect."— Foreword Reviews "Wisenberg continues her frank and provocative inquiries into perceptions of the female body . . . Drawing on her journalist’s skills and literary prowess, she applies her audacious incisiveness and wit to her family’s stories as Jews who fled pogrom-ravaged Russia and settled in Houston and Selma."— Booklist " Wisenberg's direct tone and wide-ranging curiosity make this collection one to recommend, especially to those with an interest in the ways that history and memory intertwine."— Shelf Awareness   "A reader doesn’t have to be a Jewish feminist of a certain age to find something that resonates in S.L. Wisenberg’s compelling collection . . . These pieces are far more than personal essays. Wisenberg weaves her personal experience growing up in Houston, Texas as the grandchild of Ashkenazi Jewish immigrants with reflections on her own experience as a woman in the world. She connects her observations to literature and history, writing a book that hums with both the past and contemporary life."— Southern Review of Books “Each essay is a lens through which we are invited to view in Joycean detail the author’s deeply personal present, yet at the same time to ponder and to rethink larger worlds of history and cultures. It’s a collection that often is wry but never cynical, acutely learned and always alert to humor and wonder.”—David Toomey, author of Weird Life: The Search for Life That Is Very, Very Different from Our Own

"Sometimes subtle, sometimes fierce, these brilliant essays express what it's like to be a Jewish woman today, and what it's like to be an embodied human being."—Paula Kamen, author of Finding Iris Chang “Wisenberg’s years as a journalist show in the precision of her writing, as she leads us through both the distant and proximate past, from Civil-War reenactments to the private world of the mikvah. In The Wandering Womb , history breathes into our lungs and speaks through every word we say.”—Riva Lehrer, author of Golem Girl: A Memoir “A sharp, deeply questioning mind and a wayward heart inform these delicious essays. They are wry, humorous, melancholy, and universally relatable, filled with the shock of recognition.”—Phillip Lopate, author of Portrait Inside My Head: Essays

About the Author

S. L. WISENBERG is editor of Another Chicago Magazine and author of the fiction collection, The Sweetheart Is In , and two nonfiction books, Holocaust Girls: History, Memory, and Other Obsessions and The Adventures of Cancer Bitch . The recipient of fellowships from the National Endowment for the Humanities, Holocaust Education Foundation, and the Illinois Arts Council, Wisenberg works as a writing coach, editor, and creative writing instructor in Chicago.

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• ASIN ‏ : ‎ B0C6NMCW9B
• Publisher ‏ : ‎ University of Massachusetts Press (March 31, 2023)
• Publication date ‏ : ‎ March 31, 2023
• Language ‏ : ‎ English
• File size ‏ : ‎ 1170 KB
• Text-to-Speech ‏ : ‎ Enabled
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• Print length ‏ : ‎ 246 pages
• #533 in Jewish Biographies & Memoirs
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• Juniper Prize for Creative Nonfiction

The Wandering Womb

Essays in Search of Home

by S. L. Wisenberg

Published by: University of Massachusetts Press

Series: Juniper Prize for Creative Nonfiction

248 Pages , 5.50 x 8.50 x 0.60 in

• 9781625347350
• Published: March 2023

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• Description

Even as a fourth-generation Jewish Texan, S. L. Wisenberg has always felt the ghost of Europe dogging her steps, making her feel uneasy in her body and in the world. At age six, she’s sure that she hears Nazis at her bedroom window and knows that after they take her away, she’ll die without her asthma meds. In her late twenties, she infiltrates sorority rush at her alma mater, curious about whether she’ll get a bid now. Later in life, she makes her first and only trip to the mikvah while healing from a breast biopsy (benign this time), prompting an exploration of misogyny, shame, and woman-fear in rabbinical tradition.

With wit, verve, blood, scars, and a solid dose of self-deprecation, Wisenberg wanders across the expanse of continents and combs through history books and family records in her search for home and meaning. Her travels take her from Selma, Alabama, where her Eastern European Jewish ancestors once settled, to Vienna, where she tours Freud’s home and figures out what women really want, and she visits Auschwitz, which—disappointingly—leaves no emotional mark.

S. L. WISENBERG is editor of Another Chicago Magazine and author of the fiction collection, The Sweetheart Is In , and two nonfiction books, Holocaust Girls: History, Memory, and Other Obsessions and The Adventures of Cancer Bitch . The recipient of fellowships from the National Endowment for the Humanities, Holocaust Education Foundation, and the Illinois Arts Council, Wisenberg works as a writing coach, editor, and creative writing instructor in Chicago.

"Wisenberg is an affecting guide through the nuances, joys, and complications of contemporary Jewish womanhood; The Wandering Womb both celebrates those identities and mourns the past pains that they reflect."— Foreword Reviews "Wisenberg continues her frank and provocative inquiries into perceptions of the female body . . . Drawing on her journalist’s skills and literary prowess, she applies her audacious incisiveness and wit to her family’s stories as Jews who fled pogrom-ravaged Russia and settled in Houston and Selma."— Booklist " Wisenberg's direct tone and wide-ranging curiosity make this collection one to recommend, especially to those with an interest in the ways that history and memory intertwine."— Shelf Awareness   "A reader doesn’t have to be a Jewish feminist of a certain age to find something that resonates in S.L. Wisenberg’s compelling collection . . . These pieces are far more than personal essays. Wisenberg weaves her personal experience growing up in Houston, Texas as the grandchild of Ashkenazi Jewish immigrants with reflections on her own experience as a woman in the world. She connects her observations to literature and history, writing a book that hums with both the past and contemporary life."— Southern Review of Books “Each essay is a lens through which we are invited to view in Joycean detail the author’s deeply personal present, yet at the same time to ponder and to rethink larger worlds of history and cultures. It’s a collection that often is wry but never cynical, acutely learned and always alert to humor and wonder.”—David Toomey, author of Weird Life: The Search for Life That Is Very, Very Different from Our Own "Sometimes subtle, sometimes fierce, these brilliant essays express what it's like to be a Jewish woman today, and what it's like to be an embodied human being."—Paula Kamen, author of Finding Iris Chang “Wisenberg’s years as a journalist show in the precision of her writing, as she leads us through both the distant and proximate past, from Civil-War reenactments to the private world of the mikvah. In The Wandering Womb , history breathes into our lungs and speaks through every word we say.”—Riva Lehrer, author of Golem Girl: A Memoir “A sharp, deeply questioning mind and a wayward heart inform these delicious essays. They are wry, humorous, melancholy, and universally relatable, filled with the shock of recognition.”—Phillip Lopate, author of Portrait Inside My Head: Essays “[A]ll the essays are all well written and consistently interesting.”— Rabbi Rachel Esserman ,  The Reporter

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The NFB at the 2024 Sommets du cinéma d’animation: a wave of premieres

From: National Film Board

News release

The NFB is making an impressive return to Montreal’s Sommets du cinéma d’animation (May 6–11), with 11 productions and co-productions screening as world premieres—including Le tableau (The Painting), by Michèle Lemieux, made with the famous Alexeïeff-Parker pinscreen, and LOCA, by Véronique Paquette.

April 24, 2024 – Montreal – National Film Board of Canada (NFB)

The NFB is making an impressive return to Montreal’s Sommets du cinéma d’animation ( May 6–11) , with 11 productions and co-productions screening as world premieres—including Le tableau ( The Painting ) , by Michèle Lemieux, made with the famous Alexeïeff-Parker pinscreen, and LOCA, by Véronique Paquette. The festival’s closing film will be Loïc Darses’ G raver l’homme: arrêt sur Pierre Hébert (Scratches of Life: The Art of Pierre Hébert) . Additionally, filmmaker Arash Akhgari will be giving an Artist’s Talk about his new film In the Shallows (En surface) , which is also receiving its world premiere . Films from the 14th edition of the Hothouse mentorship for emerging animators across Canada will be having their world premieres as well.

Many of the films in this rich selection at the Sommets have their roots in various other artforms , such as poetry, dance and visual art.

Canadian Competition

Le tableau (The Painting) by Michèle Lemieux (NFB, 11 min 56 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/the-painting

• A virtuoso of the Alexeïeff-Parker pinscreen , filmmaker Michèle Lemieux created this troubling yet tender film that revisits the tragic fate of Queen Mariana of Austria and her 1652 portrait by painter Velázquez .

LOCA by Véronique Paquette (NFB, 5 min 19 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/loca

• Through the energy of tango , a woman finds a path to freedom in LOCA by Véronique Paquette . This short film from the last Cinéaste recherché(e) competition will also be screened outdoors on the Esplanade Tranquille .

In the Shallows (En surface) by Arash Akhgari (NFB, 4 min) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/intheshallows

• Through a carefully choreographed collision of hand-made sculptural collages and ink and paint animation , In the Shallows takes us on a deep dive into the shallow and fragmented world of news, entertainment and ads.

Les gens dans l’armoire (Society of Clothes) by Dahee Jeong ( Miyu Productions /Between the Pictures/NFB, 15 min 7 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/society-of-clothes/

• When morning arrives, a shirt and a pair of pants step outside the closet, transforming into a human figure. Dahee Jeong has earned international recognition , notably at Cannes’ Directors’ Fortnight and the Annecy festival, where she won a Cristal for short films .

My World, Your Melody by Bianca Shonee Arroyo-Kreimes (NFB, 1 min 34 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/my-world-your-melody

• A choir of tropical frogs performs infectious pop in delightfully unsettling animation. Produced as part of the 14th edition of the NFB’s Hothouse

Not Enough Womb for the Two of Us by Cameron Kletke (NFB, 1 min 46 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/not-enough-womb-for-the-two-of-us

• An in utero skirmish between twins , created with spacious hand-drawn animation, watercolours and pastel that plunge us into a comic battle of wills . Produced as part of the 14th edition of Hothouse .

Misérable miracle ( Miserable Miracle ) by Ryo Orikasa (Miyu Productions/NFB/ New Deer , 8 min) Press kit: mediaspace.nfb.ca/epk/miserable-miracle

• Inspired by the poems and drawings of Henri Michaux , Miserable Miracle takes animation to the breathtaking limits of language and perception. The film won the Grand Prize for Short Animation at the Ottawa International Animation Festival (OIAF) and was selected to screen at the Clermont-Ferrand Festival.

Aphasie ( Aphasia ) by Marielle Dalpé (NFB, 3 min 45 s) Press kit: mediaspace.nfb.ca/epk/aphasia

• Aphasia is an unsettling sensory experience that immerses us in the world of people with Alzheimer’s disease who are facing the loss of their language capabilities . The film has been selected to screen at many festivals in Canada and around the world .

Wide-Angle (non-competitive)

Corpus and the Wandering by Jo Roy (NFB, 7 min 13 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/corpusandthewandering

• One dancer, one body, one phone . In a time of collective alienation and technological mass control, one woman rediscovers her soul and reclaims her mind in this short, experimental self-portrait, composed of 100 video screens and made using mixed techniques .

Don’t Let the Sun Catch You Crying by Natalie Baird and Toby Gillies (NFB, 7 min 6 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/dont-let-the-sun-catch-you-crying/

• In this animated and live-action short , Edith Almadi’s imagination transcends grief, revealing a vibrant world of art where love endures . This poetic piece celebrates life and the transformative ability of art to elevate and transcend us.

The Last Tango by Mochi Lin (NFB, 1 min 42 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/the-last-tango

• Drawn to unorthodox materials and themes, Mochi Lin works with diaphanous stockings and acetate to depict courtship in the insect world . Produced as part of the 14th edition of Hothouse .

Unblending by Michele Ku (NFB, 1 min 38 s) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/unblending

• For people living with structural dissociation , falling asleep can be a challenge—a time when multiple contradictory thoughts conspire to keep you awake . Produced as part of the 14th edition of Hothouse .

Pierre Hébert: closing film and René Jodoin Award

Closing Film

Graver l’homme: arrêt sur Pierre Hébert (Scratches of Life: The Art of Pierre Hébert) by Loïc Darses (NFB, 75 min) – WORLD PREMIERE Press kit: mediaspace.nfb.ca/epk/scratchesoflife

• At the behest of the NFB’s French Animation Unit, Loïc Darses ( Where the Land Ends ) examines the career of outstanding animation filmmaker Pierre Hébert . Employing a delicate black-and-white approach , punctuated with flashes of animation, the film follows the Ariadne’s thread of scratch-on-film animation, taking us into the inspiring labyrinth of Hébert’s life and work . The documentary opens on May 12 at the Cinémathèque québécoise .

René Jodoin Award

This year, the award goes to Pierre Hébert , honouring the exemplary career of this important figure in Canadian animation . Hébert worked at the NFB from 1965 to 2000 . He will soon be marking 60 years as a filmmaker , performer and visual artist .

Artist’s Talk

Presented by the Sommets du cinéma d’animation and the NFB , this Artist’s Talk by Iranian-born filmmaker Arash Akhgari will take place on Saturday, May 11, at the Cinémathèque québécoise . The filmmaker will discuss the creative process behind his film In the Shallows (En surface) , produced by the NFB and screening in the Sommets’ Canadian Competition.

Hothouse 14

Movie lovers will get an opportunity to view the six animated shorts —including Akash Jones’ Amma and Jenny Yujia Shi’s Red Star Alley —produced as part of the Hothouse program for emerging animators across Canada . A screening will take place at the Cinémathèque québécoise Terrace on Thursday, May 9. All six films will also be screened outdoors the next day, Friday, May 10 , at the Esplanade Tranquille .

Theodore Ushev retrospective and exhibition

On Friday, May 10, at 5:30 p.m ., the Sommets will present a retrospective of short films by filmmaker Theodore Ushev , many of which were produced at the NFB . You’ll be able to see The Physics of Sorrow , Demoni , Tower Bawher , Drux Flux , Gloria Victoria , Lipsett Diaries , Sonámbulo and Nightingales in December . In addition, a major exhibition devoted to the artist, The Matter of Memory , will make its Canadian premiere at the Cinémathèque québécoise from May 3 to September 22 .

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About the NFB

Nadine Viau NFB Publicist C.: 514-458-9745 [email protected]  |  Linkedin

Lily Robert Director, Communications and Public Affairs, NFB C.: 514-296-8261 [email protected]

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