For centuries, midlife women have been misunderstood, misdiagnosed, and mistreated - often when they were beginning to reclaim their voice.
There is a long and sobering history of pathologizing women who dared to step out of the roles that were expected of them. When women in their 40s and 50s began to question, resist, speak up, or say “no,” they were often labeled as hysterical, unstable, or mentally ill.
The word hysteria has ancient roots - but its weaponization against women became especially dangerous in the 19th and early 20th centuries. Derived from the Greek word hystera, meaning uterus, hysteria was historically used as a medical diagnosis to pathologize women’s emotional expression, especially during transitional life phases like perimenopause and menopause.
In the late 19th and early 20th centuries, women were institutionalized by the thousands - often by husbands or family members - for behavior that was deemed socially unacceptable, emotionally volatile, or simply non-compliant [1]. These women were not ill in the way we understand mental illness today. Many were grieving, setting boundaries, resisting conformity, or experiencing hormone-related changes that no one understood. Rather than being offered care or compassion, they were often locked away.
One notable case is that of Elizabeth Packard, who in 1860 was institutionalized by her husband for expressing differing religious views and advocating for women's rights. She would later fight for and win legal reforms that required due process before involuntary commitment—something previously denied to countless women [2].
The tragedy of this history is not only the personal toll it took on the women affected but also the cultural message it embedded: that women who grow louder, stronger, or more demanding in midlife must be controlled. That female anger, desire, or resistance is dangerous. That when women stop making themselves small, they must be put back in their place.
The result? Generations of women who have suffered in silence - or been punished for not doing so.
Midlife Symptoms Aren’t Madness - They’re Messaging
Though we’ve made significant progress, echoes of this history persist. Today, women in midlife are still often dismissed when they describe symptoms like brain fog, anxiety, sleep disruption, or mood shifts. They’re told it’s “just stress,” offered antidepressants, or advised to “wait it out.” But midlife is not a disorder. And perimenopause isn’t a character flaw.
Hormonal changes during this time affect nearly every system in the body, including the brain, nervous system, and immune function. These changes can create symptoms that are very real and sometimes distressing. But they are not signs of weakness or inadequacy. They are biological and neurological shifts, made worse by cultural silence and outdated stereotypes.
To make matters worse, a 2023 survey by the Mayo Clinic revealed that only 31% of U.S. medical schools include menopause education in their curriculum [3]. As a result, even well-meaning doctors are often unequipped to provide effective care.
Here’s the good news: We are seeing the rise of a generation of doctors and scientists who have made it their mission to become informed about the meno-journey and support women through midlife in ways never before seen or experienced. Among the most well-known is Dr. Mary Claire Haver. In her most recent book, The New Menopause (which I highly recommend), she says the thing our mothers and grandmothers would have loved to hear: “This is not in your head. You are not hysterical. You are not crazy. You are hormonally and physiologically different”[4].
Understanding the biochemical drivers of these symptoms is essential. But so is naming the social forces that continue to dismiss, minimize, and misdiagnose them.
From Pathology to Power: Reframing the Menopause Journey
What if we stopped seeing these symptoms as problems to be hidden or fixed and started viewing them as messages? What if, instead of being told we’re broken, we were told the truth: that we’re in the midst of a profound transformation? Because we are.
Midlife, particularly the perimenopause and menopause transition, is a time of awakening. Our hormones are shifting, yes. But so is our sense of self.
The menopause journey isn’t a descent into madness - it’s a return to self.
As our estrogen, progesterone, and testosterone levels shift, so too do our priorities. We begin to see more clearly. What once felt bearable may now feel intolerable. We say “no” more freely. We grow more direct. More vocal. Less willing to bend or shrink. And for a culture that benefits from our silence and self-sacrifice, that’s threatening.
But for us? It’s liberating.
We may crave solitude, purpose, or reinvention. We may find ourselves feeling everything more deeply — and that emotional intensity is not a problem to be solved. It is a signal. A reckoning. A reclamation.
At CLEA Midlife, we call this your Menomorphosis - a bio-psycho-social-spiritual transformation that invites you back to yourself.
If you’re in the midst of this transition and you feel overwhelmed, confused, or even ashamed, please hear this: There is nothing wrong with you.
You are not hysterical. You are becoming.
You are not crazy. You are waking up.
You are not broken. You are breaking through.
You’re shedding decades of programming and perfectionism.
You’re being called inward. And it’s not always graceful. But it is sacred.
Let this be a moment when we stop gaslighting ourselves and each other. Let this be a time when we trade shame for support, and silence for knowledge. We are not here to be institutionalized, dismissed, or diminished. We are here to lead, to heal, and to rise - together.
Works Cited
[1] Showalter, E. (1985). The Female Malady: Women, Madness, and English Culture, 1830–1980. New York: Pantheon Books.
[2] Packard, E. (1866). The Prisoners’ Hidden Life, or Insane Asylums Unveiled. Chicago: A.B. Case.
[3] Kling, J. M., et al. (2023). "Menopause Education in Medical Schools: A National Survey." Menopause: The Journal of The North American Menopause Society. https://doi.org/10.1097/GME.0000000000002185
[4] Haver, M.C. (2024). The New Menopause. Rodale Books.
