CONTENT WARNING
Discussion of issues related to violence/murder, mental health/suicide
As she finds out the witches’ prophecy about Macbeth being crowned king and the current king’s imminent visit to their home, Lady Macbeth invokes evil spirits to help her be rid of her feminine qualities so that, together with Macbeth, she can murder the king:
Come, you spirits
That tend on mortal thoughts, unsex me here,
And fill me, from the crown to the toe, top-full
Of direst cruelty! Make thick my blood,
Stop up th’ access and passage to remorse,
That no compunctious visitings of nature
Shake my fell purpose, nor keep peace between
The effect and it! Come to my woman’s breasts,
And take my milk for gall, you murd’ring ministers,
Wherever in your sightless substances
You wait on nature’s mischief!

In one of the most famous soliloquies in the play, Lady Macbeth plans to become a murderess while referencing her female body. However, modern viewers or readers of Shakespeare often overlook these bodily references (blood, breasts, milk), with more attention being given to her psychological changes. Contemporary viewers of the play, on the other hand, would think of physiological and psychological processes as profoundly intertwined. For Lady Macbeth to change her personality and become a murderess, she must also change her biology.
In Tudor times, strict gender roles and expectations associated women with nurture and care; by moving away from her expected femininity, both in mind and body – being ‘unsexed’ – Lady Macbeth exhorts the spirits to make her capable of murder. By asking for the ‘compunctious visitings of Nature’ (menstruation) to cease, she wants to eliminate one of the primary markers of womanhood in the early modern period. Her bodily changes both foreshadow and cause her mental change away from femininity: by blocking compassion as well as the flow of her blood, she can let the king’s blood flow.


In Shakespeare’s time, menstruation was considered a sign of overall female health and a prerequisite to conception. Menstrual blood was thought to feed the growing foetus in the uterus and, after birth, nourish the baby in its concocted form (breastmilk):
…the childe, while it is in the matrice [womb] is nourished with this bloud; and it is as true, that being out of the womb, it is still nourished with the same; for the milke is nothing but the menstruous bloud made white in the breasts; and I am sure womans milke is not thought to bee venomous, but of a nutritive quality.
By asking for the milk in her breasts to be replaced with gall (bile), Lady Macbeth hints at the corruption of her body as well as her spirit. In a world where womanhood was often synonymous with motherhood, murdering her femininity is essential for murdering the king: she will have no children but be impregnated with cruelty.

This move away from womanhood and into violence was preceded in the theatre by Seneca’s Medea, translated and published in London in 1581, which is likely Shakespeare would be familiar with. Medea also invokes evil spirits as she prepares to murder her and Jason’s children, referencing her womb, breast, gall, and bloody hands, just like Lady Macbeth. She lets go of her femininity and motherhood to punish Jason through violence. While Medea murders her actual children, Lady Macbeth destroys the possibility of children by making herself barren. The smell of blood and the bloodstains in Lady Macbeth’s hands evoke, therefore, not only the king’s blood and her guilt but also the loss of her future children through her ‘unsexing’. Moreover, they symbolise the end of Macbeth’s line in a patriarchal society, as she will have no heir to the throne. This murder of her potential children by stopping the flow of blood corrupts her body, just like the stopping of the flow of blood in king Duncan’s body corrupts the nation: both go against nature.
Lady Macbeth’s unnatural amenorrhea (lack of menstruation) could also be understood as the physiological cause for her changes throughout the play, as her mental state deteriorates. The absence of menstruation in women of a fertile age was a serious medical concern, not only because it prevented them from fulfilling their primary social role as mothers but also because it was thought detrimental to their general health. Fainting spells, melancholy, and fearfulness were believed to be connected to amenorrhea, as well as sleep troubles and ‘sorrow, and anxiety, obfuscation of spirits, agony, desperation’.
(Burton, p. 478)
Lady Macbeth suffers from all these symptoms after the king’s murder: she faints as the body is found and is plagued by melancholy passions, fears, and somnambulism for the rest of the play. These are, of course, connected to her guilt, and I do not mean to simplify her psychology but rather to add a medical layer to it, as Shakespeare’s contemporaries probably would. In his Anatomy of Melancholy, Robert Burton hinted at the suicidal tendencies the women suffering from this condition might develop – and Lady Macbeth’s suicide is implied at the end of the play.

The replacing of femininity with violence through a process of ‘unsexing’ was not unique to Lady Macbeth. Joan of Arc, who appeared in Shakespeare’s Henry VI, Part 1 as Joan la Pucelle (literally Joan the Virgin), also did not menstruate. In a world where women rarely engaged in battle, the female body was thought to be unsuited to war – in no small measure because of its natural functions such as menstruation, seen as a ‘debilitating and weakening’ condition. Joan of Arc’s military prowess is linked to her lack of femininity and even witchcraft as a female warrior. This brings to mind Lady Macbeth’s conjuring demons to ‘unsex’ her and replace one kind of blood, the menstrual one, with another one, the blood of violence.
Condemned for heresy and burnt at the stake in 1431, Joan’s trial was nullified in 1455-56, with witnesses testifying to her piety. Her valet attested that ‘she never suffered from the secret disease of women’, reinforcing her purity as a maid, but also linking her amenorrhea to cross-dressing (as Joan of Arc dressed in male military clothes) and her role in battle. Just like Lady Macbeth, for Joan to embrace violence, she would need to let go of her femininity and be ‘unsexed’.
Lady Macbeth’s soliloquy has long been read as a general invocation to eliminate qualities seen as feminine, such as compassion, and commit murder. But the literal understanding of her ‘unsexing’ in physiological terms would have been clear to most of Shakespeare’s contemporaries: the ‘unsexing’ of amenorrhea was a metaphor but also the medical cause of Lady Macbeth’s psychological change.
References:
John Sadler, The Sicke Womans Private Looking-Glasse, London: 1636
Robert Burton, The Anatomy of Melancholy, Oxford: 1621.