Infertility in the Middle Ages

By Danièle Cybulskie

For medieval people, success meant succession. Heredity was at the centre of law and order, from the king down through the ranks of society. As a result, the moment children reached marriageable age – and sometimes even before that – everyone’s focus was on their fertility.

While begetting legitimate heirs was of paramount importance, infertility was not a good enough reason to get an annulment under church law. Couples who were having trouble having children – especially male children – would have to do their best to solve the problem, or find another reason to annul or otherwise end their marriages (I’m looking at you, Henry VIII).


Contrary to modern opinion, if a couple was infertile, it was not always believed to be the woman’s fault. However, because of cultural rules which prevented women from having children with anyone but their spouses (they may have had premarital sex on the sly, but they certainly were not permitted to have children that way and retain their honour), it wasn’t possible to tell if a woman was fertile before she was married. By the time a man married, on the other hand, he might have already had the chance to prove his fertility by fathering illegitimate children. For this reason, it was easier to point fingers at the woman (still looking at you, Henry).

So, what to do if you couldn’t get pregnant? The first, simplest, and most private solution was prayer. Naturally, prayer for fertility was common, and women frequently petitioned St. Anne, patron saint of the infertile. If the couple felt as if their prayers were not being heard, they could also go on a pilgrimage, together or separately, to a holy site associated with fertility, such as St. Thomas Cantelupe’s shrine or one of the many sites associated with the Virgin Mary or St. Anne. Pilgrims could take home blessed badges and souvenirs from these journeys to help them. Secular amulets and badges were also a popular way to put a focus on fertility, and featured animals and wildmen known for their lusty ways.


In conjunction with their prayers, couples had the option of seeking medical treatment. The twelfth-century medical collection The Trotula suggests ensuring that both of the couples’ weight is correct first, a wise idea since both malnutrition and obesity do have a strong effect on fertility. Sweating out the fat is suggested for both women and men with baths or hot sand, not through exercise. Once that is settled, the author offers a simple test to diagnose whether the man or the woman is the one who is infertile: mix the man’s urine with wheat bran in one pot and the woman’s urine with bran in another pot. After nine or ten days, whoever’s urine is smelly and full of worms is the problem (See? Simple.). If it is the man who is the problem, The Trotula provides suggestions to help aid desire, as well as listing “substances which augment and generate seed, such as onions, parsnip, and similar things.”  If it is the woman who is infertile, more intervention is required.

Like many other medieval thinkers, The Trotula’s author is convinced that troubles with conception are based on hot/cold and wet/dry conditions. To figure out the temperament of a woman’s womb, the woman is instructed to soak a small cloth attached to a string with “pennyroyal or laurel or another hot oil” – that is, oil that is considered “hot”, not burning oil – and insert it into the vagina, tying the string around her leg, and going to sleep. If in the morning, the cloth has come out, the woman’s body is too hot; if it has not, the woman’s body is too cold, the theory being that things that are too similar repel one another. Once her natural state is established, the author recommends fumigating the woman with herbs of the opposite “temperature”: one who is hot should use “marsh mallows, violets, and roses in water”; one who is cold should use “clove, spikenard, calamite storax, and nutmeg.”

In her article “Anne of Bohemia and Her Struggle to Conceive”, Kristen L. Geaman suggests that the amount of these and other herbs found in receipts for Anne of Bohemia (Richard II’s queen) strongly implies that remedies such as the ones found in The Trotula were put into practice, even by queens. This makes sense, given that a queen would have more invested in her ability to beget heirs than pretty much anyone else in the kingdom.

Sadly, unlike other medieval medical treatments that actually did work, these herbal infertility treatments were unsuccessful for Anne, and probably for pretty much everyone else. Medieval people considered infertility to be permanent, although this did not stop them from doing all they could to reverse it.


There is a whole lot more to say on medieval fertility, including more helpful recipes, so if you’re interested, start with Kristen L. Geaman’s “Anne of Bohemia and Her Struggle to Conceive” and Monica Green’s hugely informative edition of The Trotula – a worthwhile read for everyone.

You can follow Danièle Cybulskie on Twitter @5MinMedievalist

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Top Image: Drawing from a 13th-century manuscript of Pseudo-Apuleius’s Herbarium, depicting a pregnant woman in repose, while another holds some pennyroyal in one hand and prepares a concoction using a mortar and pestle with the other.