History has a weird way of remembering Mary I. We call her "Bloody Mary" because of the 300-odd Protestants she sent to the stake, but when you look at her final days in 1558, the story isn't about a monster. It’s about a deeply sick, incredibly lonely woman who was essentially falling apart. If you’ve ever wondered how did Mary 1 die, you have to look past the religious executions and dive into a medical mystery that involves phantom pregnancies, possible cancer, and a broken heart.
She died on November 17, 1558. She was only 42. By modern standards, that’s incredibly young, but for a Tudor monarch under extreme stress, she was basically at the end of her rope.
The Mystery of the Phantom Pregnancies
You can't talk about Mary’s death without talking about her health history. It was a mess. For years, she suffered from what her contemporaries called "strangury" and "suffocation of the mother"—basically catch-all terms for excruciating menstrual cramps and what we’d now recognize as severe hormonal imbalances.
But the biggest clue to her decline was the "pregnancies."
Mary was desperate for a Catholic heir. She married Philip II of Spain, a man who, quite frankly, wasn't that into her. Twice, Mary announced she was pregnant. Her belly swelled. She felt "quickening" (fetal movement). She went into confinement, waiting for a baby that never came. The first time, in 1555, she waited for months past her due date until it became a national embarrassment.
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Historians like Anna Whitelock have argued that these weren't just psychological delusions. Something was physically wrong inside her. Many modern physicians who look at the records suggest she might have had a pituitary tumor. This would explain the lack of a cycle, the headaches, the vision problems she reported, and the "phantom" symptoms. Or, it could have been ovarian dropsy—a massive buildup of fluid in the abdomen. Imagine the physical toll of carrying that weight, only to have it disappear into nothing while the world mocked you.
The Final Year: Influenza and Despair
By 1558, Mary was a shadow of herself. The war with France had gone sideways, and she’d lost Calais, the last English possession on the continent. She famously said that when she died, "Calais" would be found lying on her heart.
That autumn, a particularly nasty strain of "quartan fever"—a type of influenza or malaria—was ripping through London. Mary was already weakened. Her immune system was shot. She started fading in and out of consciousness at St. James's Palace.
A Slow Decline in the Dark
The palace was quiet. Philip was away in the Low Countries, barely bothering to write. Mary spent her final weeks obsessed with the succession. She hated the idea of her Protestant half-sister Elizabeth taking the throne, but she had no choice. She was too weak to fight it.
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Her symptoms in those last days were brutal:
- High, recurring fevers that left her drenched in sweat.
- Severe abdominal pain (which points back to those "pregnancy" issues).
- Extreme lethargy and loss of appetite.
She wasn't just "dying." She was mourning her entire life’s work. She knew her attempt to return England to Rome was going to die with her. That kind of stress does things to the body. It kills.
Was it Uterine Cancer?
A lot of experts point toward uterine or ovarian cancer as the primary answer to how did Mary 1 die. If you look at the timeline of her abdominal swelling followed by rapid weight loss and then death, cancer fits the bill perfectly.
Back then, they didn't have biopsies. They had "humors." Her doctors tried to balance her blood and bile, but they were essentially throwing darts in the dark. If she had an ovarian tumor, it likely grew large enough to cause the "pregnancy" symptoms and eventually led to organ failure or a secondary infection like the influenza mentioned earlier. It’s a grim way to go. No painkillers. Just heavy velvet curtains and the smell of incense as priests performed the last rites.
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She died during Mass. As the priest elevated the Host, Mary took her last breath.
The Aftermath of Her Death
The moment she was gone, the "Bloody Mary" myth-making began in earnest. John Foxe’s Book of Martyrs would later paint her death as a divine judgment. But if you look at the medical reality, it was just a tragic, biological end for a woman who had been sick most of her adult life.
She was buried in Westminster Abbey. Eventually, her sister Elizabeth was buried in the same vault. If you go there today, you’ll see Elizabeth’s grand monument, but Mary is tucked underneath, almost an afterthought. The inscription says they lie together "in hope of the resurrection," but in life, they couldn't have been further apart.
What You Can Learn From Mary’s Medical History
While we can’t perform an autopsy 400 years late, Mary’s death highlights a few things about the Tudor era that still resonate.
- Stress is a physical killer. Mary’s reign was one long panic attack. The loss of Calais and the rejection by her husband undoubtedly accelerated her physical decline.
- The danger of "Great Pox" and other theories. Some historians have suggested Philip gave her syphilis, but there’s little evidence she showed the specific symptoms of that disease’s final stages.
- Misdiagnosis was the norm. What they called "dropsy" or "vapors" were often terminal internal diseases that we now catch with a simple ultrasound.
To truly understand the Tudor period, you should look into the specific records of the 1558 influenza epidemic, which killed nearly 15% of the English population—Mary was just its most famous victim. You might also find it useful to read the letters of Count Feria, the Spanish ambassador, who sat by her bedside and recorded her final, agonizing days with startling clarity.
If you're visiting London, head to the National Portrait Gallery. Look at the late portraits of Mary. You can see the sallow skin and the haunted look in her eyes. It’s the face of a woman who knew her time was up long before the fever took her.