CHAPTER VII.MENOPAUSE OR CHANGE OF LIFE
In the previous chapter on Puberty, it was stated that the menstrual function began in the average girl at fifteen years of age and continued until the forty-fifth or fiftieth year.
At this later age it ceases, together with her sexual or child-bearing capabilities and is known as the Menopause or Change of Life.
This constitutes a period from the beginning of irregularities in the appearance of the menstrual flow, until it has actually ceased, which period usually lasts two and one-half to three years.
Thousands of women know nothing of the period which, like puberty, they must pass through, but are entirely ignorant of the process.
It is usual for them to look toward this age with dread and foreboding; where a little knowledge of the nature of the process would enable them to enter upon this period physically prepared, which would insure their safe arrival through this dreaded and much-feared period.
The greatest change occurring in the woman at this time is that which goes on in the ovaries. They cease to do their work and ovulation stops.
The first indication that the woman has, that this is likely to occur, is by the ceasing of the menses or monthlies.
Ovulation, however, very often continues for several months, even a year after menstruation has entirely ceased.
The glandular tissues of the uterus, tubes and ovaries degenerate, which is said to account for the Menopause, and that of the ovaries occurs later than the tubes and uterus, which explains the continuance of ovulation after the menses have stopped.
In a few women the Menopause is accompanied by very little or almost no discomfort at all, just a sudden stopping of the monthlies announces to them that this period has come.
The majority, however, do not pass through this time so easily, but suffer for the entire period with one affliction or another.
Among those symptoms most common are flushings or flashes, which are mostly confined to head, face and neck, are increased by heat and motion and followed by profuse sweating, giddiness, backache, headache, sleeplessness, disturbances of digestion like diarrhoea or constipation, blueness, depression of spirits, shortness of breath, palpitation and nervous irritability.
But the most alarming symptom of the Menopause is hemorrhage. This is too often considered lightly and classed with the minor symptoms of this period.
Whenever there is excessive bleeding, there is surely a cause and calls for special and immediate attention. It may be caused by an inflamed condition of the lining of the uterus (womb), ulceration, general diseases of the heart, lungs and kidneys can also be the cause of excessive bleeding at this period. Some authorities claimthat it also has its cause in early or profuse menstruation, too frequent and difficult labors, abortions and alcoholic drinking, but the most common cause of hemmorhage at this time is cancer. It is a fact that cancer in women, from the age of 40 to 50 is more common that at any other age.
Perhaps it is not generally known that cancer is now known to begin as a local disease, and if taken in time it can be removed so completely that a radical cure follows. No wonder then, that hemmorhage should be an alarming symptom, for if care is not taken and the dreaded disease, cancer, is allowed to take root, the results are too generally known to dwell upon. At the first signs of hemorrhages or excessive flow, a woman should place herself under the care of a gynecologist (specialist in the diseases of woman), just as a pregnant woman is under the care of a physician until she is entirely free from the dangers of childbirth.
Women have heretofore looked to this period with dread, on account of the consequences which neglect has caused. It need not be dreaded for assuring word comes from prominent physicians who have made this special period a study, that the natural symptoms of the Menopause do not portend loss of life, reason or health. It is a period as natural to the woman as menstruation and with little care, these symptoms or ailments will cease in a few years, leaving the woman to enjoy years of good health.
When the period is delayed beyond the fiftieth year, it calls for the same attention as excessive flow. These are two important signs of disease, and should receive immediate care. The period is, however, often broughtabout at an earlier age than is normal, by mental or physical shock, illness, operations, etc.
The age at which it occurs often differs with climate, race and according to Kisch, social relations, who claims, that the sexual function is “generally abolished earlier in the laboring classes, who are compelled to work hard and have many cares,” and further states that a vigorous vitality causes prolongation of the menstrual process.
In the average woman it does not cease at once, but has two or three periods of cessation, returns again for an irregular period and continues in this irregularity for the entire time of two and one-half to three years. It is important to know that the changes which are going on in the organs of the woman are exactly opposite from those which occur at puberty.
At puberty the organs are increasing with life, vigor, and vitality, while at the Menopause they are receding or going backward.
The generative organs gradually but surely shrink or atrophy after menstruation stops. The uterus becomes small. The vagina, whose walls were formerly corrugated or wrinkled, now become smooth. The orifice or opening of the vagina, becomes shrunken, unless it has been previously enlarged by child-bearing. The whole process tends to show that the child-bearing period is at an end, which in fact has caused much mental anxiety and disturbance among women to the extent of melancholy and insanity.
It seems a very small things to give to every woman, going through this disagreeable period of life—a complete change of climate and rest, until the change has become established. Certainly she has served society tothe best of her knowledge, often “entering into the valley of the shadow of death”; many times fearlessly, to give the best of herself to the race. It is a small thing to give in return.
Tilt believes that unmarried women suffer less at this period than married women, and says: “As at puberty, from the ignorance in which it is still thought right to leave young women, so at the change of life, women often suffer from ignorance of what may occur, or from exaggerated notions of the perils which await them.”
All that is needed is to keep guard on one's self—watch the diet and bowels. A light vegetable diet seems best at this time unless very actively engaged in physical exercise, then meat once a day. Keep free from foods difficult to digest, cheese, fried foods, hot bread, etc., drink plenty of water and eat fruit to keep the bowels open; slight exercise in the open air, rest, sleep and freedom from mental anxiety are the simple rules which are generally prescribed for women at this time.
Tilt says: “The best way to avoid the danger of this critical time is to meet its approach with a healthy constitution.” And again says, “All complaints remain chronic because there is not stamina enough to carry them through their stages.”
It is the opinion of the foremost medical men that if women at the first sign of irregularities, consult a gynecologist, it would be the means of saving thousands of lives every year, and would prepare women to enter upon the post-climatic period in health and happiness.