Change of life is one of the scape-goats of physicians and bugbears of patients. If any lady from thirty-five to fifty-five years of age is afflicted with dyspepsia, neuralgia, rheumatism, consumption or any other ailment, the doctor, not being able to cure her, pronounces it the meno-pause, or “change of life,” and that time alone can bring relief. Most women plan and expect to give up from eight to ten years of the best part of their lives to this climacteric period. They consider themselves of little account for business or social duties. They must be petted and nursed, and have every passing whim gratified.
The meno-pause is simply a cessation of ovulation. It is the exhaustion of the germ-making power. If a woman menstruates because of the monthly ovulation and deposit, she will cease to menstruate because ovulation has ceased to be a physiological operation.
At puberty the ovaries enlarge. When fully developed they begin casting off each month perfected ovula, which are taken up by the fimbriated extremities of the oviducts and conveyed to the uterus. This function of the uterus continues on an average thirty-two years. After the meno-pause begins the ovaries become small and shriveled, resembling a peach stone in shape and appearance.
“At the same time that the ovaries are undergoing this remarkable degenerative change, a similar change is taking place in the other organs of generation. The uterus diminishes in size, as does also the vagina. The mouth of the womb becomes contracted and after a time entirely closed. The upper part of the vagina is often contracted to such a degree as to produce folds closely resembling those which result from serious inflammation about the uterus. The breasts usually diminish in size. These changes indicate unmistakably the decline of the function of reproduction, preparatory to its entire suspension.
“As a rule, the capability of procreation ceases with the cessation of menstruation; but this is not universally the case. Instances are on record in which pregnancy has occurred before the appearance of menstruation. This seeming anomaly is due to the fact that ovulation and menstruation are really two distinct acts, although usually coincident.”
Although menstruation usually ceases from the forty-fifth to the fiftieth year, cases are on record in which “change of life” occurred at much earlier, as well as later periods. Dr. T. J. Patchen relates a remarkable case where a girl ceased menstruation at twenty-two, accompanied by all the physical changes of the organism as well as attended by the usual symptoms of that period. Cases are recorded where menstruation continued with regularity until the seventieth year, and the reproductive function remained unimpaired.
In a state of health the meno-pause should be attended by no unpleasant symptom, by no change from the normal condition. Ordinarily all the sufferings and ailments incident to this period can be accounted for from some ovarian or uterine disease, dyspepsia, or other deviation from health. Irritation or congestion in the ovaries, more than any other cause, decides the numerous symptoms of the climacteric. Uterine inflammation or derangement also causes many of the distressing ailments of the meno-pause.
Irregularity in menstruation may be looked for about the forty-fourth year in temperate climates. In the torrid zone, where girls menstruate as early as the tenth or twelfth year, it may occur much earlier. But in this country it is often delayed even far beyond the fiftieth year.
There may be occasional absence of the menses, or it may first be indicated by frequent and profuse menstruation. In rare cases the menses cease suddenly, without any warning or any special derangement. Women often feel alarmed at the sudden suspension of this discharge, but their fears are groundless if all other functions are normal. With some women the flow is alternately scanty and profuse for months.
The length of time in which these symptoms occur is extremely variable. It may be only a few months or it may be several years. In extreme cases the symptoms have continued nearly twenty years. The average period, however, is about three years.
These changes are accompanied by various pathological symptoms. Hot flashes or “flushings” are especially peculiar to this period. First one feels a decided glow or heat, as if suddenly transported to a hot room; this is soon followed by a perspiration which may terminate in a chill. They are often accompanied with a sense of suffocation or violent throbbing. The phenomenon is precisely the same as blushing, and indeed this may be said to be a sort of pathological blushing.
With some the chill is the precursor of the “hot spell.” The flashes occur at all times of day, and often one awakens with them in the night. They may occur but two or three times a day or every ten or fifteen minutes, making one wretched by their frequency. They are often the result of some sudden emotion as fright, anger, grief or anxiety. They are wonderfully the product of thought. By observation the patient will notice that they are also more frequent after drinking wine, tea and coffee, or partaking of stimulating food. Sometimes nausea and vomiting accompany flushings, as well as a feeling of weakness and malaise.
Profuse perspiration, sometimes so copious as to saturate the bed clothing, is also a common symptom of this period. This may follow the hot flushes or occur independently, but occurs more usually during sleep. It may accompany mental excitement of any kind.
Uterine Hemorrhage, common to the “change of life,” is the only peculiar symptom which really need cause any special anxiety. This may occur once a month or at longer intervals, or may be almost constant. It may become so profuse as to endanger the life of the patient. Indeed, one is often surprised that life can be sustained under the great loss of blood that some experience.
The appetite is sometimes capricious and fitful, as during pregnancy, or at the beginning of menstruation. Frequent derangements of stomach, liver and kidneys occur.
Skin diseases, often accompanying this period, are especially distressing from being attended with great itching. One also may have constipation, or diarrhea, swelled limbs or joints, swelled breasts, headaches, with heat and burning in top of the head or a sore pain at base of the brain; dizziness, dimness of vision with floating specks before the eyes, loss of voice and aching at the base of the tongue, insomnia, strange cravings, difficult breathing, neuralgia, hysteria, etc.
Tumors, cancers, polypi, etc., are more frequent during the meno-pause than at any other time of life. If the neck of the womb has been injured by attempts at abortion or indurations caused by frequent applications of caustics, conditions are produced that are liable to result in cancer.
“The mental symptoms are quite as marked and prominent in most cases as are those which relate to any part of the system. Loss of memory to a greater or less extent is apt to be first and most noticeable. Frequently there is an entire and most remarkable change in disposition. A kind, patient mother, or forbearing, confiding, exemplary wife, becomes irritable, unreasonable and suspicious.
“Her natural modesty may even give place to wantonness in extreme cases, and the mother instincts may become so thoroughly obliterated as to cause an almost uncontrollable desire to take the lives of her little ones. The once happy woman becomes despondent, moody and taciturn. She avoids company, has no taste for amusements, and spends her time in watching the varying symptoms, and bewailing her real and imaginary woes. In many cases, actual insanity, usually of a temporary character, is the result of the profound disturbance which the system undergoes at this time.”
Constipation is not unfrequently attendant upon, and the cause of, many symptoms of the meno-pause.
General Treatment.—First: Convince yourself that there is no actual need of any indisposition connected with the “change of life.” Forget all the traditions and teachings upon this subject, and learn that nature creates no pathological conditions, and that if you live according to her laws you can by no possible means experience suffering.
You have no use for these ailments. If you are possessed of any stubbornness in your nature, bring it into requisition at this time. Plant your foot down with emphasis, and say, with one of old, “Get thee behind me, Satan.”
It is thoroughly proven that mind can control even malignant diseases, and a woman that has lived until she is forty-five should know enough, and be strong enough in her mental organization to say to these symptoms, “I will not be your slave, you cannot dominate my life and chain my energies.” Do not wait for some doctor to cure you with bread-pills or placebo powders.
The physical should be subjective to the mental, and can be if one learns the law. The world is only beginning to know how much can be accomplished for physical health by the controlling power of the mind.
The charge must be laid to physicians that women have made such a mountain of the meno-pause, and they must undo their work by teaching that this is only a natural change, and removing it from the category of diseases.
Before and during this period observe all conditions of hygiene. Perfect health and vigor is more frequently attainable than women are apt to believe. The maintaining of a hygienic life by proper dress, diet, etc., will go far toward causing the “change of life” as a deranged condition to be unknown.
Sleep in rooms so thoroughly ventilated that the air will be as pure and sweet as the out-door atmosphere. If women would increase the capacity of their lungs and breathe air abundantly charged with oxygen, four-fifths of their ailments would be prevented. But who has the wisdom to convince them of this?
The dress and exercise that increase ability to breathe with the diaphragm and abdominal muscles do more to prevent and cure diseases of women, if not all diseases, than all other possible preventives or medicines. When a mother thinks her rosy nine-year-old daughter is deformed, and she must begin to put her in stays to change her horrid figure to one that is trim and neat, what can we hope for the daughter when she takes the responsibility of her own garments? If I could do the greatest thing to stay degeneracy and disease of the human race it would be to convince women that lung power more than anything else contributes to health, longevity and power of endurance. To attain this a radical change must be made in clothing.
A sponge bath (page 112), upon arising in the morning, taken quickly, three or four times a week, is valuable during change of life. Accompany it by friction from the hand, a Turkish towel or flesh brush. Follow it by a draught of cold or hot water, the latter if there is dyspepsia.
A hot sitz-bath should be taken in case of inflammation of the ovaries or uterus. (See page 184.) This may be taken every day for a week, and then every other day. In case of hemorrhage this bath is invaluable, and will relieve it when all other means have failed. It can be taken during the hemorrhage or at frequent intervals between times.
Hot or tepid vaginal injections are invaluable for controlling hemorrhage and removing congestion of the uterus. For this it is best to use a fountain syringe, hung very high so as to get good force to the water. This measure alone often removes many of the unpleasant symptoms of the meno-pause.
Hot fomentations may be applied twice a day for pain in the back. The hot water bottle is the best for this. Should be very hot and continued thirty or forty minutes, or even longer. If there is pain at base of the brain or in the pelvic region this same application is invaluable.
The Thermal bath (page 118) taken three times a week will be found invaluable in all the ailments of the meno-pause.
Sanguinaria, 2d, will give temporary relief from hot flashes. Dose, six pellets every two hours.
Alcohol and aqua-ammonia, equal parts, heated over steam, as hot as can be borne, and applied with the hand, relieves profuse perspiration. Or rub the entire surface with very hot fine salt. Hot baths will be found useful for this also.
The diet during the change of life should be simple, consisting largely of fruits and grains, moderate in quantity. These can be prepared in many palatable and dainty dishes. (See Dietetics.) If one has been accustomed to high living, to rich and greasy food, composed largely of the carbonaceous starch, sugar and fat, a change to a simple diet will work wonders in a short time.
The habit once established for a diet that furnishes the nutriment demanded for the system, one cannot be induced to return to that which gorges, stimulates and fattens, but does not nourish. The real relish and gustatory pleasure found in a fruit and grain diet can never be appreciated by those who indulge in inconsistent mixtures of stimulants and disease-producing elements. If there is no appetite, wait for its bidding; do not coax it by stimulants and appetizers. Rest of the digestive organs is often the best and surest cure for many diseases.
Let the woman who is a sufferer from hot flushes, dizziness, neuralgia, etc., give up strong tea and coffee, hot bread, pork, and rich pies and cake. Eat only what the appetite demands; and until the severest symptoms are relieved, partake of food not more than twice a day, and possibly only once. In fasting, if the stomach has a feeling of goneness or craving, drink a cup of hot water, hot lemonade or thin gruel, made from wheat, barley or oats. A sense of faintness and the inability to omit or postpone a single meal is almost a sure indication of dyspepsia. In hundreds of cases all the symptoms and diseases of change of life will yield to treatment for this common ailment. (Page 42.)
Look to it that a constipated habit is entirely overcome. Study and follow the hints in Chap. V., and the cases are rare that torpidity of the bowels cannot be removed. For any serious illness accompanying the change of life, a physician should be consulted. In all ordinary cases, however, one can be relieved entirely and that in a short time by religiously following the foregoing advice. Nature is kind and heals all our maladies if we only give her the shadow of an opportunity. In the climacteric period put yourself in harmony with nature’s laws and you will have no occasion for the physician’s potions.