MENSTRUATION--PUBERTY--MENOPAUSE
The subject of menstruation seems to be troubling several of you. I am
sorry that you did not all have the advantage of having this explained
at an early age. You might have been saved a great deal of suffering and
causeless worry.
By menstruation, or "the monthlies" as it sometimes is called, is meant
the monthly hemorrhage that takes place in the uterus or womb during the
child-bearing period of the normal woman except during pregnancy and
lactation, when it nearly always is suspended. The child-bearing period
commences at the age of puberty and ends with the menopause (change of
life).
Puberty is the period of maturing of the sexual organs. It occurs about
the age of twelve, although there may be considerable variation as to
this. It extends over a period of several years. As a rule, girls mature
earlier in warm climates than in cold and in cities than in country
districts. The signs of the approach of this period are the growth of
hair on the pubes and other parts of the body, the enlargement of the
breasts, a general rounding and increased grace of the body, the
development of the pelvis so that the hips become more prominent, and a
change in the mental qualities of the child, the girl naturally becoming
more retiring. The menstrual function usually is not established at
once, there being premonitory symptoms of a vague nature. There may be,
at first, only a slight discharge of mucus tinged with blood, later the
normal menstrual flow will be established.
During this period of puberty there are great changes taking place in
the girl's internal organs. This change and development requires
considerable of the girl's strength and naturally influences her nervous
system. It is for this reason that a girl at this period of her life
should not be subjected to any great exertion, either physical or
mental. She should have plenty of light, healthful exercise in the open
air, but should not indulge in any very violent exercise. A little care
at this time often will save her years of suffering. As the nervous
system is greatly affected at this period there should be no great
mental strain. In fact, if the girl shows many nervous symptoms, it may
be wise to take her out of school for a year so that her strength may be
used as Nature requires it. As a rule, too much work is required in
school at this age. The school duties should be lessened and the girl
allowed to rest a day or two during her menstrual period. The girl at
this age should not attempt to accomplish as much work or study as the
boy does. Her time at this period might better be occupied in learning
the rudiments of housekeeping and home-making. Then, when her body has
become developed, her strength can be spared and can be well used in the
development of her mind. If the nervous strain too common at this age
could be relieved we would have fewer nervous women and a healthier and
happier posterity.
As puberty approaches, a mother should give her daughter adequate
information so that she should not be frightened at the first appearance
of the menstrual flow, nor take any risks at this period. Menstruation
is the sign of the possibility of motherhood. If properly taught this
fact, every girl will be glad she menstruates and will want to be
careful during the period. On account of lack of early instruction, many
a girl obtains wrong ideas regarding this function and it produces in
her a feeling of repugnance. She should be taught the reasons for
observing prudence during the menstrual period. The possible lifelong
invalidism that may result should be pointed out. A woman owes it to
herself to take good care of herself during her menstrual periods. For
two or three days at least she should avoid any unnecessary strain, lie
down and rest as much as possible and not worry over school or other
duties. Especial attention should be paid to cleanliness during this
period. A sponge bath taken in a warm room is not injurious and
unpleasant odors can be avoided by sponging the parts with a warm
antiseptic solution upon changing the cloth. Every woman should be
provided with a circular girdle cut upon the bias so it may be elastic,
and provided with tabs to which to pin the folded cloth. She also should
have a supply of sanitary cloths made of absorbent cotton-fabric, or
pads made of absorbent cotton enclosed in gauze. The latter especially
are convenient for the girl who is obliged to room away from home, for
they may be burned and the cost of new ones is no greater than the
laundry of cloths. These pads or cloths should be changed at least twice
a day. It also is necessary that one should bathe the parts in warm
water with each change, as unpleasant odors can thereby be avoided. At
the close of each period she should take a bath and change all clothing.
One cannot be too careful about these matters so essential to
cleanliness. It is surprising how many women neglect these important
matters. The erroneous idea that bathing of any sort at this time may
have disastrous results accounts for much of this neglect. If proper
care is taken warm sponge baths cannot be injurious.
A woman in normal health should not suffer at the menstrual period. She
normally will have a feeling of lassitude and disinclination for any
great mental or physical work, perhaps accompanied by a slight feeling
of uneasiness in the pelvic region. Because so many women do suffer at
these periods it often is considered as "natural" and allowed to
continue.
The phenomena often noted at the menstrual period are,--pains in various
parts of the body, hot flashes, chilliness and various hysterical
symptoms. A few days before menstruation commences there may be various
nervous symptoms, as irritability and a disinclination for any exertion.
Dark circles often appear under the eyes and the breasts become enlarged
and painful. A sense of fullness and oppression may be felt in the head.
Any severe pain or profuse flow during the period or a discharge between
periods indicates a weakened or diseased condition and should not be
neglected, for it sooner or later will affect the whole system. A woman
suffering from female diseases not only is unable to perform her work in
a normal manner but the pale skin, dark circles under the eyes and drawn
haggard look which accompany these conditions rob her of her charm of
physical excellence.
The menstrual flow appears, as a rule, every twenty-eight days, although
the length of time varies with the individual. The average duration is
five days, but varies from three to seven. The flow consists of blood
from the uterine mucosa (lining of the womb) together with small
quantities of mucus. The color generally is dark at first while later it
becomes more pale. Women in poor health often have a pale discharge.
There always is a faint odor to the menstrual flow, which has been
likened to the odor of marigolds. The quantity varies with the
individual. Usually fleshy girls flow more than thin ones and dark
complexioned ones than light ones. The average quantity is four to six
fluid ounces. The time between the periods is required by the uterus or
womb to first restore the lining and then prepare it for the reception
of the ovum. Every month one or more ova (eggs) leave the ovary, pass to
the uterus and, if not impregnated, pass off with the menstrual flow.
The material prepared for the reception of the ovum is used to nourish
the new life if pregnancy occurs, but when it does not, this surplus
passes off in the form of the menstrual flow.
The menopause or change of life is the end of the child-bearing period
of a woman's life. The average age at which it occurs is forty-six,
although there is a great difference as to this. In some women it has
been known to occur as early as the thirtieth year, while in others it
does not come until the fifty-fifth year. As a rule, a woman who
commences to menstruate at an early age continues to do so until a late
age, while with a woman who commences to menstruate late, the change
comes early. At this period of a woman's life, there are numerous
changes taking place in the body. The ovaries and uterus atrophy or
shrink in size, and cease to functionate. The nervous system is being
readjusted to meet the changed conditions. One symptom of the approach
of this period is irregularity in menstruation; sometimes several
periods are missed, then the menstrual flow appears normally for several
months and then disappears again. Often the woman complains of hot
flashes, cramps in the limbs and other parts of the body. These are
caused by the attempts to readjust the nervous system to the altered
conditions. A great many women worry unnecessarily, for there is no
especial danger at this time unless the body has been neglected
previously and a diseased condition is present. But the body needs a
little extra care, just as it did at puberty. So many women break down
their health by worrying at this period over what might happen. The best
plan for every woman, as soon as she perceives the approach of this
period, is to go to a reliable physician and have a thorough
examination. Then if there are any neglected tears or chronic
inflammations they can be corrected and danger removed. If a person
were to cross a deep lake and had any doubts regarding the worthiness of
the vessel provided for his use, he would be very foolish if he did not
have a trained boat-builder examine his vessel and repair any weak
places. It is just as important for a woman about to cross this period
of her life to go to a trained repairer of bodies and have him correct
any weak places.
The various changes taking place consume so much of the woman's strength
that she requires an extra amount of rest and cannot use up as much
energy in working as at other periods of her life. The ordinary woman
does not realize the need of extra rest during this period and so
continues her usual work. Then the extra drain on her nervous system
shows itself in various forms. The disturbances sometimes are productive
of so much discomfort and so often are exaggerated beyond physiological
limits that the patient is impelled to seek relief and often requires a
physician's attention. Puberty or the period of development extends over
several years, so the menopause or period of atrophy extends over a
period of from three to five years. If a woman relaxes and allows the
changes to proceed naturally she need have no cause to worry, but she
must remember that rest from continual strain is necessary during this
period. Freedom from care, relaxation of physical and mental effort,
regular periods of complete rest once or twice a day, a reduction of the
diet and regulation of the bowels should be the first principles of
treatment. Then--do not worry but occupy the mind with happy thoughts.