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.”