Average Duration of the Menstrual Flow.—The average duration of the menstrual flow is five days, although the variations are considerable in healthy women. A flow lasting any place from two to six days is perfectly consistent with health, but a flow continuing less than two days or more than six days generally indicates a local or general disease.
Character of the Menstrual Flow.—For the first few hours, or perhaps for the first day, the flow is usually slight in quantity and light in color; on the second and third day the flow reaches its height, and is profuse and dark in color, but it should never be clotted; after this it generally ceases. The amount of the flow varies from 5 to 10 ounces. If less than 5 or 6, or more than 18 napkins, are pretty well saturated through, the amount may be considered abnormal.
Premonitory Symptoms of the Flow.—The premonitory symptoms of the monthly flow should not be so marked as to cause the individual any discomfort. The first indication of the return of the period should be the flow. There is generally a feeling of abdominal fulness, with some lassitude and sometimes slight headache. The temperature is lower and the pulse is slower than at other times. This lowered tone of the system is an additional reason for increased care against exposure in wet or cold weather.
Hygiene of Menstruation.—During the menstrual period all cold baths must be strictly prohibited, whether tub-baths or cold sponges. The reason for this is that the application of cold to the surface causes a driving in of the blood from the exterior of the body to the internal organs, and, at the time of the menstrual periods, there is already a congested condition of the pelvic organs, and it must be remembered that congestion is the first stage of inflammation.
Hot or warm sponge baths may be taken throughout the period, and the vulva should be bathed with warm water twice a day throughout the entire period of the flow, as this not only removes the clotted blood before it decomposes and becomes the source of irritation, but also removes other irritating matters, and prevents the nervousness that is caused by local irritation.
Another question which is still sub judice is the necessity for and the frequency with which vaginal douches should be taken; all physicians are agreed that a vaginal douche, taken immediately after the menstrual period, is beneficial, as it removes all of the débris of the flow, which is sometimes very irritating.
Exercise.—A moderate amount of exercise should be taken every day; this is needed now quite as much as at any other time, and only good can result from it, and no harm comes of a woman going out in the rain or the cold weather. As has been shown, the menstrual process is going on for a large part of the time, and the flow is only the external appearance, but during the time of the flow the woman must be unusually careful not to get her feet wet or sit down with damp clothing on. Violent exercise of all kinds is to be prohibited at this time, as dancing, bicycling, gymnastics, and walks of over three miles. The reason for this is very obvious: the uterus has now reached the height of its turgescence, and is heavier than at any other time, hence the danger that displacements or a very profuse flow would be caused by any kind of violent exercise.
Treatment.—If the woman has been so unfortunate as to have been caught out in a heavy rain, so that her clothes have been wet through, or if in the cold weather she should come into the house thoroughly chilled, the best thing to do is to take off her wet things as quickly as possible; be well rubbed down with hot rough towels; drink a cup of hot tea, and go to bed at once, with a hot-water bag placed over the abdomen or under the small of the back. She should remain in bed until the next morning, to the end that the circulation may regain its equilibrium as quickly as possible by the immediate relief of the pelvic congestion.
If this exposure should have caused the sudden cessation of the flow, a hot mustard foot-bath should be taken. One tablespoonful of ground mustard is used to the gallon of water, as hot as it can be borne; the pail should be made as nearly full as possible, without running over, and a blanket wrapped about the pail and woman, so as to cause a profuse perspiration; this should be kept up for ten minutes; as the water cools off, hot water may be added.
Profuse menstruation, painful menstruation, and scanty, very slight, or irregular flow are all abnormal conditions that are due to some abnormal or pathologic causes, and a good gynecologist should be at once consulted, so that not only suffering may be prevented, but that serious consequences to the general health may be averted.