CHAPTER II
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.