One of the most common of the so-called female disorders, which seems to be the lot of the majority of women, is dysmenorrhœa or painful menstruation. This is not a disease in itself, but the symptom of various disorders. A woman in normal health should not suffer at her menstrual period; so if she does suffer it shows there is something wrong. The natural thing for anyone to do who had dysmenorrhœa would be first to find the cause of this pain and then take measures to correct it. It may be due to displacements, inflammations or tumors; it may be due to a contraction of the mouth of the womb which does not dilate sufficiently to allow the menstrual discharge to flow freely. It may be due to neuralgia or rheumatism of the uterus or ovaries. Pain always indicates an unnatural condition. It is the cry of tortured nerves. The cause should be determined by a competent physician and then measures taken immediately to restore the normal condition.
One who suffers from dysmenorrhœa should try to plan her work so that she may rest the first day of her menstrual period, and, if possible, the preceding day. Absolute rest in bed at this time is beneficial. A hot sitz bath, hot foot bath or hot vaginal douche taken just previous to the commencement of the period will aid in relieving the congestion and thus lessen the pain. After the flow has started hot foot baths and hot applications to the abdomen may be used. Hot drinks also may be taken, but one should not get in the habit of using any drug at this time. Hot ginger tea will do as much good as one prepared with some habit-forming drug. Many of the remedies advertised as a cure for this condition are composed chiefly of alcohol, and, although they may give a temporary relief, the benefit is not permanent. Careful attention to diet and exercise, with regular hours of sleep, are essential points to be considered if one would be free from this disagreeable trouble.
Another symptom which often causes much alarm to the patient is amenorrhœa or deficient or scanty menstruation. This may result from fear, worry, catching cold or to an enlargement of the womb. It also is one of the first symptoms of pregnancy. Sometimes it indicates an impoverished condition of the blood and shows the need of a general building up of the system. This is true especially in young girls who have what is called chlorosis or green sickness. These girls are pale, weak, sometimes having a greenish cast to their complexions. They need good care and nourishing food and plenty of light, outdoor exercise.
In young girls I sometimes find an irritation of the vagina which causes pain. This may be due to the retention of secretions in the vagina. The general idea that only married women have leucorrhœa, or whites, is fallacious. Virgins may have it. The usual cause is catching cold at the menstrual period. Another delusion is that these girls should not take douches for fear they might injure the hymen. This is erroneous, for douches are necessary in the treatment of this condition and, except in very rare cases, a douche can be taken with an especially small douche point without injury to the parts. There normally must be a small opening in the hymen to permit the passage of the menstrual flow. If a small douche point is used no harm will result.
When I talked to you about the structure of the external generative organs, I mentioned the clitoris and explained that sometimes the prepuce or foreskin is bound down, or is too tight, so that the natural secretions are retained under it and produce an irritation; that the operation for the unhooding of the clitoris is very similiar to that of circumcision in the male and is performed for similar causes. Many a woman who has been nervous all her life, owes her condition to a hooded clitoris, which a very simple operation would correct. A hooded clitoris also may have something to do with the immoral life of some girls. The other day I received a letter from an aged physician who, in discussing the tendency to immoral practices, says: "You say in one of your articles, 'What is the remedy? Educate!' Well, perhaps, but if you would let me circumcise the girl early in life, I believe it would be more certain." There is considerable truth in his statement. A hooded clitoris produces a constant irritation which tends to lead to habits of self-abuse and perhaps immorality.
The other common disorder which I named at first is a tumor. Tumors are any unnatural growth. They may form in any part of the body, but just now we will speak only of those affecting the internal female organs. Tumors may form in the cavity of the womb, in its walls or on the outside of it. The common symptoms are an enlargement of the abdomen accompanied usually by pain due to pressure on the nerves. There also may be some hemorrhage at other than the regular menstrual periods.
Sometimes the ovaries are diseased and become enlarged, tender and filled with fluid. Then they are spoken of as cystic tumors or as cysts. The tubes may become inflamed and filled with pus. The most common cause of these pus tubes is one of the black plagues. With all these tumors the treatment usually is to remove the tumor and sometimes the entire organ. In a few cases it is possible that the fluid or other contents of the tumor may be absorbed, if the general health and circulation are improved. In some cases we find what is called a phantom tumor. There really is no tumor, although the symptoms may be such that even reliable physicians are misled. The symptoms are due to a nervous condition. These phantom tumors have given many a quack a reputation for removing tumors without the use of the knife.
A carcinoma or cancer is a malignant tumor, that is, one that tends to grow worse and to reappear if it apparently is removed. The reappearance may be in the same place or in an entirely different portion of the body. Cancer of the uterus is not uncommon in women. It frequently follows neglect of some injury. For example, it will appear on the site of an unrepaired tear. It most commonly comes after the menopause. The change that is undergone at that time seems to stir things up and bring to light any neglected injury. This is another reason why every woman at the menopause should undergo a thorough examination and have any defect repaired, thus avoiding much of the possibility of trouble. A frequent symptom of carcinoma of the uterus is hemorrhage at irregular times after the menopause. Any woman who has such a condition would be wise if she immediately repaired to a physician and determined the cause of the hemorrhage. In the beginning it is possible to remove a cancer, but later it becomes so involved in the surrounding structures that its removal is impossible.
You may think I am trying to increase business for the physicians but in reality my advice, if taken, would lessen their practice. It is another application of "a stitch in time saves nine." In the beginning almost all these diseases can be corrected with very little trouble, while if neglected the process is much slower. The probabilities are that the doctor will have the case later, if not consulted early, but instead of a few office treatments he will have an expensive operation. So, you see, I really am trying to save you doctors' bills when I urge early and thorough examinations. There is a peculiar thing about the human race. A machine will get out of order and the owner will send for an expert machinist to repair it—not attempting to patch it up himself. But when these bodies of ours, the most wonderful and complicated of machines, get out of repair we try to patch them up ourselves or try various remedies recommended by those who know worse than nothing about the physical machinery. Then we think we are saving doctors' bills, when at the same time we are spending twice as much on questionable repairs—patent medicines, which often do more harm than good. Frequently they contain stimulants which produce a mythical improvement but leave the system worse off than before.