In general, and climatic influences apart, it may be said that the earlier in any woman the age at which menstruation first occurs, the later will be the age at which menstruation ceases.
In order to ascertain the influence of the age at the menarche upon the disappearance of menstrual activity, I placed in comparison first the cases of 50 women in whom menstruation had first appeared between the ages of 12 and 16—i. e., cases of early menarche; and secondly the cases of 50 women in whom menstruation had begun between the ages of 16 and 20—i. e., cases of late menarche. The result was the following:
In the 50 women in whom the menarche had been early, the menopause occurred
| At ages 35 to 40 in | 5 instances |
| At ages 40 to 45 in | 12 instances |
| At ages 45 to 50 in | 25 instances |
| At ages 50 to 55 in | 8 instances |
On the other hand, in the 50 women in whom the menarche had been late, the menopause occurred
| At ages 35 to 40 in | 9 instances |
| At ages 40 to 45 in | 28 instances |
| At ages 45 to 50 in | 10 instances |
| At ages 50 to 55 in | 3 instances |
Thus whilst among the women in whom the menarche had been late, there were thirteen only who continued to menstruate until they were at least 45 years of age; among those in whom the menarche had been early, the number in whom menstruation thus continued up to the age of 45 or beyond was 33, nearly three times as great.
On the other hand, in those cases in which the menarche occurred at an abnormally early age, i. e., before the age of 12 years, the menopause was also a remarkably early one. The menopause also came on very early in women in whom the menarche had been extremely retarded, until the age of 20 and upwards. An extremely early and an extremely late menarche alike tend to be followed by a premature menopause.
To this rule there are, however, exceptions, and we occasionally meet with women whose reproductive energies are so powerful, that the menarche occurs at an unusually early age, and the menopause is postponed to an age considerably beyond the average. Thus, among 100 women in the Salpetrière, Raciborski observed 29 in whom menstruation had begun at the exceptionally early age of 12 years, and who, notwithstanding this, all experienced a very late menopause. Three of them were still menstruating at the age of 57, 1 at 56, 2 at 52, 2 at 50, 3 at 48, 3 at 45, and 13 at an age less than 45.
Brierre de Boismont reports the case of a woman who began to menstruate in her 12th year; she married, had several children, and continued to menstruate regularly until she was 60 years of age.