From 46 to 50 years of age in135 instances.
From 51 to 55 years of age in219 instances.
From 56 to 60 years of age in89 instances.
From 61 to 65 years of age in22 instances.
From 66 to 70 years of age in7 instances.
From 71 to 75 years of age in3 instances.
From 76 to 80 years of age in3 instances.

In Bohemia in the year 1872 the oldest bride numbered no less than—86 years.

Börner reports cases in which the sexual impulse remained in full activity after the change of life, and in some cases was greatly increased in intensity—these latter individuals being in a condition of real torment, which induced them to masturbate to obtain relief.

The sexual impulse may be present in cases in which the ovaries are entirely wanting. Thus, Hauff reports the case of a young girl who had no ovaries, but was nevertheless excessively addicted to masturbation. Gläveke speaks of a puella publica in whom the uterus and the ovaries were entirely absent, but who asserted that she experienced during coitus active sexual sensation. Both Kussmaul and Puech report similar experiences in cases of absence or arrested development of the uterus.

As regards the effect on the sexual impulse of the operation of oöphorectomy, most authors state that no change occurs; still, there remain many who express the opposite opinion. From the collective summary of cases bearing on this question made by Gläveke, it appears that after extirpation of the ovaries the sexual impulse remains unchanged in the great majority of cases, or at most is but slightly diminished in intensity. Hegar states that he has often witnessed a diminution of the sexual impulse after oöphorectomy, but that this decline is by no means constant, indeed he states that one of his patients assured him that in her case no decline in the intensity of the sexual impulse had followed the operation. Similarly variable reports were the experience of Schmalfuss. In one case he found there was but little sexual inclination; in one case, disinclination; in one case disinclination at first, followed by a return of inclination. Bruntzel reports that in four patients subjected to oöphorectomy, in two cases the sexual impulse persisted, but in the remaining two it was extinguished. Köberle is of opinion that sexual inclination diminishes as a result of this operation. Peaslee, on the contrary, asserts that the patients remain striking examples of womanhood, in whom all the qualities peculiar to their sex are preserved. Péan observed as a rule no difference in the sexual impulse to result from this operation, but he considers that the patients are apt to describe in exaggerated terms the amount of sexual feeling that remains to them. In one case, Spencer Wells observed after oöphorectomy an increase in sexual excitability; Tissier had the same experience, and this author believes that in these cases the sexual impulse is generally preserved. On the other hand, Bailly observed a case, in which both ovaries were removed on account of new growths, where the sexual impulse at first became excessive, and then completely disappeared. Anger and Goodell speak in the same sense.

I am myself acquainted with a woman twenty-six years of age who in girlhood underwent oöphorectomy on account of extremely severe nervous troubles associated with menstruation; she had not experienced in consequence any loss of the sexual impulse; she married a man belonging to the upper strata of society, and consulted me four years later to learn if she could by any means be rendered capable of bearing a child. Two other cases have come within my personal experience in which young women married after extirpation of the ovaries, and in whom sexual desire and sexual sensation were all that could be wished.

In twenty-seven women who had undergone the operation of oöphorectomy, Gläveke made inquiries regarding the three following points: First, whether the sexual impulse had been affected by the operation; secondly, whether during intercourse sexual pleasure was experienced to the same degree as formerly; and thirdly, whether during intercourse any kind of difference was observed as compared with pre-operative experience. He obtained the following results:

Sexual inclination was
Unaffected in 6 cases22 per cent.
Diminished in 10 cases37 per cent.
Extinguished in 11 cases41 per cent.
Sexual pleasure during coitus was
Unaffected in 8 cases31 per cent.
Diminished in 10 cases38 per cent.
Extinguished in 8 cases31 per cent.

In a considerable number of cases the sexual impulse was thus found by Gläveke, not indeed to be entirely extinguished, but still notably diminished. In another set of cases, the sexual impulse was entirely extinguished, but only in one case was there actual aversion to coitus. The women readily permitted intercourse when their husbands desired it, but remained themselves quite indifferent. The greater number of these women stated that the specific sensation of pleasure during coitus was markedly weakened, but not entirely lost; in a small proportion, this sensation was completely extinguished. In the case of seven women who complained that coitus was very painful, Gläveke found that the calibre of the vagina was much diminished. In these cases, the sensation of pleasure during coitus was either greatly diminished or completely extinguished. The women permitted intercourse very unwillingly, their unwillingness arising, not from any actual aversion, but because they dreaded the pain which coitus produced. An extremely hysterical woman, affected with severe prolapse of the uterus, stated that every attempt at intercourse was frustrated by violent hysterical convulsions. The sexual impulse appears always to suffer first and most severely, and only after this is the sensation of pleasure during coitus affected. In a few women only, according to the experience of this author, was the sexual impulse quite unaffected by the removal of the ovaries.

Amputation of the clitoris appears notably to diminish both the sexual impulse and the sensation of sexual pleasure, but the results of clitoridectomy for the cure of masturbation are by no means always favorable. In the women of the Russian sect of the Skopstki, the clitoris, the nymphæ, and a part of the labia majora are removed, in order to destroy sexual desire. According to von Krafft-Ebing it is probable that in the virgin the clitoris is the only erotogenic zone, that is to say, that only by the stimulation of the clitoris can erection, the orgasm, and the sensation of ejaculation be induced. It is probable that the vagina becomes erotogenic only as a result of coitus; thenceforward, however, the erotogenic significance of the clitoris is notably lessened, and in multiparæ may entirely disappear.