What a Young Woman Ought to Know

by Mary Wood-Allen

The average age at which menstruation first appears is fourteen, but some girls menstruate as early as eleven, while others may not develop till some years later. Frequently, when the girl does not manifest this symptom of womanly development, the mother becomes anxious and begins to give forcing medicines. She knows that girls often die with consumption in their early young womanhood, and has heard that it was because they did not physically develop, and she fears that such danger threatens her daughter, and imagines that if something can be done to "bring on her courses," as she expresses it, the danger will be averted.

In this case she has reversed cause and effect. The consumptive girl did not menstruate because she had not the vitality to do so. The consumption was the cause, the non-menstruation the effect. To produce hemorrhage from the reproductive system by strong, forcing medicines is only to increase the danger. The only thing to do is to improve the general health, and if the girl can increase in strength until she has more vital force than suffices to keep her alive, the function that is vital—not to her, but to the race—will establish itself.

The failure of the menses to appear at the average age may be due merely to a slow development, and in this case there is nothing to do but wait. If the girl seems well, if she has no backache, no headache, no general lassitude, no undue nervous symptoms, the mere non-appearance of the menses need occasion no alarm. If, however, she has these symptoms, it is an evidence that nature is attempting to establish the function and is hindered either by general lack of vitality or by some local condition, and in either case the giving of forcing medicines would be a mistake. The weekly sitz bath would do no harm as a semi-local measure. All proper precautions should be observed as to maintenance of general health and mental serenity, and if these do not prove sufficient the physician should be consulted.

In the case I mentioned, where the reproductive organs were lacking, the girl had been subjected to a long course of home medication which had proven disastrous to her digestion, and yet, as will be readily understood, had not resulted in the establishment of a function that is dependent upon organs which, in this case, did not exist.

Sometimes there are slight mechanical hindrances which can only be determined by the physician, though their presence will be indicated by the symptoms of menstruation without the accompanying sanguineous discharge. In these cases the home medication is dangerous. If the girl regularly has symptoms of approaching menstruation, with pain and bloating, and these subside without flow, it would be wise to consult the physician instead of resorting to domestic remedies or letting the matter go on without attention.

Quite frequently the first appearance of menstruation is followed by weeks or even months of freedom from its reappearance. In these cases no alarm need be felt as long as the general health is not affected. Again, there may be suspension of the function from change of surroundings. Girls who go away to school often suffer from irregularity. I have known of a case where the girl never menstruated during the school year, but was perfectly regular during vacations.

These cases may be accounted for by the nervous strain, the using up of vital forces in mental effort to such degree that there is nothing left with which to carry on the menstrual function. In all such cases it is wise to watch carefully the general health, and if all functions are not properly conducted, to reduce the strain until the vitality is able to keep all functions in order.

Girls are sometimes disturbed because the flow is scanty, and think they should do something to increase the amount. It is no doubt true that profuse menstrual flow is the result of our artificial lives. If we lived more normally we should have naturally a scanty menstrual flow. Therefore if a girl has good health and no monthly pain and the flow is scanty, she may consider herself as more nearly in a normal state, and be thankful.

If, however, the menses are suddenly less than normal it denotes a suppression, which may be the result of cold, exhaustion of body, weariness of nerves, mental anxiety, or disturbance of the emotions.

If gradual suppression occurs, accompanied by loss of health, it indicates some constitutional difficulty or local trouble which demands professional counsel.