Any discharge from the privates of a woman which has a bad or foul odor is suspicious; any irregular bleeding is more than suspicious. Any woman having these symptoms should be examined by a competent physician. Every woman over thirty-five years of age should be examined by a physician every six months. No woman should enter the change of life without a very thorough examination. Cancer is a disease which does not permit "taking a chance" with. It is far better to be certain, since it is curable if caught early, than to find out about it when too late, because, "too late" means death.
"CHANGE OF LIFE." THE MENOPAUSE
The average period of life during which a woman menstruates is from thirty to thirty-two years. When this period is about to expire she enters what is termed the "change of life," or the menopause, or the climacteric.
The average age at which "change of life" occurs in this country is about the forty-sixth year. It may normally occur, however, at any time between the fortieth and fiftieth year. There are cases on record when it has occurred earlier than the fortieth and later than the fiftieth year. When menstruation in a girl begins early, the menopause occurs late. On the other hand, if a girl does not have her regular monthly periods until she is older than usual,—about the eighteenth or twentieth year,—the "change of life" will set in at a very early age. Women who are victims of certain exhausting diseases, as, consumption, Bright's disease of the kidney, diabetes, or whose health is poor because of general physical debility from any cause, or who have had a large number of children in rapid succession, enter the "change of life" earlier than they otherwise would if their health was good. In women who are excessively fat the menopause is apt to occur at an early age. On the other hand disease of the generative organs, or the presence of tumors of the womb may retard the process. Women in the higher walk of life, those living in cities those who do not labor or exercise sufficiently will enter this period at an earlier date than those who live in the country, who work and are physically more healthy.
Symptoms of "Change of Life."—When the menopause begins, the monthly periods are less profuse, the flow is scanty. As the months pass, menstruation becomes less and less until it ceases entirely. In a certain number of cases it stops abruptly and never appears again. Sometimes a period misses altogether, or a number of periods are passed over without any sign of menstruation, after which it may reappear either as a scanty flow, or as a profuse discharge. This may be followed for a number of months by irregular appearances of the menstrual phenomenon and then by its total cessation.
These may be the only symptoms or signs of the "change of life," and this is the normal state if the health is good. It cannot, however, be said that this is the average experience. Unfortunately the women of the present time do not live lives which conduce to robust health at this period of life. We find as a rule that the general health is below par. So they suffer from headache, "flushes," digestive disturbances, and many nervous symptoms which appear to be directly caused by the process through which they are passing. The "flushes" are disagreeable experiences. They consist of a feeling of heat which spreads over the entire body as if the blood was rushing to the surface and to the head. These flushes are followed by sweating and chilly sensations. The nervous symptoms may be quite marked. The woman loses her interest in the daily happenings. She may have mental vagaries, she is irritable and often melancholy and periods of seeming insanity may occur.
Importance of a Correct Diagnosis.—It is a mistake to attribute every symptom a woman may have at this time of life to the menopause. She is just as liable to develop conditions at this time, which she would at any age, and which have no relation to the "change of life." Every symptom should, therefore, be carefully investigated, because serious conditions may complicate the menopause, and if attributed to it and neglected, may end disastrously.
During the "change of life," the generative organs become smaller or, as it has been termed, "dry up." The breasts also are involved in the shrinking process. It is quite a common experience for women to "lay on" fat, to become "flabby," at this age.
It is important that women should become familiar with the ordinary symptoms of the "change of life," in order that they may be constantly on guard against conditions that may indicate danger. Medical investigation has conclusively proved that many women lose their lives because they regarded the presence of certain symptoms as common to the "change of life." There is a tendency to disease at this time which must be intelligently considered, and if women are not posted to note unusual signs or symptoms they may neglect or ignore them, only to find when too late that these signs and symptoms were no part of the "change of life."
The Danger Signals of the Change of Life.—There are certain "danger signals" which should warn every woman that something is amiss, these are:—