MENOPAUSE-DURATION OF THE ACTIVITY OF THE GENITAL ORGANS.
Even as we have seen that puberty causes in a young girl a series of external phenomena which are the evidence of changes taking place in the internal genital organs, in the same way the menopause, critical age, or change of life, shows itself by a series of changes which indicate the cessation of the active period of woman's existence.
The menopause is the time when menstruation ceases. No definite time can be fixed, the menopause taking place in some women at thirty five, thirty, or even twenty-eight years, in some the menses occur up to sixty, sixty-five and sixty-eight years. I once saw a very curious case of a woman, in whom the menses stopped at forty-eight years with all the phenomena of the menopause, and in whom at sixty, a dozen years after,. they reappeared for two years, the periods having the same regularity and the same intensity as at her prime. This tardy reappearance had no effect on her general and local health, and the last appearance at sixty two years and two months took place without injuring her health. This woman died at seventy-two years of age of pneumonia. But the extreme figures, from thirty and sixty to eighty years, are wholly exceptional, and general's it is between forty-five and fifty that the critical age occurs.
According to statistics of various authors, the ordinary age in Paris is fifty years. The average duration of genital life in women is, then, from thirty to thirty-one years. We ought to add that, the early or late cessa tion of menstruation, does not necessarily prove that ovulation suffers the same cessation, or the same persistence, for we know that the two phenomena, hemorrhage and follicular development, are not necessarily dependent on each other. (Depaul). We find the same influences, in versely, as in puberty, but less marked; and we must not conclude that women who menstruate early are those in whom the menses stop the soonest. The contrary would rather seem to be true. Lancereaux said
that alcohol caused an early atrophy of the ovaries, especially in their glandular part.
In general, the menopause does not take place suddenly. It com mences by irregularities in the menstrual flow. Soon this ceases for several months, followed by a real flow; then there are variations in the duration, quality and quantity. At the same time various general ail ments appear, congestions of different organs: the head, the lungs, and, above all, the liver. The genital organs, on the contrary, seem in some cases to be, for the time, especially active. The genital sense seems to awake, and as there still survives, in general, some development of the breasts and abdomen, certain women believe themselves to be pregnant, (a nervous, false pregnancy), all the symptoms of which they think they have.
These phenomena are accompanied by more special ones in the genital organs, which are expressed by one word, atrophy. The ovaries, first, waste rapidly, their vascularization diminishes, and they are changed into a true fibrous tissue. The uterus, the same as the ovaries, becomes atrophied, its arteries are incrusted with calcareous matter, its veins become varicose, the cervix loses its length, decreases in size, sometimes shrinking entirely away.
Even the external genital organs change; the labia majors dry up and sink down, the vulva has a venous tinge, the hair of the pubes whitens and falls, the breasts becorie flabby, in a word the woman loses her sex— habits, desires and functions, approaching those of a man. (Depaul.) The name critical age, given to the menopause, seems to indicate that the menopause predisposes to certain diseases, particularly organic dis eases of the genital apparatus. This opinion is considerably exaggerated, as statistics prove, but it is not the less true that this time is marked in woman by the appearance of various affections generally unimportant, as hemorrhoids, bleedings, cutaneous eruptions, etc.