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If these tears are extensive they should be repaired, as it is certain that malignant growths frequently do follow local injuries and traumatisms. Any irregular or profuse bleeding demands an immediate investigation by means of a local examination. A stormy, irregular, or delayed menopause should excite in the woman a suspicion of some abnormal condition.
But any one can appreciate the fact that diseases of the womb may interfere with the menstrual process. Menstruation is influenced, also, by the ovaries. As a result of age, for example, the ovaries undergo changes which invariably bring about the permanent cessation of menstruation, called the menopause. This event occurs prematurely if both the ovaries are removed by operation.
The next act shows her thirty years later when, as an elderly spinster, she is passing through the climacteric, and is in the state of sexual hyperesthesia some women are afflicted with before the menopause. It is as if the ovaries and the accessory sex internal secretions erupt into a sort of final geyser before they are exhausted.
This is sometimes caused by sugar in the urine; there is a congestion of the liver which results in sugar being thrown into the system and this is eliminated by the kidneys. It is quite possible that this is due to the altered circulatory conditions of the menopause. Kidney Disease. The last pathologic condition which we will mention is kidney disease.
"Locksley Hall." Average Duration of Menstrual Function. The average duration of the menstrual function is from thirty to thirty-two years. Raciborski estimated the duration of menstrual life at about thirty-one years and nine months. According to him, the mean age of puberty at Paris was fourteen years and seven months; therefore, the average age of the menopause was forty-six and one-half years.
Tilt gives the average age of the cessation of menstruation in 1082 cases as forty-five years and nine months. The average age is between forty-five and fifty years. It has been shown by Krieger, Kisch, and others, that the earlier the menses appear, the later they cease, and vice versa. However, when the first period is unusually early or late, the menopause comes very early.
The chain of events at the menopause, the acme and then ebb of the sex tide, may be summed up something like this: The ovaries cease producing their eggs and so shrivel as a storage battery atrophies when it dries up. An important member of the endocrine board of directors thus drops out, and so a rearrangement of gland activities, a new régime, becomes necessary.
It frequently follows neglect of some injury. For example, it will appear on the site of an unrepaired tear. It most commonly comes after the menopause. The change that is undergone at that time seems to stir things up and bring to light any neglected injury.
The widespread belief among the laity that hemorrhage at the time of the menopause is a normal condition, and that if left alone it will stop in the course of a few years, is most erroneous and fatal. On this altar of ignorance thousands of women sacrifice their lives every year. The case-book of any gynecologist will testify to the truth of this statement.
Armstrong says that in almost all cases at the time of the menopause the amount of urine passed is below normal, the specific gravity is increased, and that the urine contains urates and almost always uric acid in excess.
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