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Castration is comparable in every way with the menopause or the time of cessation of sexual life, a process that might be called self-castration. It produces certain general constitutional effects. Adiposity often develops, undoubtedly associated with underfunction of the thyroid and pituitary glands. The woman breathes less oxygen per minute and burns up less food and tissue.
In obese patients with hypertension, in the hypertension of women at the menopause, and in hypertension with insufficient kidneys, thyroid medication is often of great value. Sometimes a small dose of from 0.1 to 0.2 gm.
Menstruation continues from puberty to about the forty-fifth year, which usually marks the menopause, or "change of life." When it disappears a woman is no longer capable of bearing children. Her period of fertility has passed. In rare cases menstruation has stopped at 35, or lasted till 60.
Further, that the functions of digestion and assimilation and the various metabolic changes are so largely under the control of the nerve-centers that nothing seems more likely than that so great a disturbance of that system as takes place at the menopause should cause secondary derangements of these most important functions.
Women are learning from experience and specialists are discovering by investigation that the "safe period" is anything but safe for all women. Some women are never free from the possibility of conception from puberty to the menopause. Others seemingly have "safe periods" for a time, only to become pregnant when they have begun to feel secure in their theory.
After the cessation of the menopause any bleeding whatsoever, whether slight or profuse, should always be regarded as a danger signal which demands an immediate and thorough local examination. The same is true of any offensive vaginal discharge. Pain is frequently so late a symptom that to wait for its appearance means that the favorable time to perform an operation has passed by.
A further investigation in order to ascertain any possible relation between the age of marriage and the number of pregnancies and the sufferings of the menopause elicited the following statistics. The average age of marriage was twenty-five years and ten months.
Although the menopause is a physiologic occurrence, yet, owing to the many pathologic changes which are liable to take place at this time, the woman should be as carefully watched during the menopause by the gynecologist as the pregnant woman now is by the obstetrician.
The anatomic changes in the glands and substance of the uterus also favor the irritation, and the development of new growths, which may be malignant or benign as cancers, fibroid growths, and so forth. Hemorrhage at the Menopause a Significant Symptom of Cancer.
That being the case, the woman must lead such a life as will insure her having on hand a large reserve force necessary to meet these heavy demands. Tilt's observations show that women who have experienced no suffering at puberty or, at the menstrual periods do not suffer at the menopause. It is therefore evident that the time to begin this preparation is in childhood.
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