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Updated: June 26, 2025
All physicians are aware of the frequent dependence of menorrhagia upon anemia, not only acquired, but congenital. The existence of anemia, or of an imperfect elaboration of the blood and vascular system, previous to the occurrence of the first menstruation, is a possible condition of menstrual disorder that must always be very carefully eliminated before any other cause be assigned.
Moreover, she would not, or could not, make any more allowance for the periodicity of her organization than for the shape of her skeleton. When about twenty years of age, perhaps a year or so older, she applied to me for advice in consequence of neuralgia, back-ache, menorrhagia, leucorrhoea, and general debility. She was anemic, and looked pale, care-worn, and anxious.
The patient first discovered her peculiar condition by a stain of blood upon the night-gown on awakening in the morning, and this she traced to the breast. From an examination it appeared that a neglected lacerated cervix during the birth of the last child had given rise to endometritis, and for a year the patient had suffered from severe menorrhagia, for which she was subsequently treated.
She was a stout, pleasant featured and intelligent woman, somewhat anaemic, and with a slight bluish tinge of lips, though beyond a lack of tone in sounds, the heart was normal. Her anaemic condition was accounted for by her having suffered from menorrhagia for the greater part of two years, which only stopped a few months before her admission to the Asylum.
A friend of undoubted accuracy testifies to a case where acute dysmenorrhoea and menorrhagia, begun in over-excitement and tight clothing, and aggravated by the very cause above-mentioned, gradually yielded to regular and nutritious food, a rational mode of dressing, regular sleep, and to the regular brain-work which gave sufficient employment to the over-excited imagination.
If this be so, how comes it that while every practical physician of experience has seen many cases of anæmia and chlorosis in girls, accompanied by amenorrhæa or menorrhagia, headaches, palpitations, emaciation, and all the familiar accompaniments of breakdown, an analogous condition in a school-boy is so rare that it may well be doubted if it is ever seen at all?"
Menorrhagia and Metrorrhagia; Dysmenorrhea; Amenorrhea; Leuchorrhea; Pruritus Vulvae. "Defer not till to-morrow to be wise, To-morrow's sun on thee may never rise." Menorrhagia and Metrorrhagia. By menorrhagia is meant an excessive or too profuse menstrual flow; by metrorrhagia, a flow of blood between the menstrual periods.
Before analyzing such influence it is important to notice two other causes of menorrhagia, that are very frequently present in just such cases as Dr. Clarke describes. These are prolonged sedentary position, and deficiency of physical exercise. Either may determine anemia, or impoverishment of the blood, a condition which alone is sufficient to induce excessive menstrual flow.
But on further inquiry it appeared: first, that the mother of the girl had always been subject to menorrhagia, and it is well known that this often occurs exclusively as the result of hereditary predisposition.
Let us now look at another phase; for menorrhagia and its consequences are not the only punishments that girls receive for being educated and worked just like boys. Nature's methods of punishing men and women are as numerous as their organs and functions, and her penalties as infinite in number and gradation as her blessings. Amenorrhoea is perhaps more common than menorrhagia.
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