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The Woman's Menopause
This is popularly known as the "change of life," the period in the life of a woman when her reproductive capacity stops, the ovaries creasing to mature ova and ceasing to render them capable of fertilization. Just as, during puberty, the preparation of the entire organism for the phase of sexual maturity is gradual, so the transition to the changes characteristic of the menopause takes place gradually, producing a series of sysmptoms known as climateric symptoms. Just as the commencement of ovarial activity during puberty is concluded from the first menstruation, it is customary to diagnose the beginning of "the change," at a suitable age, from the most obvious phenomenon, the gradual or sudden cessation of menstruation. This is not a wholly correct conclusion, for the limits of the climacteric are defined by the first and last ascertained climacteric phenomenon, and menstruation is not the most important symptom. In accordance with this temporal definition, we also speak of the climax as the commencement of the menopause. The disturbances occuring before the climax are designated as pre-climacteric, and those occurring after the cessation of the menstruation, as post climacteric symptoms, or post-menopausal. The duration of this transition period varies a great deal. Usually a period of from one to two years is sufficient to extablish the new equilibrium. Sometimes, however, the process may take several years, athough in these exceptional cases the undue gradualness is generally attributable to some pathological condition. It would be difficult to establish that the period of change in all cases precedes old age, as the climacteric often reaches into old age. Delaying Sexual Death -- It marks the commencement of the ageing of the entire body, and particularly of the genital organs. Statistical investigations of the subject have provided us with more accurate informations of the subject have provided us with more accurate information concerning the average age of the menopause. Thus a considerable amount of polyclinical material has been sifted with a view to extablishing the commencement, duration and cessation of menstruation. What we are interested in here are data concerning the the time of the menopause, in respect of which we investigated 903 cases. The average age was 47.26 years, which tallies with the general view that the change in our latitudes usually takes place between the ages of forty-five and fifty. The range of this fluctuation is indicated by Schaffer's detailed table. According to his investigations the cessation of sexual maturity and the cyclical activity of the genital apparatus occurs:
In 3.65% of cases at the age of 40 years
" 20.5 " " 40 44 3/4 years
" 44.19" " 45 49 3/4 "
" 30.01" " 50 54 3/4 "
" 1.64" " 55 57 3/4 " Kleinwachter, who investigated the data concerning 373 women, also observed the occurrence of the climax between the ages of forty-five and fifty in 54.15% of cases; in 18% of the cases the memopause occurred later, in 34.85% before the age of forty-five. Stratz calculated on the basis of 86,000 observations occurring in literature that the average age for the first menstruation in Europe is the fourteenth, and for the cessation of the menses, the forty-sixth year. The normal range of fluctuation in respect to menstruation is, according to this author, from the tenth to the twenty-first year, and in respect to the menopause from the thirty-sixth year to the fifty-sixth year. It has long been known that the time of the change is influenced by a number of factors. Climate, race, heredity, mode of life and constitutional characteristics all play a part in this connection. However, with regard to the importance of climatic conditions the various authors do not appear to be in agreement. Whereas Montegazza concluded from investigations carried out in Italy that a warm climate frequently delayed the menopause Bruce and Oppenheim hold the contrary view, namely, that in warm climates the menopause usually occurs earlier. The latter view seems to be borne out by the fact that women of the South reach sexual maturity and also lose their attractiveness earlier than women of the North. However, other investigators have been unable to discover any variation. In our view it is far more probable that differences in the ages when the menopause occurs depend not so much on climatic as on racial and hereditary characteristics. Wiesel is of the same opinion. He writes: "For instance, if a woman born in the South, who has reached puberty at an early age, gives birth to a daughter in a northern climate, the later will not follow the native rule in those regions as regrads the commencement of menstruation, but will also menstruate earlier. The daughter of these children, though they may also be born in the North, will similarly menstruate considerably eariler, just like their grandmother. The same applies to the climacteric,which as a regular rule follows the family type, and is unaffected by purely local factors." That the menopause in different races occurs at different ages has been known for a long time. Thus Chinese women menstruate not longer than until the age of forty, and the climax frequently occurs even earlier. The time of climax in the Japanese women is towards the end of the forties, while an investigation as to the time of the menopause in North American Indian women has shown that it often occurs as late as the early fifties, and that these women continue to menstruate at an age when women of our own race have long passed the climacteric. The menopause comes particularly early in women of the black races. For instance, the women of the Woloff tribe have their climax between the ages of thirty-five and forty. The women along the Sierra Leone Coast are also said to cease menstruating at an average age of thirty-five. The reproductive capacity of the women of some Indian peoples is also said to cease earlier than in Europe. Marshall has compiled a table concerning the women of the Todas, according to which they cease to bear children at an average age of thirty-seven. In Tungus and Ostiak women's productivity similarly ceases between the ages of thirty and thirty-five. etc.. |
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This intel was contributed by bjk48
bjk48
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May, 2012
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