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Menopause in 1936
From_Facts and Frauds in Woman's Hygiene: A Medical Guide against Misleading Claims and Dangerous Products_ 
Rachel Lynn Palmer and Sarah K Greenberg, M.D. Sun Dial Press NY.

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Little has changed in the scam department

CHAPTER VII  THE CHANGE OF LIFE

THERE is no one phase of the menstrual life which is regarded with so much apprehension on the part of women as the menopause, or change of life. Having heard stories of this woman who went insane at this period of life and of that one who developed cancer, the average woman gets an exaggerated idea of the difficulties ahead. A knowledge of what constitutes a normal menopause should do much to allay a woman's fears and enable her to pass through the change of life with a minimum of disturbance.

What is it?

To most women the menopause means merely ceasing to menstruate. But cessation of the menses is but a small part of the whole process just one result of a fundamental change in body functions. One doctor has said of the menopause: "It is fundamentally a glandular story, a process of adjustment whereby the female body has to accustom itself to carrying on its functions without the assistance of a glandular secretion (the ovarian hormone) which it has had for the past thirty to thirty-five years. That such a radical change can occur within the comparatively short period of a few years without more profound symptoms is nothing short of remarkable

Age

The ending of menstruation is the most obvious part of this change. There is great variation among women both in the age at which menstruation ceases and in the way in which it disappears. The menopause may take place in the late thirties, or not until well after fifty; the usual period is between forty-five and fifty. With some women menstruation stops very abruptly. More commonly, however, the menstrual periods are separated by longer and longer intervals until at last they end altogether. This process may extend over a year or two. 

Contraception

A question in which all women are vitally interested is the time at which they can no longer conceive.   Practically no woman with a family wishes to assume  the responsibility of another child at the time when her other children are well started toward adulthood. The only safe course is for a woman to adhere strictly to her contraceptive program through all the years of the  menopause. Dr. Hannah Stone and Dr.  Abraham Stone say in their Marriage Manual that it is safest for a woman to consider herself as apt to conceive until a year has elapsed since her last menstrual period. The danger of relying on the so-called safe period in order to prevent conception is pointed out elsewhere. It is obviously unsuited to the menopause when all regularity of the periods is apt to disappear.

Change in libido

A decrease in sexual desire does not usually accompany the menopause. Occasionally the opposite occurs and there is a flare-up of the sexual life. One reason for this may be removal of the fear of becoming  pregnant. Another may be the woman s belief that her hold upon her husband is largely sexual; hence, fearing a decline of her sex appeal, the woman temporarily exaggerates this side of her nature. 

Hot flashes

 Various physical and mental manifestations quite commonly accompany the menopause. The most frequent of the physical symptoms are the "hot flushes"  which may involve only the face and neck or may extend over the whole body. In some they are accompanied by profuse sweating. Dr. George Gellhorn says in his Gynecology for Nurses that sponge baths with one part of vinegar to two parts of water often relieve these attacks of sweating.

Oher symptoms

Some of the other disturbances which may appear are dizziness, digestive difficulties, sleeplessness, and mental distress which may extend from a mild nervousness and irritability to a profound feeling of depression. 

Weight gain

 There is a tendency on the part of many women to gain weight at this time, the fat being distributed over the hips, abdomen and breasts. A sudden and pronounced gain in weight should be avoided, since it may aggravate other symptoms of the menopause. Although no woman should go on a severe diet without the supervision of her doctor, any woman who shows a tendency to a decided increase in weight will be safe in reducing her consumption of sugar and starch in the form of candy, pastries, cake and bread. 

variety of experience

Dr. Emil Novak in his book, The Woman Asks the Doctor,* has pointed out that it must not be assumed that all women exhibit such marked symptoms. "On the contrary," he says, "a large proportion of women go through the menopause with scarcely a ripple, and need no medical treatment whatsoever." Others, he points out, may need to build up their general health, and perhaps take a simple sedative to quiet their nerves. In the minority of cases, he says, the symptoms of the menopause may be so distressing as to call for the administration of glandular ovarian substances. These often give complete, or almost complete, relief.

surgical menopause

 If, for any reason, a woman must have both ovaries removed, an "artificial" menopause is induced, and because of the abruptness of the change, the symptoms accompanying the artificial menopause are much more severe than those of the natural menopause. For this reason doctors try whenever possible not to remove both ovaries, for as long as one remains menstruation continues. Sometimes, however, it is necessary to remove both. The woman who must submit to such an operation often fears that she will be "unsexed." Experience has shown that this is not true; a woman who has had both ovaries removed is   still quite capable of enjoying a normal sex life, though she cannot, of course, bear children.

Importance of 
mental attitude

At no time is a woman's mental attitude of more  importance than during the menopause. The prevalent  belief that during the menopause women are apt to go insane is absolutely false. It is true that neurotic women who have shown evidence of emotional in- stability throughout life sometimes have such an exaggeration of this tendency that melancholia involutia, a form of insanity, does result. But the normal woman who has met with poise the stress and strain that constitute normal life can pass through the menopause in command of both her emotional and mental life. If a woman is nervous, irritable, and slightly depressed, she can comfort herself with the thought that a comparatively short time will see the end of these symptoms. Dr. Frank P. Norbury has pointed out that even for the neurotic women who develop definite psychoses during the menopause the outlook is very good; at least 80 percent are able to make a satis- factory adjustment to life afterward.

Empty nest syndrome

Many of the tragedies of the menopause arise because a woman has put "all of her eggs in one basket." The woman who has devoted her energy and time to making a home for her husband and children, to the exclusion of other interests, finds at middle age that her children are launched on their own lives and no longer need her, while the attention she can still give her husband is not sufficient to fill her time adequately. Having spent a major part of her life in the home, she finds herself unequipped either to fill a place in the business world or to throw herself into a cause.

Necessity for
varied interests

To the extent that this explanation is true, the solution to the psychological difficulties which some women experience lies in a different orientation to life long before the advent of middle age. When her children are small she should realize that the time will come when they will be independent of her; and she should train them toward this end. The woman who strives to remain a dominating influence in the lives of her children after they have reached maturity and expects them to fill for her an otherwise empty life, usually succeeds in making both herself and her offspring thoroughly miserable. Even during the period when her home duties are most pressing, a woman should develop social, cultural, and economic interests which divert her from her own immediate problems and those of her family. The women who   have successfully done this may find that the years of the menopause and the years following, with their freedom from family cares, are the most enjoyable part of life. A career - or just a plain job - offers for the majority of women the most positive insurance against complete absorption in family life. More and more women, for either economic or personal reasons, are now undertaking the task of having both a career and a family. It is a difficult task and will remain difficult until men are more freed of the old tradition that accepting tasks and responsibility at home is beneath their dignity and capacity. Perhaps some future generation will find, as seems to have been discovered in Russia, that the greatest chance for happy, well-rounded lives for both men and women consists in equal sharing of the economic burden, of the management of the home, and of participation in the problems of the world.

Bleeding
Cancer

It must be emphasized that a wholesome attitude toward the symptoms of the menopause does not mean ignoring any untoward physical symptoms. Middle age is the time at which cancer of the uterus is most apt to develop. Any symptoms such as a discharge or bleeding should be considered as indicating the possibility of cancer, and calling for an immediate and thorough physical examination. A discharge- even though it seems of a harmless nature - should not be disregarded, since the cancerous discharge does not acquire a disagreeable odor or become irritating until the cancer reaches an advanced stage. Bleeding from the vagina is one of the first indications of cancer of the uterus; hence, any - abnormal bleeding should be looked on with suspicion. This applies also to a menstrual flow which is too profuse or lasts too long; a flow which appears after a long period of amenorrhea; and a slight bleeding between periods, after intercourse, or after physical exertion.
 A woman having any abnormal bleeding should not allow a sense of prudishness to keep her from seeking medical attention until the flow is stopped. She should go to the doctor promptly.The uterus is the organ most frequently attacked by cancer but the breasts are likewise susceptible to it, and the nature of any lump or growth in the breast should also be ascertained immediately. Because cancer may exist  without pain or other symptoms, and in a woman who has lost no weight and to all appearances is in good health, it is wise for every woman when she reaches   the end of her child-bearing period to have a thorough physical examination.

Cancer quacks

The belief on the part of many women that every abnormal growth is cancerous has caused a great deal of mental agony. There are various growths, such as tumors or polypi, which the doctors call benign; they are easily removed and never fatal. Such growths frequently produce just the same symptoms that cancer does, and are more common than cancer. Just as erroneous is the belief that cancer is always incurable. This idea has kept many women from obtaining treatment at a time when their lives might have been saved. Cancer in its early stages can be cured. There are, however, only three effective ways of treating it by x-ray, radium, and surgical removal. Any doctor who tries to treat cancer by any other method is a quack. It seems hardly necessary to say there is no salve or patent medicine which can have any effect on cancer. Yet Ruth de Forest Lamb in her American Chamber of Horrors says, "the Federal Food and Drugs Act has been responsible for more than eighty court actions against these inhuman fakes." Miss Lamb also points out the dangers of the various cancer "institutes" over which the federal government often has no control because they do not sell their products in interstate commerce.

Patent medicine 
quacks

Any patent medicine which claims to be beneficial during the change of life is a hoax. As has been said, the menopause is caused by the ovaries ceasing to produce the female sex hormone, and the only two types of medicine which a doctor prescribes at this time are either a mild and safe sedative or a glandular product. Yet what are the ingredients of some of the remedies which so brazenly claim that they will help a woman through the menopause? There is, for example, Beach's Gen-Sen Tonic, which claims to be "effective as a treatment for change of life," and capable of relieving "the many ailments which may afflict women." When seized by the Food and Drug Administration it was found to consist of extracts of plant drugs including aloes and senna, magnesium sulphate, benzoic acid, glycerin, and water, flavored with oil of anise and methyl salicylate. The most that could be expected from this conglomeration is a slightly laxative effect. Then there are Bowers Remedies Normalettes, put out by a company ambitiously designated as Health Laboratories. These remedies are labeled in Groups 1 to 10. Group 8, Female Diseases, is claimed by its makers to be of value in the change of life. Analysis showed these tablets to consist of ground plant material coated with calcium carbonate and sugar. If a woman takes Group 8 of the Normalettes they will, in all probability, do her no harm, but she will pay rather a high price for the psychic benefit she receives from swallowing some pills every day.

"Glandular" quacks

Nor should any woman be so gullible as to purchase any of the glandular products on sale at drug stores. The administration of the female sex hormone will sometimes alleviate the distressing symptoms of the menopause, but the only way to get this sex hormone is through a doctor's prescription. Many of the so-called glandular products on the market have no glandular substances in them, and no matter how impressive their claims, or how high their price, they are sheer frauds.

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July 22, 99

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