HYGIENE FOR WOMEN IN ADVANCED LIFE 



CHANGE OF LIFE.-The two most important 

 periods in a woman's life are those which mark 

 the beginning and the end of the menstrual 

 function. The duration of sexual activity in women is 

 usually thirty-two years, extending from the average 

 age of thirteen to forty-five or forty-six. There is 

 great individual variation in this respect, however, the 

 termination of the menstrual function in some persons 

 occurring as early as the thirtieth year, while in others 

 it is delayed until the age of sixty or upward. In a 

 case under the author's care a few years ago, the pa- 

 tient, aged sixty, was still menstruating regularly. It 

 is never possible to predict with any degree of accu- 

 racy just at what age the change of life, or menopause, 

 will occur. 



The physical changes which occur at the change of 

 life are the opposite to those which mark the period of 

 puberty. The ovaries, womb, and vagina undergo a 

 process of atrophy, or shrinkage, by which they become 

 reduced to a smaller size than before development 

 occurred. 



The symptoms which mark the beginning of the 

 change of life are : irregularity of the menses, both as 

 to time and quantity; nervousness and general decline 

 of health, signified by loss of flesh, and various disturb- 

 ances in the stomach, bowels, bladder, and other organs ; 

 occasionally eruptions of the skin, particularly upon 

 the face; sometimes a slight growth of hair upon the 

 upper lip; suffering from neuralgia, nervousness, and 



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