Chapter 30

HYGIENE OF THE MENOPAUSE.

Diet; Constipation; Stimulants; the Kidneys; the Skin; Turkish Baths; Massage; Exercise; Profuse Menstruation; Hemorrhage; Mental Therapeutics.

"'Tis the breathing time of day."

-- "Hamlet."

Hygiene of the Menopause.-- The changes which occur in all the organs of the body at the time of the menopause are retrograde, and therefore just the opposite of those which occur at the time of puberty. This fact should be borne in mind in the matter of alimentation. All that is now needed is to make the repair equal to the waste.

Diet.-- Unless the woman is taking a great deal of active exercise, it is better to diminish the amount of meat eaten, and to increase the vegetable food and take more fluids. Unless the effect of the meat eaten is counterbalanced by active outdoor exercise, it produces an excess of waste matter, which accumulates and causes biliousness, and sometimes rheumatism and gout. A vegetable diet is less taxing to the excretory organs than an animal diet.

Indigestion is at this time of life apt to appear in the form of fermentation, which may assume the gastric or intestinal type. The chief causes of the formation of gases are the lessened peristaltic action of the intestines, the increased tendency to congestion of the liver and to obstinate constipation.

All dishes rich in sugar, as cake, candy, preserves, and jelly, should be indulged in with moderation; or where there is a tendency to fermentative indigestion, they should be wholly avoided.

All dishes known to be difficult of digestion, as hot breads, pastry, cheese, fried dishes, and rich salads, should be cut off the menu, since these readily overtax an already weakened digestive system.

If there is a hereditary tendency to rheumatism or gout, the disease is most apt to take on an active form at this time. In either case the manifestation of the disease indicates an excess of uric acid in the system, and a diet becomes a necessity. Pickles, all highly spiced articles of food, and vinegar must be omitted from the bill of fare. The vinegar may be replaced in salad-dressings by lemon juice. Tomatoes, rhubarb, strawberries and grapefruit are contra-indicated; also all articles of food rich in sugar.

In chronic cases animal food cannot, as a rule, be excluded from the dietary, but must be limited in quantity. Fish, eggs, and fowl may be eaten, also a moderate amount of lean meat in the form of beef, lamb, and mutton. Milk may be indulged in freely. The diet should consist principally of easily digested fresh green vegetables. The amount of tea and coffee should be limited. All malt liquors, sweet wines, and champagne must be absolutely prohibited.

Constipation.-- A daily free evacuation of the bowels is essential to good health. Where constipation exists, and the woman is full-blooded, with a tendency to a rush of blood to the head, saline laxatives are indicated. But if the woman is constipated and anemic, cascara sagrada is a better laxative; while cod-liver oil acts as a laxative and at the same time improves the quality of the blood.

Stimulants.-- Women resort to alcoholic stimulants as an analgesic to relieve pain, whether physical or mental; as a narcotic to produce sleep; and as a spur to a failing appetite or bodily powers.

The majority of women patients say that they first used alcohol in the shape of whisky, brandy or gin to relieve pain at the time of the menstrual period. The pain that is caused at this time by a chilling of the body would be as effectually relieved by drinking a cup of hot tea; while if the pain is intense and constant, recurring every month, it is doubtless caused by some local inflammation, and the use of alcohol only veils the real trouble, and the woman loses valuable time by not consulting a physician at once.

As to the use of alcohol to blunt the nervous sensibility due to mental suffering, it is the testimony of the entire medical profession that this is the greatest cause of inebriety or drunkenness among women of all classes of society.

Sleeplessness generally arises from some well-defined physical cause-- very frequently from inaction of the liver-- and the proper remedial agents should be used to remove the cause.

While at first the use of alcoholic beverages increases the appetite, as the amount taken is increased, distaste for food is created, the system languishes under an insufficient food-supply, and the original aim of increasing the appetite is defeated.

As to taking stimulants to do more work than one could otherwise accomplish, it is by means of stimulants that woman can accomplish her physiological ruin more quickly than is possible in any other way. And the early symptoms of chronic alcoholism show themselves in the form of neuralgia, insomnia, palpitation of the heart, and muscular tremors.

The Kidneys.-- On account of the prevalence of some form of Bright's disease after forty years of life, the kidneys should be carefully watched at this time. And in order to keep them in good condition they must be well flushed with water every day. Three pints of urine should be excreted daily, and three pints of water as such must be taken into the system daily. The urine should be examined by the physician every six months. In this way kidney disease is often discovered in its incipiency, which otherwise might run into a serious form of Bright's disease.

The Skin.-- It must be remembered that the skin is one of the excretory organs of the body, and the pores should be kept well open by the various forms of baths.

The Turkish bath or some modification of it will often be found to be particularly useful. Massage with alcohol after the bath lessens the tendency to take cold. For a woman who is anemic or run down, it is well to follow the Turkish with the Roman bath, which is an inunction with almond oil or cocoa-butter. A much more thorough massage is given with the Roman bath than with the "alcohol rub." It is often necessary to modify the Turkish bath by omitting the steam-room and shortening the time spent in the hot dry air. In ordinary cases the time spent in the hot dry-room should be only that necessary for producing a free perspiration. This time varies in different individuals from ten to twenty minutes. No woman should go to a Turkish bath without first consulting her physician, since if the woman has a weak heart, the bath may be the source of positive danger. Comparatively few women are strong enough to take the cold plunge.

Massage.-- Massage, well given by a skilful masseuse twice a week, will greatly tone up the nervous and circulatory systems. Women who are very stout and who have sluggish livers with obstinate constipation will find massage particularly beneficial.

Exercise.-- Daily exercise in the open air is absolutely essential to every woman's good health. The minimum amount of outdoor exercise compatible with health is an hour's walk, at the rate of three miles an hour. If the woman has never taken any exercise, she must begin with a very short walk and stop on the first sign of fatigue. Gradually increase the distance and the speed until the three miles is reached.

Profuse Menstruation.-- If the menstrual flow is unusually profuse or lasts beyond the regular time, the woman should stay quietly in bed until the flow ceases. All exercise increases the flow.

The flow now becomes less in quantity, and the periods more infrequent than formerly. Hemorrhage must always be regarded as a danger-signal the significance of which can scarcely be overestimated. To immediately consult a specialist on the appearance of any irregularities of the flow would, in the opinion of the most eminent gynecologists of the day, be the means of saving thousands of women's lives every year.

Mental Therapeutics.-- It is particularly necessary at this time of life that the mind should be pleasantly occupied. Her children have passed the age when they need her constant supervision, and the mother must take some relaxation from her home cares, in the form of social diversions, amusements, outdoor life, and change of scene. Any mental occupation that will take the woman out of herself is the best possible safeguard against a state of introspection which conjures up a host of evil fantasies, and which is the first step in the downward road to a fixed and permanent melancholia.

"Hang sorrow, care will kill a cat; And therefore let 's be merry."