CHANGE of life, also called menopause or climacteric period, is the most critical turning point in the women’s life; it means the period when menstruation and the ability for bearing children stops. In some cases, but by no means in all, it may be accompanied by a special liability to bodily and mental disorders. In robust women these disorders generally are only temporary.
The troubles are due to the cessation of the ovarian function, resulting in disorders of the hormonal balance. As a rule the intensity of the disorders corresponds to the suddenness and the time of its onset. Women after 45 years of age, whose menstruation cases quite gradually, suffer much less than women, whose menstruation has suddenly stopped owing to a psychic shock, or to surgical removal of the ovaries or sterilization by X-rays. The reason is, that in these circumstances the patient’s system does not have time to adapt itself to the new and altered circumstances. (According to Dr. Haehl)
As a rule the climacteric period is delayed in women suffering from tumours, especially in the case of fibromyoma of the womb. In another category of patients the climacteric period is delayed owing to congestion and hyperaemia of the liver and the portal venous system. Climacteric disorders in themselves are independent of local diseases of the genital organs.
With the cessation of the menstruation the breasts and sexual organs diminish in size, the changes in the pelvic organs being, in general, the reverse of those which occur in puberty, and in addition there is a profound alternation in the whole constitutional which may show wide variations.
In the first place they concern the circulatory system, heart and blood vessels. Flushing often described as a rush of blood, is one of the most common symptoms : the face is most frequently affected by it, but any other part of the body, for instance, the stomach may also be affected; these flushes are due to sudden alterations in the blood supply to different parts of the body, resulting in unpleasant sensations of heat or coldness. When the face and neck are involved, the condition is closely allied to blushing. In nearly 75 per cent. of all climacteric women there are some disorders of the heart, the slightest exertion may induce palpitation of the heart at any time of the day or night, coupled with breathlessness and distress. As a rule such attacks are short, passing off gradually and followed by cold perspiration. Giddiness, dizziness, due to irregularity of blood circulation in the brain are other common symptoms. Such attacks usually begin abruptly, lasting for a few seconds or a few minutes; they are often accompanied with ringing in the ears and dimness of vision; in the majority of cases all these symptoms are coupled with high blood pressure, resembling the symptom- picture of arteriosclerosis or chronic Bright’s disease. As a rule the blood pressure, at least during the first period of the climacteric, is very variable, there may be differences up to 80 mm. Hg. during the different hours of a day.
Most of the climacteric women show an increased corpulence, especially in the face, on the breasts, the thighs and the abdomen, but on the other hand in some cases we see emaciation. In a great number of cases obesity may be the result of faulty habits rather than of inevitable organic changes. In the minority of cases however, corpulence is accompanied with a slow pulse, dryness of the skin, losing of hair and mental heaviness proving that the climacteric influence has led to degenerative changes in the thyroid gland and perhaps in other glands as well.
Nervous and psychic disorders are the most common complaints; very few women are free from some of these troubles. “Slight fugitive aches may be felt in any part of the body and all painful sensations are appreciated acutely owing to general nervous tension, but the most common affection is usually neuralgic character.” Especially I mention the hemicrania or one- sided headache, the left side being more frequently affected than the right. As a rule these pains are boring or throbbing and are usually connected with hot flushing of the skin. In other cases there are neuralgias of the breast, characterized by sharp intermittent stabbing pains or neuralgias of the stomach, felt about the centre of the abdomen, especially during a meal; it is often accompanied with nausea and vomiting followed by relief. Other women, again suffer from backache, affecting the lumbar region, whilst some patient experience neuralgias in the bladder and ovaries usually due to over-exertion.
Mental disorders of all kinds are met with during the climacteric period. A tendency to irritability or shortness of temper, a sense of fatigue, unjustified feelings of fear or anxiety are very common. “The general emotional tone of these women tends towards depression.” More serious mental states are observed in those who have been suffering from mental instability throughout their whole life, such as the chronic nervous disorders, epilepsy, migraine, or nervous asthma.
Disorders of the digestive organs is another climacteric symptom. Indigestion of any type may occur, but it usually takes the form of flatulent dyspepsia. Constipation is common.
Finally I must refer to the haemorrhages of the womb. In some cases the loss of blood is excessive and persistent. Here a thorough medical examination is of vital importance, because the bleeding may be due to fibroma or polypi, or to a serious inflammatory condition of the womb, or a new growth.
The rational treatment of climacteric patients should be based on general hygienic rules, all disadvantageous influences, and wrong ways of living must be discarded. All stimulants, such as spirits, tea, coffee, tobacco and condiments should be restricted up to a certain limit. All emotions, psychical irritation, mental and physical over-exertion must be temporarily avoided; a nap after lunch and sufficient sleep for at least 7-9 hours is absolutely necessary, daily short walks and sufficient fresh air should never be missed.
In consideration of the frequent attacks of profuse perspiration during the climacteric period the patient should were suitable underwear. Every unnecessary irritation of the genital organs must be avoided. Sexual intercourse, therefore, ought to be restricted.
As a rule a lacto-vegetarian diet is the most suitable one for these women, it acts on the bowels, preventing constipation. Generally speaking regularity and moderation should be the two vital rules for all climacteric women.
Homoeopathic treatment at this period has always been proved to be a great success, provided the remedy is selected in accordance with the whole symptom-picture as well as the patient’s constitution and the pathological conditions of the diseased organs. That is the only way to achieve good results, even in the most desperate cases.
As a rule homoeopathic treatment will be constitutional. An experienced homoeopathic can easily differentiate between special climacteric types of women as for instance the Sepia-the Pulsatilla-the Cimicifuga-and the Sanguinaria patients. I am now going to give a review of these important drugs as seen in the attached Materia Medica.
The Sepia woman may be compared with an overworked, asthenic, vexatious and nearly maniacal laundress. The key symptom is the sinking down of the abdominal organs, due to the general looseness of all tissues. In these women everything is slackened; the features, the ribs, the blood vessels, henceforth these patients suffer from varicosities, haemorrhoids, congestion of the genital organs, resulting in discharge and profuse haemorrhages; furthermore there is disposition to oedema of the legs, due to slackening of the humidity of the tissue and flat foot with reaction upon the whole skeleton. These women incline to prolapse, they suffer from pressure in the abdomen downwards, trying to get relief by crossing their legs. They have dark shadowed rings under the eyes and yellowish pigmentation of the face around the nose and on the forehead. they feel badly in the morning better after walking in fresh air, especially at midday.
The Pulsatilla women are characterized by blue eyes and light complexion, generally speaking these women, during the climacteric period, are plethoric and stout, whining without always was too late and scanty, instead of menstruation there was sometimes bleeding from the nose (vicarious menstruation). Fat, of any kind of form, especially dishes fried or roasted in fat, disagrees with these patients. These women like cold, fresh open air, and are unable to stay in stuffy rooms.
The Cimicifuga patients are characterized by the unbalanced physical and psychical condition, resulting in the most serious troubles, due to disorders of the inner secretory glands. They all suffer from nervous symptoms, such as sleeplessness, great changes in the frame of mind, mental excitement and hystero- maniacal conditions, due to the suppressed ovarian function which should have resulted in the proper climacteric psychosis.
The Sanguinaria climacteric woman is especially disposed to hot flushes, due to congestion of the blood-vessels.
All these women are pycnic patients, who generally speaking, pass through the climacteric period without serious troubles, they are inclined to corpulence, hot fits and increased perspiration. In some cases Belladonna or Sulphuric acid is the suitable drug, the latter drug is especially suitable for women, suffering from sweats, followed by extreme exhaustion, whereas Belladonna is the suitable remedy for women feeling the sweats as as most agreeable relief.
Other cases, suffering from hot flushes are covered by the drug picture of Sulphur, here the face is extremely reddened, the patient complain of a sensation of intensive heat in the region of the crown; in other cases, again, where the flushes are coupled with salivation and the most profuse sweat, Jaborandum is the remedy.
No doubt the reader will find it much easier to select the most effective remedy by studying the following short review of drug according to the different symptoms of the patient. (Dr. Haehl, Wechseljahre der Frau.) For the special key symptoms see the attached Materia Medica.
(1) Headache and vertigo : Belladonna, China, Cimicifuga, Gelsemium, Glonoin, Sanguinaria, Xanthoxylum.
(2) Flushes and congestions : Aconite, Jaborandum, Lachesis, Sanguinaria, Sepia, Sulphur, Veratrum viride.
(3) Increased perspiration : China, Hepar sulphuris, Jaborandum, Sulphuric acid, Veratrum album.
(4) Palpitation of the heart : Aconite, Cactus, China, Crataegus, Kalium carbonicum, Lachesis, Lycopus virginicus, Veratrum album Ignatia.
(5) Haemorrhages : China, Crocus, Erigeron, Hamamelis, Hydrastis, Ipecacuanha, Lachesis, Plumbum, Sabina, Sanguinaria, Sanguisorba, Trillium, Ustilago.
(6) Disorders of the digestive organs : Anacardium ori., Nitrate of Silver, Carbo vegetabilis, Carduus marianus, China, Cocculus, Graphites, Ignatia, Lycopodium, Natrum phosphoricum, Nux vomica, Pulsatilla, Sepia, Sulphur.
(7) Nervous disorders and exhaustion : China, Gelsemium, Ignatia, Moschus, Valeriana.
(8) Sleeplessness : Aconite, Avena sativa, Chamomilla, Cimicifuga, Coffea, Gelsemium, Lachesis.
(9) Itching around the genital organs (Pruritus Vulvae) : Ambra grisea, Caladium, Carbo vegetabilis, Collinsonia, Conium, Dictamnus, Sulphur.
(10) Senile genital discharge : Arsenicum album, Baryta carbonica, Helonias.