onthly
periods until she is older than usual,--about the eighteenth or
twentieth year,--the "change of life" will set in at a very early age.
Women who are victims of certain exhausting diseases, as, consumption,
Bright's disease of the kidney, diabetes, or whose health is poor
because of general physical debility from any cause, or who have had a
large number of children in rapid succession, enter the "change of life"
earlier than they otherwise would if their health was good. In women who
are excessively fat the menopause is apt to occur at an early age. On
the other hand disease of the generative organs, or the presence of
tumors of the womb may retard the process. Women in the higher walk of
life, those living in cities those who do not labor or exercise
sufficiently will enter this period at an earlier date than those who
live in the country, who work and are physically more healthy.

SYMPTOMS OF "CHANGE OF LIFE."--When the menopause begins, the monthly
periods are less profuse, the flow is scanty. As the months pass,
menstruation becomes less and less until it ceases entirely. In a
certain number of cases it stops abruptly and never appears again.
Sometimes a period misses altogether, or a number of periods are passed
over without any sign of menstruation, after which it may reappear
either as a scanty flow, or as a profuse discharge. This may be followed
for a number of months by irregular appearances of the menstrual
phenomenon and then by its total cessation.

These may be the only symptoms or signs of the "change of life," and
this is the normal state if the health is good. It cannot, however, be
said that this is the average experience. Unfortunately the women of the
present time do not live lives which conduce to robust health at this
period of life. We find as a rule that the general health is below par.
So they suffer from headache, "flushes," digestive disturbances, and
many nervous symptoms which appear to be directly caused by the process
through which they are passing. The "flushes" are disagreeable
experiences. They consist of a feeling of heat which spreads over the
entire body as if the blood was rushing to the surface and to the head.
These flushes are followed by sweating and chilly sensations. The
nervous symptoms may be quite marked. The woman loses her interest in
the daily happenings. She may have mental vagaries, she is irritable and
often melancholy and periods of seeming insanity may occur