in the morning. She
skipped her periods during her two pregnancies, then they were
irregular for a while, then they came back to Wednesday. Other women
have their menses on a certain day of the month, say the first or the
fifth, regardless of the number of days in the month (such cases are,
however, exceptional). And in some women the menses are irregular:
every three weeks, every five or six weeks, every six or seven weeks,
etc. Some women never know when they may expect their menses, so
irregular they are.

CHAPTER SEVEN

ABNORMALITIES OF MENSTRUATION

Disorders of Menstruation--Menorrhagia--Metrorrhagia--Amenorrhea--
Vicarious Menstruation--Dysmenorrhea of Organic and of Nervous
Origin.

In many girls and women menstruation is a perfectly normal,
physiological process. They suffer no discomfort whatever from it.
They suffer no pains, no headache, no irritability, they have no
admonition of its onset, until they feel the blood oozing or trickling
out. But, unfortunately, this is true only of a small percentage. The
majority of women have some unpleasant symptoms. Some have a headache
for a day or two, some complain of a dragging down sensation, some are
irritable, feel depressed or quarrelsome; some have no appetite, no
ambition, no desire for work or company, while some girls have such
severe pains and cramps that they are obliged to go to bed for a day
or two and call in medical aid.

When the menstruation is very profuse, resembling more a hemorrhage
than normal menstruation, it is called _menorrhagia_; if the
hemorrhage from the uterus occurs out of the regular menstrual
periods, it is called _metrorrhagia_. When the menses are skipped, or
when they are so scanty that you can hardly notice any blood, we use
the term _amenorrhea_. In a few rare cases the menstruation instead of
coming normally from the uterus, comes from some other part of the
body, for instance, the nose. Some women have a hemorrhage from the
nose every month. In some a bloody discharge may come from the
breasts. To such a substitute menstruation we apply the term
_vicarious menstruation_. Such cases, however, are rare, and are mere
curiosities.

=Dysmenorrhea.= I mentioned before that in some girls and women the
menses are accompanied by pains and cramps. This affliction, which is
the lot of millions of women, and from which men are entirely free, is
called _dysmenorrhea_. Dysmenorrhea means painful and difficult
menstruati