A Paper on NERVOUS AND MENTAL MANIFESTATIONS OF THE CLIMACTERIC
G. Riddoch · BMJ · 1930
THE climacteric or involutional period is that phase of life during which the reproductive funcetionis diminish and become finally extinct.The most obvious manifestationis of it in women are the disappearance of menstruation and power of connceptioii; but associated with it, anid, in formlling ani essential part of it, are a series of bodily and Iiieimtal chaiiges, the appearance of which frequently pie- ce(les the onset of menstrual irregularity, and which often continue for a time after menstruation has stopped.Those of thiem which will form the basis of this discussion are more or less transient, butt others are permanent, and are the hall-marks of middle age.Such are wrinkles, grey hair, and a calmer, if more conservative and less romanitic, outlook on life.The majority of womeni pass through the climacteric with its psycho-physiological adj ustments without great dis- comiforts, and in somie, who are specially favoured perhaps with a balaiiced natural equipment and a happy env-iron- nment, it hardly causes a ripple in theirliv-es.O(thers, how- ever, (are less fortunate, and to the ilervous and ineital disorders which beset them special attentioii will be given.Men, as we11 as women, are compelled by iiature to experience this period of involution, but in them it begins about ten years later, and on the whlole the reactions are less initense.It is an easier transition, unaccompanied by fluslhes a.n(l otlher' discomforts of vasomotor origin, and althlough thlei waist line increases, ajid they lose their youtlhful vigour, nlii(dle age is apt to bSe accepted mnore philosophically, perhaps because their interests are more diffuse and absorbing, and the loss of the power of repro- dutction means less to them thani to womeni.But, general, the mental and physical changes at the climatteric are of the same order innen as in women, although, because of time later age at wh-lich it occurs, and the greater liability to arterial degemleration, complicatinig psychoses more often merge into the pre-senile degenerative mental -states.I propose, therefore, to confine my contribution to the dis- cuission to thenervous and mental phenomena in women at the natural climacteric, and to do niomore than indicate, when occasion arises, features that distinguish the artificial menop.usefromii o-ariectomiiy in younIg womnieii.PHYSIOLOGY OF THE CLIMACTERIC.