H. J. O'CONNELL, C.SS.R. FACTS ABOUT THE CHANGE OF LIFE Hugh J. O'Connell, C.SS.R. Copyright 1960 LIGUORIAN PAMPHLETS Redemptorist Fathers Liguori, Missouri Imprimi Potest : John N. McCormick, C.SS.R. Provincial, St. Louis Province, Redemptorist Fathers January 20, 1961 Imprimatur: St. Louis, January 26, 1961 ^ Joseph Card. Ritter Archbishop of St. Louis Here is a clear presentation of the dif- ficulties a person may meet with in middle age and of the common sense attitudes and procedures which should be adopted. Every adult should know at least this much about the change of life. FACTS ABOUT THE CHANGE OF LIFE Hugh J. O'Connell, C.SS.R. For many persons the period called "the change of life" or more technically, "the menopause" or "the climacteric" is a time of anxiety and stress. This is clear from many letters received by the Li- GUORiAN Pamphlets. Some of these directly seek instruction and advice on this problem; others, though concerned with other matters, exhibit symptoms which a skillful observer will recognize as pertaining to the change of life. It is important that everyone, espe- cially those who are approaching middle age, should have clear and accurate ideas 5 on this subject. Ignorance, resulting from lack of instruction and old wives' fables, can only serve to engender excessive fear and to complicate the effects of this period through which all must pass. Actually such fears — which are all too common — of mental breakdown, insan- ity, invalidism and the like, are for the most part without foundation. The proper attitude toward the men- opause may be summed up in these words: 1) know what it is all about; 2) have no exaggerated fear of it before it comes; and 3) pay as little attention as possible to it while it is going on. Basically, the change of life is nothing else but the gradual slowing down and final cessation of the functioning of the body's marvelously complicated and deli- 6 cately balanced reproductive system. This means the ending of the cycle of fertility. In women this usually occurs between the ages of 40 and 55 — the average age is 47; in men generally be- tween the ages of 50 and 65. PHYSICAL CHANGES At this time, there occurs a change in certain glandular activities that pro- foundly affect the body, and through the body exert an influence upon the mind. In the human body there is found a system of endocrine or ductless glands, which pour minute but very powerful chemical secretions directly into the bloodstream. These chemical secretions, or "hormones," regulate many functions 7 of the body, such as growth, bone forma- tion, metabolism, muscular tension and sex development. As part of the endocrine system in women are found the ovaries, chief of the female sex glands These supply the "ovum," the source of new life, which ripens in a monthly cycle. They also produce hormones which determine the feminine characteristics, control men- struation, and play an important part in the working of the nervous system. Sim- ilarly, the male organs not only produce the spermatozoa, but also hormones which profoundly affect the body. At the menopause the ovaries grad- ually cease to function. Consequently, conception becomes less likely, finally impossible; menstruation becomes spo- radic, then ceases altogether; and because 8 J of the interworking of the endocrine glands the chemical balance of the body is temporarily upset. Little by little, the body adjusts itself to the change; but in the meantime there will often be noticed some of the physical and psychological symptoms that are customarily associated with the menopause. These symptoms vary in degree and duration according to the individual. In some they are quite pronounced; and in others they scarcely appear at all. Au- thorities estimate that 15% of women exhibit no symptoms at all at the men- opause; about 10% have symptoms which do not cause distress; about 75% experience some distress, though this varies greatly in degree. The symptoms may last anywhere from a few weeks to 20 or 25 years in extreme cases; as a rule they disappear within three years. 9 An artificial menopause, produced in younger women by removal or X-ray of the female organs, can produce the same symptoms as the natural change of life. Indeed, in such cases the symptoms are often more violent and require more extensive treatment. The climacteric also occurs in men, though usually at a later period in life. Its cause is the same: the atrophy of the sexual glands. The onset is more gradual, and the symptoms usually less notice- able. Treatment follows the same lines as in women, excluding, of course, what- ever is properly feminine. EFFECTS OF CHANGE OF LIFE The effects of the change of life manifest themselves in three fields: 1) physical; 2) emotional; 3) moral. 10 In the physical order the person may notice the "hot flashes," which are per- haps the most commonly recognized sign of the menopause, profuse perspiration, lack of energy, sleeplessness, headaches, nervousness, restlessness and loss of appetite. In the emotional life there may be a more pronounced tendency to depres- sion, irritability, peevishness, anxiety, resentment, jealousy, self-pity, criticism, excitabiUty, fits of weeping, inability to concentrate and regrets for real or im- aginary mistakes of the past. These emotional symptoms, unless re- sisted, may carry over into moral order, and give rise to faults of selfishness, harshness and unkindness to others. At the onset of the climacteric, there often 11 occurs a strong increase in sexual temp- tations, though these usually subside as the condition advances. In most men and women these symp- toms remain well within the range of the normal. However some individuals — comparatively few in number — in connection with the change of life develop a psychosis, called technically "involutional melancholia.'" This results from some inherent defect, their pecu- liar life experience, or from some other unknown cause. This psychosis, which is akin to the manic-depressive, is characterized by an extreme exaggera- tion of the more or less ordinary symp- toms of the climacteric. Such persons are abnormally anxious and depressed, un- reasonably worried about the past, and apprehensive of the future. They are 12 frightened, restless, moan about having committed the "unforgivable sin," about having brought ruin on their famiUes. Sometimes they develop delusions, refuse to eat or sleep, and may even in their despair try to take their own life. Fortunately, this psychosis, as was mentioned, develops rarely, in only about three people in a thousand. Even in these, it usually clears up in two or three years, and treatment can make this pe- riod still shorter. Just how far the physical factor of glandular disturbance is responsible for the psychological symptoms at the change of life is a matter of dispute. Some experts consider the upsetting of the balance of the endocrine system as a chief cause for the mental and emo- tional trouble. As proof of their position, 13 they point out the fact that proper treat- ment by the substitution of the missing chemical substances, or hormones, can in most cases effect the disappearance of the symptoms, or at least greatly relieve them. On the other hand, other experts declare that various mental and emo- tional factors which influence the in- dividual during the change of life are even more important than the organic in causing psychological upsets and dis- turbance. Undoubtedly, the climacteric is a dif- ficult period of human life. The body is gradually losing the health and vigor of youth; various diseases of middle age appear. Other problems, such as finan- cial worry, the death of relatives and friends, the break-up of one's home, unfortunate living arrangements, and de- pendence on the charity of relatives, often add to the burdens of life. Then 14 too, there is the reaUzation that life is passing swiftly, that one is growing old, and that new adventures and the attain- ment of ambitions are becoming more unlikely. All these influences throw an added burden on the personality. When the factor of glandular disturbance, with its physical and psychological repercussions, is added, it is not surprising that some mental and emotional stress is felt, at this time of hfe. It is, in fact, a tribute to the mental soundness of most men and women that the vast majority pass through the cUmacteric with compara- tively little trouble. ATTITUDES AND PROCEDURES In order to keep the emotional re- actions from getting out of hand, to lessen the likelihood of nervous or men- 15 tal breakdowns, and to diminish the severity even of the normal symptoms of the change of Ufe, certain common sense attitudes and procedures should be adopted. First of all, one must accept with serenity and peace the fact that old age with its bodily decline is coming on. Quite a few men and women set up conscious or subconscious resistance to this thought. They refuse to face it and become panicky if it is forced upon their attention. However, there is neither peace nor profit in refusing to accept the truth. Youth is passing; old age is com- ing on; we can no more halt the march of the years of time than we can stem the tides of the sea. The only sensible thing is to accept this inevitable fact and make the best use of the years that are given to us, being grateful for the past, and trusting in God for the future. 16 There should be no exaggerated fear of the difficulties of the change of life, such as is sometimes produced in the minds of the uninstructed by supersti- tious fables and the whispered tales of old women. Fear itself can add to the severity of the climacteric. Actually, as has been mentioned, most men and women go through the change of life without too much trouble. A person who has been able to ride the bumps of life without mental breakdown up to the period of the climacteric will pretty surely get over this bump too without undue difficulty. The way to go through the change of life with the least possible trouble is not to fear it before it comes, and to pay as little attention as possible to it while it is going on. Those who have need of them should make use of the resources of modern medical science. Everyone, and particu- 17 ■J larly persons of middle age, should un- dergo periodically a careful physical examination by a competent physician, not only for treatments of disorders proper to the change of life, but also to discover and arrest other diseases that may possibly be present, such as heart disease or cancer. When necessary, the doctor will take steps to relieve the distressing symptoms of the climacteric, chiefly by re-establish- ing the endocrine balance of the body. This is called "hormonal therapy," and consists in supplying the chemical sub- stances which are missing because of the atrophy of the sexual glands. These hor- mones, administered in carefully meas- ured doses, help the body to adjust gradually to the change of life. This method has proved very effective, so that fairly complete reUef can be afforded in the great majority of cases. 18 Not all persons need such treatment during the change of life. Only about 30% of women need medical treatment at all during the menopause, and of these only about 10% need hormonal therapy. The percentage of men is even lower. However, it is a relief to know that such treatment is available if needed. Developing a sane and reasonable out- look on the various problems of life that arise during the climacteric is even more important than physical care. Many will notice in themselves tendencies to sensi- tiveness, irritability, sadness and fear. They must learn to discount and dis- regard as far as possible these emotional states, realizing that they are the product to a great extent of their subjective state of health, rather than of objective condi- tions. They should remind themselves from time to time: "I am going through the change of life; therefore I must be 19 on my guard against my emotions, and live my life according to common sense." Relatives, friends, employers, and su- periors can often give important help to those experiencing the difficulties of the change of life. They can: 1) see that they receive adequate physical care; 2) remove social and environmental con- ditions which interfere with mental peace and happiness; and 3) show patience and understanding with their faults, which are often the result of emotional conditions rather than ill-will. Sons and daughters especially, re- membering the many years of unselfish service on the part of their parents, should in the spirit of love and sacrifice do what they can to provide father and mother with a secure and tranquil home in their declining years. 20 ■J SPECIAL NOTE FOR THE MARRIED Special problems may arise at this time for married people with regard to their sexual relations. Their solution will require unselfishness on the part of the husband and wife, fidelity to duty, and deep religious convictions. The husband should be aware that after the menopause women very often lose the desire for physical union, and may even develop an aversion to it. This will demand understanding and consid- erateness on his side. On the other hand, the wife must take into account the fact that the sexual impulses of men usually go on much longer than those of women, that she is still under the obligation of the marriage contract, and that she may be putting her husband in serious temp- 21 tation by refusing her wifely duty. In this matter, as in all other aspects of mar- ried life, unselfish love is the key to happiness. Some married women, as they ap- proach the menopause, have an unrea- soning horror of pregnancy. This results from the fear of childbirth at their age, anxiety about being able to care for the child until it is grown, and probably most of all from worry about what friends and neighbors will say. Actually, such fears are to a great extent without foundation. As the menopause advances, conception becomes less likely, finally impossible. The only proper attitude is to place one's trust in the providence of God, to accept life as He sends it, and to be faithful to God's will, confident that He never sends a responsibility without at the same time giving the 22 means to fulfill it. One who is a Chris- tian, must live according to Christian principles, and not be turned from doing God's will by fear of earthly loss, or undue solicitude for the future, which is in the hands of God. PEACE OF SOUL In the consoling truths of religion will be found, during the climacteric, as at every stage of human life, the founda- tion and bulwark of peace of soul. The mistakes and sins of the past, after sin- cere repentance and confession, should be left to the mercy of God. The dif- ficulties and trials of the present should be borne with generosity and patience, following the example of Christ Who walked before us on the way of the cross. The future, when one has done what he can to provide for it, should be 23 left without undue care and anxiety to the providence of God, knowing that He loves us and has arranged all things for our welfare. In this way, the advanc- ing years will bring, not anxiety and fear, but serenity, peace, and the bright hope of youth renewed in God's eternal kingdom. Send for a free copy of the complete list of popular LIGUORIAN PAMPHLETS Over 400 Titles ^ m WRITE TO LIGUORIAN PAMPHLETS LIGUORI, MO., U.S.A. Published by LIGUORIAN PAMPHLETS KEDEMPTORIST FATHERS Liguoriy Missouri Printed In U.S. A.