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Whereas many women feel that menstruation is a castration threat, the author stresses the fact that sometimes girls, who had previously exhibited a very 'masculine' behavior, react to the first menstruation with great pleasure and experience it as a relief. Psychoanalysis of four cases of this kind revealed that the patients had behaved in a masculine way not out of any deep-seated penis envy, but rather because they had doubted their feminine qualifications, especially their ability to bear children, and therefore felt that menstruation was a reassurance. They were all suffering from an unconscious fear of retaliation for hostile tendencies against their mothers, who were believed to have damaged them internally. In the discussion of the development of these patients, Langer comes to the conclusion that there are in women two kinds of castration fear, the usual type, which is analogous to the boy's castration fear, and another one, the fear of having lost female genital abilities. Furthermore, the author refers to two other possible unconscious significances of menstruation. It can be used to deny and reject homosexual tendencies, and it may satisfy sadistic attitudes towards the mother: 'mother'='bleeding uterus'.