Therapy of the Patient in the Menopause: Endocrine Methods

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Abstract
Diagnostic study should precede any therapy, to make sure that the change in menstrual rhythm is truly indicative of the menopause, and that no neoplastic contraindications exist. The objective of treatment is the relief of symptoms, not reestablishment of flowing, nor the reduction in excretion of gonadotrophic hormone or the alteration in vaginal cytology. Materials available include the several natural steroids, estradiol, estrone, and estriol, in several combinations and vehicles, and a few synthetic compounds, of which diethylstilbestrol is best known. The detailed advantages of these items are presented. The routes of adm. include injns., implantations, inunction, and oral therapy, the last being held preferable. Dosage must be varied to fit the need of the individual, starting high for quick benefit, and being reduced gradually. Contraindications in the form of overstimulation of breast and genital activity, or of neoplastic growth must be watched for. Progress of the patient under therapy is to be gauged by relief from symptoms, not by any changes in pituitary or estrogenic hormone levels detd. by bioassays. Along with such a program of treatment it is important that the patient be treated as a person, sometimes requiring simple psychotherapy.

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