Brooke M. Anspach

The foundation of an endocrine clinic for the study and treatment of amenorrhea, uterine bleeding, and sterility

I T IS becoming more and more apparent that enclocrine dysfunct,ion is a frequent cause of menstrual disorders and sterility. We constantly meet with patients who complain of menstrual dist,urbances, in whom there is no gross lesion in the pelvis. The same statement may be made relative to the female partner in the barren marriage. ln a further general study of these two groups one often concludes that none of the usual constitutional diseases are present and then asks whether imbalance of the endocrine glands may be at the bottom of the trouble. Sometimes our attention is turned in this direction by the very obvious stigmas of the endocrinopathies in the individual, and sometimes our att,ention is turned to the endocrine glands because, so far as we know, we have excluded all other causes. The patientas who complain of these symptoms form a considerable part of the gynecologist’s clientele. The need of methods of precision in diagnosis is obvious and a successful plan of treatment is much to be desired. The problems presented are perplesing for what appears to be true one da.y may be shown to be a fallacy t,he next. Perhaps the time has arrived when the theories that have been built up may be applied. For that reason we have organized at the Jefferson Medical College Hospital a special clinic to which all endocrine cases are referred. This paper is for the purpose of reviewing the information that is now at hand relative to the influence of the endocrine glands upon t,he genital function and of appraising the available means of treatment,. We are especially interested in two groups, first, the deficiences of the menstrual flow, complete or partial and the lowering of the fertility index with which it is often associated, and second, the abnormal hleedings appearing as menorrhagia or metorrhagia in which an exhaustive search for organic lesions in the pelvis has been fruitless. L411 outstanding fact which should be mentioned at, this point is that

The end results of the simpson operation in sixty-one patients delivered at term

Retroflexioversion acquires a new significance, however, in the childbearing woman, and in the majority of them, at some time requires attention. It may interfere with conception; it is one of the most frequent causes of abortion in the early months of pregnancy; it may be responsible for backache, lower abdominal pain, and almost any pelvic symptom in the woman who has gone through pregnancy and labor.