Edwin C. Jungck

Sequential estrogen-progestogen therapy in gynecology.

Abstract 1. 1. Sequential estrogen-progestogen administration, i.e., a 16 day course of ethinyl estradiol followed by a 5 day course of ethinyl estradiol plus dimethisterone, was found to be an effective method of inhibiting ovulation. 2. 2. This form of hormonal sequence was found to be helpful in the treatment of dysmenorrhea, particularly in membranous dysmenorrhea. Simultaneous administration of estrogen-progestogen therapy throughout the cycle aggravated the tendency to decidual cast formation. 3. 3. Sequential therapy was valuable in regulating the cycles in women with various menstrual problems and in amenorrheic females. 4. 4. At times, sequential therapy may be a valuable adjunct in the management of acne, mild hirsutism, mittelschmerz, and premenstrual tension. 5. 5. The pregnancy rate was 0.3 per 100 woman years exposure, and the untoward effects of nausea, breakthrough bleeding, weight gain, etc., were minimal. 6. 6. Thromboembolic phenomena were not in evidence in any of the patients in this series. 7. 7. Randomized laboratory studies were within normal range, attesting to the safety of a sequential regimen.

A new progestogen: the 18-homologue of norethisterone.

A new agent with progestational, anabolic, and antiestrogenic properties in man is the 18‐homologue of norethisterone. On clinical examination it proved to be more potent than norethisterone (17‐ethinyl‐19‐nortestosterone). The progestational potency was considered to be quite high since as little as 1.25 mg. given with 100 μg of ethinyl estradiol delayed the onset of menses in 100 per cent of the trials. Like norethisterone, anabolic and mildly androgenic characteristics were in proportion to doses. The drug was markedly antiestrogenic and readily neutralized the effect of endogenous estrogens on the vaginal mucosa of children with precocious puberty and of menopausal women with evidence of persistent estrogenic activity. Because of its multifaceted properties, the 18‐homologue of norethisterone may be useful in the management of endometriosis and also gynecomastia in adolescent males.

THE PREMENSTRUAL TENSION SYNDROME: A COMPREHENSIVE APPROACH TO TREATMENT WITH A PROGESTIN-DIURETIC-TRANQUILIZER COMBINATION

The premenstrual tension syndrome has been under attack for a couple or more decades. The authors believe they have had a high degree of success by attacking the hormonal, water-sodium imbalance, and derangement of the autonomic nervous system by combined therapy.