William H. Perloff

Effect of prednisone on abnormal menstrual function.

Abstract Prednisone reduces or eliminates excess hair growth in women with idiopathic hirsutism 1 or, a preferable term, adrenal virilism. 2 While studying this phenomenon, we noted concurrent improvement in the menstrual status of patients with amenorrhea, menometrorrhagia, anovulation, and infertility. Intrigued by this desirable development, we treated women with menstrual abnormalities, with and without hirsutism, by this means, and the purpose of this paper is to report our observations.

Treatment of the surgical menopause with estradiol pellets at the time of operation.

Abstract 1.1. The results of implanting estradiol pellets in the abdominal wound at the time of operation in 38 consecutive, unselected patients undergoing hysterectomy and bilateral salpingo-oophorectomy are described. 2.2. Comparison with a control group of 37 patients shows that this procedure is an effective method of delaying, ameliorating, and perhaps eliminating the surgical menopause. 3.3. The major contraindications are discussed.

THE ENDOCRINE TREATMENT OF CLIMACTERIC (STEROID-DEFICIENCY) OSTEOPOROSIS

The incidence of osteoporosis in the aged is unknown, but mounting evidence suggests that it is much more prevalent than has been realized. Not only is it often asymptomatic, but the diagnosis may be overlooked by the roentgenologist when density changes in the spine are slight. The recent report of GershonCohen et al. (1) describing asymptomatic and unrecognized vertebral fractures in the osteoporotic spines of the aged is interesting in this connection. Despite the classic observations of Albright and Reifenstein (2) that menopausal osteoporosis is primarily a disorder of the bony matrix and that the decalcification is secondary, and despite their demonstration of the beneficial effects of estrogen and androgen, most physicians are apparently unaware of the therapeutic improvements which result from the administration of these hormones. Recently Spencer et al. (3), employing a calcium tolerance test devised by Schilling and Laszlo (4), showed that patients with osteoporosis excreted a larger proportion of intravenously administered calcium than did normal individuals-once again proving the futility of treating this metabolic disorder with calcium. If osteoporosis be due to a steroid-hormone deficiency, why is it apparent in only certain postclimacteric patients, and why does it take so long to develop? What is the optimal therapeutic dose of estrogen and androgen, and why does clinical relief from pain occur so rapidly, whereas x-ray improvement takes many years? It was with the hope of answering these questions that the present study was undertaken.

Estradiol buccal tablets in the treatment of the menopause.

Abstract In this study of fifty menopausal women, the daily minimum effective dose of estradiol by the buccal route was essentially the same as that give intramuscularly as estradiol benzoate, or by pellet subcutaneously as compressed alpha-estradiol. One-sixth of this dose was required as ethinyl estradiol but five times as much was needed as alpha-estradiol when given orally. There were no untoward reactions reported to the buccal estradiol tablets by any of the fifty menopausal patients, and these tablets were generally preferred to other types of previously administered oral estrogens.

Clinical management of a male pseudohermaphrodite.

The authors describe a male pseudohermaphrodite who wanted to be more feminine in appearance and who was treated accordingly, both endocrinologically and surgically. The ramifications of such a regimen are discussed.

Treatment of the menopause. II

Abstract In a previous communication, 1 a large variety of estrogenic substances were compared regarding their effectiveness in relieving the symptoms of the menopause. It was manifestly impractical to study all the estrogens, so that only representative members of each of the large classes were employed. Since that time, two new oral estrogens have become commercially available, and the purpose of this study is to evaluate their clinical usefulness in similar fashion.