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DISCUSSION 



Milne : Dr. Swyer rightly stressed the difficulties of showing the cyc- 

 lical changes in electrolytes in the menstrual cycle. But there is one 

 change which has been found by all those who investigated it, and that is 

 the cyclical changes in organic acid excretion in urine. There is both high 

 citrate and high a-ketoglutarate excretion at the time of o\ailation and an 

 abrupt fall immediately premenstrual. That is very constant indeed. 

 The easiest way to produce changes in these organic acids experimentally 

 is by variation in the systemic acid-base balance. Body alkalosis, not the 

 pH of the urine, tends to cause a rise in excretion and acidosis a fall. It 

 struck me that the previous investigations of acid-base balance in the 

 menstrual cycle had been rather contradictory. Some workers claim 

 there is a cyclical change in serum bicarbonate and others suggest a 

 change in pCOg, but this has been contradicted in other papers. Dr. 

 Swyer, have you any data in your metabolic studies which relate to 

 acid-base balance in normal menstrual periods? 



Swyer: No, but I am very interested to hear of these changes. 



Scribner: Dr. Swyer, were your studies made with constant intake? 



Swyer: No, we did not attempt that because our subjects were ordi- 

 nary ambulant persons and it was rather difficult to restrict them much. 

 It was hoped that if the changes were going to be sufficiently distinctive. 



