THE HORMONES IN HUMAN REPRODUCTION 



tried, from psychological analysis to operations designed to 

 correct faulty positions of the uterus. The fact that each of 

 these widely different measures sometimes succeeds and some- 

 times fails, suggests strongly that dysmenorrhea is not a 

 single disease, but rather a symptom due to different causes in 

 different cases. The whole situation creates a problem for 

 investigation by the combined forces of clinical gynecology 

 and the laboratory investigators. Unfortunately, we can ex- 

 pect to get very little help, in such a problem as this, from 

 study of animals. Even the female Rhesus monkey, so useful 

 for study of the physical aspects of menstruation, cannot 

 help us in this investigation, for even if she suffered from 

 dysmenorrhea or could be made to experience uterine cramps 

 for the purpose of our studies, she cannot report her symp- 

 toms or help us evaluate the results of treatment. 



When it was discovered that progesterone can quiet the 

 normal contractions of an animal's uterus and even the violent 

 spasms that cause post partum pain in human patients, many 

 physicians thought of trying it in dysmenorrhea, thinking 

 that it might relieve a crampy state of the uterus. As usual 

 whenever a new treatment, no matter what, is tried in one of 

 the old reliable guaranteed-to-baffle diseases, some of the 

 doctors and patients reported hopeful results. A little later 

 skeptical reports began to be published. Critical observers 

 reminded us anew that dysmenorrhea is such a peculiar thing 

 that we must be very cautious about accepting a new cure. 

 For example, there are undoubtedly some cases in which the 

 pain is largely subjective, arising from psychic causes. These 

 people will be helped by any treatment that happens to win 

 their confidence. Depending upon the patient's turn of mind, 

 a hypodermic injection of sterile water given with due assur- 

 ance, any new hormone in an impressive package, psycho- 

 logical or religious comfort — any of these may give genuine 

 relief. With equal certainty there are other cases produced 

 by some sort of actual physical or chemical disorder in the 



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