176 



THE SEX-COMPLEX 



Mammary 

 changes at 

 the meno- 

 pause. 



Gross changes are, apparently, less directly sensitive to the withdrawal 

 rrhcei? of ovarian secretion than the thyroid ; and this organ 

 organs. j j oo k U p On as being the most closely correlated with 

 and supplementary to the ovary. 



Changes in the Mammary Glands. Although the 

 mammary glands cannot be considered organs of internal 

 secretion, they are so closely related to the reproductive 

 system that changes in regard to ovarian activity 

 naturally affect them. 



The alteration which takes place in the mammae of 

 women at the natural menopause is similar to that 

 produced at the artificial (with a certain qualification 

 to be mentioned directly) namely, involution of the 

 glandular elements. With this atrophy of the secretory 

 structures the breasts become shrunken and in the 

 glandular area fibrous tissue develops. These changes 

 are, of course, most marked in women in whom lactation 

 has occurred, except in the circumstances to be described. 

 Indeed, in young and obese patients the breasts may 

 remain bulky, and no change occur that is visible to 

 the naked eye. However, on histological examination 

 of the mammary gland atrophy will be found. 



The qualification mentioned above in connexion with 

 this description is important. We have seen that in 

 cows the quality of the milk may be improved by 

 oophorectomy 1 . This, of course, does not resemble 

 what occurs in the human female unless she be pregnant 

 at the time oophorectomy is performed ; in these circum- 

 stances she may have a plentiful supply of milk after 

 parturition. Cases are on record which demonstrate 

 this fact. 



Another point of interest which may be observed 

 is the disappearance of adenomatous cysts in the breasts 

 after oophorectomy. I have seen such a case, in 

 which bilateral ovarian cysts coexisted with bilateral 

 cystic adenomata of the mammae in a woman who was 

 forty-eight years of age. After both ovaries and the 

 uterus, to which one ovary was adherent, had been 

 1 Hobday, F. T. G., Castration and Ovariotomy, 2nd ed., 1914. 



Disappear- 

 ance of 

 mammary 

 adenomata 

 after oophor- 

 ectomy. 



