INFLUENCE OF OVARY ON GENERATIVE TRACT 621 



breasts at the menopause, as in the case reported by Landau, ind also a 

 series recorded by Alterthum. 



Diagnosis. As a rule, the diagnosis of the menopause is simple 

 enough, but occasionally the problem is rather difficult. It becomes neces- 

 sary at times to determine whether amenorrhea occurring at the meno- 

 pausal age is actually menopausal in character, or whether it is due to 

 pregnancy. Not infrequently women who are anxious for childbirth are 



Fig. 2. .Senile endometrium from a patient aged 49 years. 



deceived by menopausal amenorrhea and menopausal increase in the size 

 of the abdomen into the conviction that pregnancy exists (pseudocyesis). 

 It is often difficult to disillusion such patients, even when pelvic examina- 

 tion shows that the above symptoms are associated with no increase in the 

 size of the uterus and, perhaps, an actual atrophy. 



Treatment. In many women the discomfort caused by the meno- 

 pausal manifestations is so great that treatment is indicated. It need 

 scarcely be said that the higher the standard of general health the less 

 troublesome the symptoms are apt to be. For this reason it is important 

 to urge such general measures as the avoidance of worry and anxiety, the 

 securing of an abundance of sleep, the avoidance of constipation, etc. 

 Drugs are frequently resorted to for the relief of such symptoms as ner- 



