INFLUENCE OF OVARY ON GENERATIVE TRACT 623 



pausal vasomotor symptoms, The results, as I have already stated, have 

 been gratifying, if not brilliant. Others have reported results just as 

 satisfactory from the use of ovarian extracts. 



It is difficult to suggest the dosage of these preparations, owing to 

 the lack of standardization of the products put forth by the various manu- 

 facturing pharmacists. It would scarcely be in good taste to specify 

 them by name. Generally speaking, the corpus luteum extract is given in 

 doses representing about five grains of the dried extract, administered 

 three times a day, in either capsule or tablet form. Some advocate 

 much larger doses, but I have personally rarely seen good results from 

 the very large doses when moderate amounts of the extract have been of 

 no avail. The corpus luteum extract is prepared also in a soluble form 

 suitable for hypodermic administration. This has become quite popular 

 with many gynecologists. The solution is prepared in convenient am- 

 pule form, one ampule being injected at intervals of two or three days, 

 depending upon the severity of the symptoms. 



The ovarian extracts are likewise used in either tablet or ampule 

 form. The literature of the various manufacturing houses is easily 

 available, giving full details of the preparation and the dosage. Re- 

 cently Graves has reported encouraging results from the use of what he 

 calls ovarian residue, an extract prepared from the ovary after separation 

 of the corpora, lutea. Tyler has also reported favorably on the results 

 yielded by this preparation, although it is too early to decide whether 

 it will yield results any better than the preparations already spoken of. 



Occasionally other ductless gland extracts are of value in the therapy 

 of the menopause. In the obesity which sometimes develops at this 

 period, thyroid extract is frequently resorted to, either alone or in asso- 

 ciation with the ovarian extracts. The principles governing its use are 

 similar to those applying to thyroid medication generally. The dosage 

 should usually be small, owing to the fact that its administration is pro- 

 longed. Ordinarily one or two grains a day is a sufficient dose for pro- 

 longed employment. At times pituitary extracts are also used, as in the 

 treatment of the functional uterine hemorrhage of the menopause. This 

 subject will be discussed under a separate heading. 



Functional Amenorrhea and Oligomenorrhea Due to 



Hypogenitalism 



Introductory 



Etiologic Considerations. In a much larger proportion of cases than 

 is commonly believed, amenorrhea (absence of menstruation) or oligo- 

 menorrhea (scanty menstruation) are the results of endocrine disorders, 

 rather than of local disease in the pelvis. This is in contrast with the 



