Vitamin E in the Menopause

Menopausal flushing and sweating can usually be controlled by oestrogens, but the stimulating effect of these hormones on the genital tract and breasts sometimes contraindicates their use-for instance, after radium treat- ment of cancer or before cessation of menstruation.Although oestrogens promote cancer development in animals there is so far no proof that they do so in man (Gemmell and Jeffcoate, 1939; Gardner, 1947).Neverthe- less, "cancer-like" areas are quite often a troublesome finding in curettings from patients whose oestrogen- withdrawal bleeding has necessitated curettage (Gusberg, 1947).Vitamin E was first used by Evan Shute (1937) to control flushings, and several confirmatory reports have followedThe Investigation Clinical Material.-Inview of the cost (£7 per case), treatment was given only to patients seriously disabled by drenching sweats, flushings, loss of sleep, and so on.The incidence of severe flushing after cessation of menstruation is about 17%, while after radium or surgical castration the figure is 50% (McLaren, 1941).Vitamin E in the form of alpha-tocopherol (" ephynal ") was given to 47 patients with severe flushings; these included four regarded as new cases, although in fact they had relapsed after successful treatment with vitamin E. Forty cases had not been pre- viously treated, while three had resisted stilboestrol.The 47 cases fall into the following categories Cases Radium menopause (two years approximately) .25 Deep x-ray (one year approximately) 9 Hysterectomy and double oophorectomy .10Hysterectomy and one ovary 2 Spontaneous menopause .1As a control before vitamin E, 18 cases were treated as follows.After completion of her case history and pelvic examination the patient was given blank tablets and a card to record the number of flushes at each period of the day.TABLE 1.-Effect of Vitamiiin E on Flushing No. and Class 778 Spont.M. 732 X-ray 720 , 701 Castrate..