Studies on Ovarian Dysfunction. Iii. The Menopause1

Science rightly concluded many years ago that the phenomenon called the menopause is associated with a cessation of ovarian function. The structure of the ovary after the menopause, the atrophy of the uterus and vagina during the menopause, the close analogy between physiological menopause and artificial menopause were all evidence of this. But ovarian function, it is now known, may cease because the ovary per se ceases to function or because the stimulating hormone or hormones from the anterior pituitary cease to be furnished. With which of these possibilities is one confronted at the menopause? Evidence that ovary is primarily and not secondarily hypofunctioning at the menopause. In the previous paper of this series (1) it was pointed out how the determination of certain hormones in the urine could be used in differentiating between a hypogonadism of primary ovarian cause and one secondary to a hypofunction of the gonad-stimulating hormone or hormones of the anterior pituitary. Obviously in both instances there would be a cessation of menses, and atrophy of ovaries, uterus, and vagina.