Contemporary Therapy of the Menopausal Syndrome

Therapy for the postmenopausal patient has three aspects: psychotherapy, sedation, and hormonal therapy. A convenient index (menopausal index) for expressing the status of a patient is calculated by assigning to each of the 11 most common symptoms a weight factor and a severity coefficient; the sum of the 11 products ranges from 0 (for complete absence of menopausal symptoms) to about 35 (for serious distress). It was used as a criterion in comparing the efficacy of 27 types of treatment, including use of conjugated equine estrogens (299 cases), ethinyl estradiol (284 cases), and chlorotrianisene (124 cases). There are objections to the prolonged use of barbiturates, and the results obtained by the use of ataractic drugs alone in this study were but slightly better than those obtained with a placebo. Superior results were obtained with conjugated equine estrogens and ethinyl estradiol alone or when the latter was used with androgens. These effects were augmented with the addition of a phenothiazine compound to the estrogen-androgen combination. The judicious use of such therapy can afford relief from unnecessary discomfort to the everincreasing number of menopausal women in the population.