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This survey is based on the careful study of one hundred patients who were not analyzed. Statistically our diagnostic evaluation of these data conforms to a high degree with the findings of Jacob Hoffman (1) and those of August Werner (2) whose studies were carried out on much larger material. The statistical data only show that the condition of the majority of women during the climacteric is not normal. We hold that an undisturbed menopause is normal though extremely rare.
The fact that the diminishing or the cessation of menstruation is accompanied by a great variety of symptoms suggests the plausible assumption that it is this physical change which produces all these symptoms. This assumption then logically implies that the therapy of these conditions should consist in replacing the diminishing function through hormone therapy. Inasmuch as psychic disturbances constitute the bulk of menopausal symptoms, it is further assumed that hormone therapy should also effect a cure of the varying degrees of depression; however, the results of endocrine therapy have become more and more disappointing. Failures of such therapy have been reported by H. S. Ripley, H. D. Palmer, A. E. Bennett and their co-workers (8).
Two clinical facts became increasingly apparent (6), (7): 1, a strange discrepancy developed in the response to hormonal treatment. The best results were the relief of hot flushes and the symptom of sweating. Headaches, numbness, tingling, and formication responded much less satisfactorily. 2, Even less encouraging was the efficacy of such therapy in dispelling irritability and the almost inevitable depression.