The Management of Functional Menstrual Disorders
The majority of menstrual disorders are due to some derangement in the function of the ovaries. This may be due to factors which influence the general health or to more specific factors which alter the production of the hormones of the ovaries in one of several ways, i.e., (a) by affecting them directly, (b) by affecting their chief governing agent, the pituitary gland, or (c) through other endocrine glands, notably the thyroid or adrenal glands. In this paper, we shall deal with treatment of menstrual disorders chiefly from an endocrine point of view. The physiology of menstruation will be summarized briefly. We shall then examine the available hormonal and nonhormonal remedies, and discuss the application of these agents to menstrual disorders of known or presumed endocrine origin and to some of uncertain etiology.
Sex is determined primarily by the gene, but the development of the sexual apparatus is dependent to a large degree upon the hormones elaborated by the sex cells. No new structures are formed in the body by the action of hormones, maleness and femaleness depending upon the degree of differentiation of structures already laid down. Male sex hormone acting prior to the time of sex differentiation causes development of sex organs of male character while female sex hormone (estrin) acting before the time of differentiation causes these structures to assume the female characteristics and is necessary for the maintenance of normal structure and function.
Estrin is elaborated chiefly by the graafian follicles and exists in several. . .