Clinical and metabolic effects of the menopause and the role of replacement oestrogen therapy.
Doctoral Thesis
1970
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University of Cape Town
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The present investigation was undertaken in order to clarify the clinical and metabolic effects of the menopause following bilateral oophorectomy in the human female and to evaluate the role of subsequent replacement exogenous oestrogen therapy. To this end pertinent clinical and laboratory studies were carried out. It is considered that the following contributions to knowledge have been made: 1. The symptoms and clinical signs directly related to endogenous oestrogen withdrawal following bilateral oophorectomy have been clarified and defined. 2. Symptoms responding to exogenous oestrogen therapy have been differentiated from those responding to placebo (general supportive) therapy. 3. The ability of exogenous oestrogens to produce a feeling of well-being in postmenopausal females is statistically substantiated. 4. The parabasal cell is shown to be the best cytologic index of the oestrogenic status of the postmenopausal female. Claims for an increase of vaginal superficial cells with exogenous oestrogen therapy are refuted. 5. Bi lateral oophorectomy. in the female of reproductive age is shown to have no effect for up to 2 years on the total serum cholesterol level. Oestrogen therapy, however, reduced the level of serum cholesterol in oophorectomized females. 6. The effects of b i lateral oophorectomy on plasma calcium and inorganic phosphorus are shown. The ability of oestrogen to lower plasma calcium and phosphorus is demonstrated and the possible explanation and implication of these findings is discussed. 7. A controlled comparative evaluation of two different forms of oestrogen demonstrates different oestrogens to have different effects. Moreover, endogenous, and exogenous oestrogens are shown to be not entirely similar in their clinical and metabolic effects. 8. The specific short-term sequelae of oophorectomy are demonstrated and the current role of exogenous oestrogen replacement therapy in postmenopausal females is discussed.
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Utian, W. 1970. Clinical and metabolic effects of the menopause and the role of replacement oestrogen therapy. University of Cape Town.