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Fibrocystic disease of the breast (FCD) is an exaggeration of the normal physiologic response to cyclic estrogen and progesterone stimulation. The disorder can persist, with much less severity, in the menopausal woman. Whether FCD predisposes to mammary cancer remains moot. A new steroidal agent, danazol, can eliminate nodosities in the majority of women with FCD. Thermography may identify women who are at greater risk because of increased heat production. Mammography should be employed in women with persistently abnormal thermograms, even though no suggestive breast masses are palpable. Needle biopsy or surgical biopsy should be undertaken whenever a firm indurated mass is palpated, regardless of negative findings with a thermogram or mammogram. In a series of 1548 women treated for 10,715 women‐years, the incidence of breast cancer after prolonged estrogen therapy was not increased. Although estrogens and prolactin have been incriminated in the etiology of mammary cancer, no hard facts exist to confirm such allegations.

ABSTRACT: The influence of aging on serum levels of gonadotropins (FSH and LH), testosterone and estradiol was studied in the following groups: 4 normal men (ages 30 to 50), 38 men with symptoms of the male climacteric (ages 51 to 84), 25 men with relative impotence (ages 31 to 50), 10 normal women (ages 24 to 31), and 6 menopausal women (ages 58 to 76). FSH and LH levels began to rise in men in their 40's, and the increase became more conspicuous in the later age decades. The degree of elevation was nowhere comparable to that observed in the aging women. In the male, the serum testosterone levels showed a progressive decrease from the fifth age decade onward, whereas in the female there was an increase after the menopause. Estradiol levels showed no significant change in the aged male, but they were somewhat higher than in the aged female. Exceptions to the low‐testosterone and low‐gonadotropin relationship were observed in individual cases and might be explained by relatively high estradiol values. Proper replacement therapy by means of estrogens for the postmenopausal female and androgens for the aging male is often of great benefit, physically and emotionally.

ABSTRACT: Defective sexual adjustment can be managed more easily when there is some understanding of the respective roles of psychogenic and endocrine factors in sexual behavior. Millions of men and women are in need of help. The problems are discussed under the headings of maleness and femaleness, sex interest in the female, sexual inadequacy, and sexual gluttony. Only after differentiation of the psychogenic and endocrine factors can proper therapy be started.

Constant, adequate dosages of estrogen, androgen or estrogen‐androgen combinations provide relief from the migraine and migrainoid headaches often experienced by menopausal women. This form of therapy employs natural physiologic hormones in preference to synthetic nonphysiologic agents such as ergotamines, barbiturates or addictive drugs. In the author's studies of hundreds of women with menopausal headaches, such hormones administered by pellet implantation gave beneficial results superior to those obtained by oral or parenteral administration.

ABSTRACT: Relationships between the hypothalamus and the pituitary in the aging woman are discussed under the following subheadings: synthesis and release of follicle‐stimulating and luteinizing hormones, estrogen receptors, other releasing factors, neurotransmitters, and the mechanisms of hot flushes and migrainoid headaches. The hypothalamus is the main regulator of pituitary function. In the female, the hypothalamic‐pituitary axis appears to remain functionally intact well into old age.

Postmenopausal women should not be denied estrogen therapy because of the controversy about the alleged causal relationship of estrogens to endometrial cancer. A prestigious team of biostatisticians reviewed three publications that claimed this relationship and concluded that no such association could be confirmed. Although the incidence of endometrial cancer has doubled in the past 25 years, there is no valid basis for the assumption that the widespread use of estrogens is the cause. The incidence also has increased in Norway and Czechoslovakia where estrogens are rarely used. Moreover, the histologic pattern of endometrial dysplasias is such that many pathologists will make a diagnosis of endometrial cancer as a safeguard for the patient. Thus the statistics for the incidence of endometrial cancer may be inflated. As a test, the administration of 200 mg of an oral progestogen over 5–10 days will convert a histologic pattern of pseudomalignancy, but not of adenocarcinoma, into one of secretory endometrium. Unopposed endogenous or exogenous estrogens may induce hyperplasia, atypical adenomatous hyperplasia or adenocarcinoma in women who are genetically predisposed. To minimize such a possibility, it is advisable to give a 5–7 day course of an oral progestogen so that the endometrium will be shed at monthly intervals. The benefits of hormone replacement therapy for the postmenopausal woman far outweigh the putative risk of endometrial cancer

ABSTRACT: In this preliminary study, pellets of pure (naturally occurring) estradiol and/or testosterone were implanted in 44 women and pellets of pure testosterone were implanted in 9 men, at six‐month intervals. The effects on serum lipid levels were determined. There was no evidence that either estradiol or testosterone influenced the blood cholesterol level in women. This is not in agreement with the findings of several other investigators who used synthetic estrogens. Also, there was no significant change in the blood levels of lipoprotein, cholesterol or triglyceride after administration of large doses of testosterone to men.

Among the many factors that shade and color the intensity and direction of human sexuality are gonadal integrity, chromosomal determinants, external genital adequacy, socio‐economic influences, endogenous and exogenous hormonal dependency, and possibly hypothalamic sensitization during fetal life. Neither gonads nor chromosomal sex decide the direction of overt sexual behavior. Libido, in great measure, is a chemical test‐tube equation. Testosterone is the hormone that intensifies sexual drive in both man and woman; it is particularly useful in restoring sexual drive in the woman who once knew, but has lost her libido. Testosterone in the adult female does not alter the direction of sexual behavior or amatory responsiveness. Age need not alter performance nor eliminate the satisfaction and pleasure that attend sexual gratification. Several illustrative cases are presented.