View report page

Second cycle
Visit D—beginning: 0.1 mg. ethinyloestradiol daily for a fortnight.
Visit. E—middle: 0.1 mg. ethinyloestradiol and 4.0 mg. megestrol daily for a
fortnight.
Visit F—end : nothing for a fortnight.
Visit G—end of trial: final tests.
At each visit (except the second) they had the following observations: weight,
temperature, haemoglobin, serum cholesterol, grip, photograph, re-action time, skin
elasticity, blood pressure, electrocardiograph, ankle-jerk time, vaginal cytology, history,
and physical examination. Each woman acted as her own control.
Every woman showed improvement in various ways at the end of the first cycle
(point C). This improvement was partially maintained over the second cycle (F) but
fell to the original condition at the end of the trial (G).
The photographs were assessed by five judges acting independently. They all
agreed that the photographs at the end of the first cycle (point C) looked much more
attractive than the ones at the beginning; the women looked younger, brighter, happier,
and more alert. The 4th (D), 5th (E), and 6th (F) photographs showed the improvement
at C had been maintained, but with some irregularities. Between the beginning
and the end of each cycle the hair improved and became glossier, brighter and thicker,
and grew better, with dryness and dullness gone. The dry muddy dullness of the eyes
recorded in four women at the beginning of the trial seemed to improve and change to
brightness at the end.
We measured the skin elasticity for each woman on each occasion. On the back
of the right hand we defined a point over the prominence at the base of the second
metacarpal. On each side of this point we marked two short lines with two pens
fastened together 14 mm. apart. The hand was placed on a board over which was fixed
a cine-camera set to run at a speed of 64 frames per second. With a pair of forceps
the skin between the two lines was pinched up and held; the camera was started and
the skin quickly released. The camera photographed the rate of recovery of the two
lines to their original position. Photographs were taken twice for each woman for each
of the seven occasions they attended. The results showed that in every woman the skin
elasticity improved under the influence of oestrogen; it fell during the fortnight between
the first and second cycle—C to D; it improved again in the first half of the second
cycle D to E; it decreased again in the second half of the cycle during the time when
the progesterone was taken—E to F. The elasticity fell still further in the fortnight
after the second cycle to the end of the trial—F to G.
On each occasion we examined clinically the skin of the face, neck, back of hands,
and behind the upper arm for changes in elasticity. On the back of the hand of a
young girl the skin when pinched up will fly back into position in less than one-tenth
of a second; the skin of an old man or woman will require one second or more. The
face of an older person shows loss of elasticity in the creases, lines, wrinkles, crow's feet,
and mouth creases; the neck shows vertical skinfolds, and curtain formations; the skin
at the back of the upper arm becomes very slack. We noted improvements in the face
under the influence of oestrogen by recovery of the youthful oval formation, the fillingout
of the lines, the creases becoming less prominent, the skin smoother, and the
expression happier.
At the end of both cycles the breasts in every case showed changes. From being
flabby, pendulous, atrophic, and diminished, they become firmer, enlarged, the nipples
more erect and the figure improved. In between the cycles and at the end of the trial
the firmness had subsided, the nipples gone smaller, and the whole structure reverted
37