London's Pulse: Medical Officer of Health reports 1848-1972

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Richmond upon Thames 1965

[Report of the Medical Officer of Health for Richmond upon Thames]

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at the end of the trial (G). This effect was consistent throughout the whole of the
observations and applicable to every woman. The average cholesterol level was:

TABLE 1

Serum Cholesterol — m.g./100 ml. Mean for 10 Women

First cycleSecond cycle
Beginning of cycle343347
End of cycle240234
End of trial278

There were no differences in temperature throughout the trial. One or two of the
heavier women showed a tendency to decrease in weight during the trial; but generally
the weights of the group did not change significantly. We used an instrument for
testing grip strength which has a strong spring in the handle. We found no significant
differences due to the medicaments. The systolic blood pressure fell on the average by
13 millimetres between the beginning of the trial (A) and the end of the first cycle (C);
it remained down continuously through the second cycle to F and then crept back to its
original point at the end of the trial G. The diastolic blood pressure followed the same
pattern with a fall of 7 millimetres. The haemoglobin was measured on each visit.
There was a hint that the mean level for the whole group fell from the beginning of the
trial to the end, but we could not prove the fall statistically significant. The reason may
have been the blood loss on the two occasions the women menstruated.
We took an electrocardiogram of each woman on each visit using the three limb
leads, I, II, and III; lead III with deep respiration; and three chest leads. CR1, CR4,
and CR7. We examined the leads for differences between the various visits, and found
none worth recording. We tested the ankle-jerk reaction time—Woltman's sign—with
an instrument which measured electrically the time-interval for the foot to return to its
original position after each tap on the tendon. Each woman had three recordings on
each visit. We found no significant variation whatever due to the influence of the
medicaments. We tested the reaction-time of all the women on all the occasions. The
test was to extinguish a small electric bulb by releasing a push-button after it had been
lit by the doctor. The time was recorded electrically in hundredths of a second. There
was no significant difference between the visits.
Oestrogen deficiency in older women
We tried the effect of oestrogen therapy on 108 older women whose ages ranged
between 54 and 90 with a mean of 72. The very old ones had most of the disabilities
mentioned previously. They will accept the therapy even with the possibility of menstruation
if the purpose and the possible effects are carefully explained beforehand.
We gave them 0.05 mg. of ethinyloestradiol (E.O.) or 0.05 mg. of ethinyloestradiol and
4.0 mg. of megesterol (Meg.) combined, either as tablets or mixed in prevention powder.
In some cases we used a 42-day cycle, giving E.O. for 30 days and the combination for
12 days; in other cases we gave the combined medicament continuously. Fifty-two
women on continuous E.O. and Meg. combined, for periods varying from three months
to one year, reported themselves feeling better and were much improved in general
well-being. None of these reported spotting or vaginal bleeding. Generally these women
were in the younger age-groups and were the more intelligent and reliable. They were
warned they must not cease taking the tablets or powder and for the most part have
conformed. Forty-four women have had regular cyclical bleeding or withdrawal bleeding.
Most showed improvement in well-being whilst on the medicament. Twelve
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