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April 13, 1929

The Climacteric. (The Critical Age.)

JAMA. 1929;92(15):1296. doi:10.1001/jama.1929.02700410066035

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The author first defines his thesis and differentiates between the symptom, menopause, and the epoch, climacteric. The latter, he states, is not merely the cessation of the menses, but a critical age due to a complex endocrine crisis. Three fundamental glandular elements enter into the development of the crisis: the genital, the thyroid and the suprarenal. The rôle of the pituitary is secondary. The author devotes a chapter to each of these endocrine factors, treating the subject in an understandable and interesting style. The appended notes by Culbertson also add to the value of the text. The relationship of the vegetative nervous system and of emotion to the climacteric are especially well discussed. Concerning the limits of the critical age, Maranon states that while there is no chronological relationship between the beginning and the end of menstrual life there is a relationship to the vigor of the ovaries. Women with

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