EUTHANASIA

There is littledoubtthatoestrogenis ahormonalpreparationwhich can producepositive affectivereactions,as well as physical changes, in women who aredeprivedof an adequatelevel of oestrogeneither post menopausalor post hysterectomy. The real issue in any argumentas to whetherit shouldroutinely begiven to women is not that it mayormay not producepositive feelingsand improvedsexual tissue, butwhetherit may induce anincreasedincidence ofcarcinoma. It does appear that oestrogenadministeredin high dosages for prolongedperiodsof time will produce,at least,atypical hyperplasia of the endometrium,and possiblycarcinomatouschange in some women. This risk has been, quite correctly,broughtto theattention of the public by the lay press, but, before post menopausal oestrogen administrationis condemned,one must look at the benefits, and at how one canmanagethe side effects ofoestrogenadministration. Only a smallnumberof women will suffer fromatypical endometrial changeswhen the regimepropoundedby Hailes and Burger! is used, and if due caution is exercised, andcurettageis performed,and/or progesteroneadministeredas indicated, then no increasedincidence of invasive carcinomashould be seen. LikeProfessorLlewellynJones, I will also beinterestedin the results of theMenopausalClinic in Melbourne. School ofObstetricsand Gynaecology, University of New SouthWales, Royal Hospital for Women, Paddington,N.S.W. 2021.