A Tribute to Dr. Katharina Dalton

It’s not really funny. PMS jokes abound in today’s society. It’s very likely that most of us toss around the acronym of PMS for premenstrual syndrome without giving a thought to where this originated.

PMS in the Movies

In 1994, there was a movie entitled “Tom and Viv” about the relationship of T.S. Eliot (the American poet) and his wife.Vivienne Haight-Wood Eliot., whom he married in 1915 She suffered terribly each month from what we now could recognize as PMS. After trying to help her unsuccessfully, T.S. Eliot has his wife committed to an asylum where she spent the remainder of her days. Upon their marriage, T. S. Eliot became custodian of her fortune both of her money and her physical self. He never saw her again after she was committed.
This story reflected the times. Women who suffered from hormone disturbances were thought to have mental rather than physical problems Dr Katharina Dalton made a huge contribution to our understanding of hormone disturbances and she is the person who named the syndrome PMS. As we explore the mysteries and the benefits of hormone therapies today, we are standing on the shoulders of her achievements and the tremendous amount of observation and study she did.

The concept of a women’s health movement may very well have started with her work. She identified and successfully treated many problems that was uniquely female.

PMS Defined

On her death at 87 on September 17, 2004 .her life and her work were reviewed by many major newspapers in Great Britain where she practiced and in the United States where she also made a huge impact. She was still a medical student and pregnant at age 32 when she wondered why she was suddenly free of the severe headaches she experienced monthly. She took her observations to Dr. Raymond Greene, an endocrinologist and determined that progesterone which is abundant during pregnancy and also should be abundant during the luteal phase (2nd half of menstrual cycle) might be a key. She and Dr. Greene first published their clinical experiences and theory in British medical journals in 1958 and proposed the term – premenstrual syndrome. She had by then successfully treated premenstrual asthma, epilepsy and migraine with progesterone.

Dr. Dalton used progesterone which was equivalent in structure to the hormone found naturally in the human body. She was adamant that other synthetic derivatives of progesterone could not be used contrary to what her medical colleges believed.

Charting the Menstrual Cycle is Key

Throughout her career. Dr. Dalton carefully examined her patients, collected data and posed theories and tested her ideas. She developed a system of charting to help contain the large number of symptoms that could present with PMS.

Toxemia of Pregnancy

One of her observations was that some of the symptoms of PMS which included edema, hypertension and albumin in the urine seemed to also occur as early signs of toxemia in pregnancy. She began trials of interventions with progesterone in collaboration with a maternity hospital. The hospital records showed a average of incidence of toxemia to be 9%. After the first treated patients delivered in 1955, the incidence dropped to a low of 1.0%. Each patient was given a test dose of progesterone when early symptoms occurred and then treated continually if symptoms resolved while moderating the doses according to symptom relief.

Progesterone Receptors

She focused her attention on progesterone receptors. Since only natural progesterone fit the receptors, this was the only appropriate hormone to use. If there was too much adrenaline being produced, progesterone would not be able to be picked up by the receptors. Similarly, if women were experiencing swings of low blood sugar, progesterone could also not activate the receptor. Men, women and children all have progesterone receptors in operation throughout their life time. Progesterone which has an effect throughout the body is produced in the adrenal glands.

Progesterone Testing is Meaningless

She used very generous doses of progesterone to treat women often a 400 mg suppository would be the minimum dose.. Tests for levels of progesterone in the body with various means was immaterial in her opinion since the only test meaningful would be of the receptor sites.

Progesterone and Luxuriant Hair

She observed that progesterone has a very positive effect on hair growth in women. After delivery of a baby, many women experience significant hair loss because of the sudden drop of progesterone. When progesterone is supplemented for those women, the hair will regrow luxuriantly.

Brain Trauma

Progesterone was also effective for brain trauma because of its protective effect on the myelin sheath which covers nerve tissue. Additionally, progesterone can reduce swelling in the brain and had even been used by neurosurgeons prior to surgery.

Progesterone is Safe at Any Dose

She claimed that there was no unsafe dose of progesterone. In high enough doses started before ovulation, progesterone could be used as a safe contraceptive. It was also safe to use with breast cancer even concurrent with breast cancer treatments. Prior to menopause, progesterone would start to become deficient for at least two years. During this time women would develop symptoms that were the same as she identified as PMS.

Depression after Childbirth

She also identified the onslaught of symptoms in some women after childbirth as having a similar pattern to PMS. She advocated for using large doses of progesterone immediately after childbirth especially in those with a history of PMS to cushion women from the effects of the huge drop of progesterone which occurs at delivery,.

More Progesterone is Needed after Hysterectomy

Unlike current conventional thinking, she claimed that women who have had a hysterectomy need MORE than the amount of progesterone needed by a woman who has undergone a natural menopause. The reason for most hysterectomies are consistent with a long time deficiency of progesterone and afterwards so much more progesterone is needed to relieve symptoms. Conventional thinking today claims that that women with hysterectomy do NOT need any progesterone because ignoring considerable research on progesterone receptors throughout the body, they maintain that it is only the uterus that benefits from progesterone and since it has been removed, progesterone no longer has any function.

Crimes Associated with Progesterone Deficiencies

She published a book entitled “Premenstrual Syndrome Goes to Court” as she was an active advocate in the justice system. She documented that for women in prison, a large majority of the crimes and violence such as manslaughter, baby battering and assault happened during the luteal phase in women who had a history of PMS symptoms. She published that the best documentation for PMS was a menstrual chart indicating both the symptoms and the cyclical occurrence.

Sex Hormone Binding Globulin as a Marker

She tried to find an independent marker for PMS and studied sex hormone binding globulin (SHBG). In her groups studied, she found that SHBG which would bind estrogens and testosterone tightly was low in the women suffering with PMS. She theorized that low SHBG translated into more free estrogens which then created an inadequate progesterone activity. This premise unfortunately was not verified by other scientists. She appeared in court in about 50 trials in defense of women suffering from PMS and claiming a state of diminished responsibility when their criminal actions occurred during the luteal phase of their cycle.

Using the Scientific Method

Dr. Katharina Dalton practiced the true scientific method. She made her observations based on the evidence she found, devised a theory that tested the observations she made, tested her theory and even applied it to other situations as she recognized the implications of the host of symptoms to further strengthen the theory. Today, faced with the numerous symptoms presented with PMS, scientists only look at one issue at a time. Instead of turning to progesterone which is indeed the golden key for the progesterone receptors as Dr. Dalton has shown we turn to other ineffective treatment.

Piecemeal Drug Treatments

We treat PMS piecemeal with diuretics for edema, with narcotics and antiinflammatories for pain, with antidepressants, anxiolytics and antipsychotics for mood disorders and antiepileptics for seizures.

Some say it takes 50 years for a new idea to take hold in our collective minds and since we are more than 50 years from her first publication, the time is now ripe for acceptance. Pointing to the current wide spread use of bioidentical hormone therapies in women’s health today as proof, perhaps Dr Katharina Dalton’s ideas have at last a place in our consciousness.

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