The initial clinical trials in the early 1920s were mainly restricted to the treatment of menstrual disorders, in particular amenorrhea. By the late 1920s, female sex hormones were promoted for a substantially wider array of medical indications. This trend may have been facilitated by the marketing of Organon’s new product Menformon, a less expensive drug available in larger quantities than the previous product.13
The first extension in medical indications consisted of the prescription of female sex hormones for menstrual disorders other than amenorrhea. In 1927, Laqueur advised the Dutch gynecologists involved in clinical trials to administer Menformon also to female patients with multiple menstrual bleedings (polymenorrhea) and in cases of very heavy menstruation (hypermenorrhea). Laqueur noted that if these trials succeeded, the indications for female hormone therapy could be increased substantially (Organon Archive 22 December 1927).
This extension to other medical indications is also reflected in Organon’s publicity for female sex hormone preparations. In the first advertisement for Ovarnon in January 1925, medical indications were not described at all. The advertisement mentioned only that literature would be sent upon request. Evidently, knowledge of the therapeutic effects of female sex hormone therapy was too vague to formulate a well-defined description of medical indications.14 But in a 1927 advertisement forMenformon (published in more than thirty countries), medical indications were described for the first time. Hormone therapy was now recommended for “all anomalies of ovarian function, causing disorders in menstruation and other sexual functions in women, in particular retardation in growth of the genital organs leading to sterility and in cases of menopausal complaints” (Organon Archive 28 September 1927).
In less than two years, the medical indications for female sex hormone therapy were thus extended from the treatment of menstrual disorders to the treatment of menopause, infertility, and problems of the genital organs. Although this extension of medical indications was quite substantial, female sex hormone therapy remained restricted to the gynecological clinic. This restriction disappeared after 1927, when Organon extended the clinical trials for female sex hormone therapy to the psychiatric clinic, thus creating an even broader market for female sex hormones. In December 1927 Organon initiated the first clinical trials in psychiatric clinics in Germany, in which female sex hormones were administered to female patients for treatment of schizophrenia and melancholia (Organon Archive 22 December 1927). The prescription of female sex hormones in cases of psychoses and depressions attributed to disorders in the menstrual cycle was also described (Beek 1933; Esch 1935; Organon Archive 19 August 1933).
In 1929, female sex hormone therapy was further extended to other medical indications. In the pamphlet advertising Menformon to Dutch and British general practitioners, Organon not only mentioned gynecological and psychological disorders, but also included dermatological diseases (such as eczema) and diseases of the joints; both disorders were presumably related to the dysfunction of the ovaries. Other medical indications mentioned in reports from Dutch and German gynecologists, general practitioners and psychiatrists on the results of female sex hormone therapy in female patients, suggested an even wider therapeutic use: for epilepsy, hair loss, eye disorders, diabetes, hemophilia and even chilblained feet (Organon Archive 19 August 1931, 7 October 1932, 28 January 1933, 30 April 1934, 20 May 1934 and 13 February 1935).
This wide range of therapeutic applications illustrates how, since the 1920s, female sex hormones developed from a treatment specifically indicated in cases of well-defined menstrual disorders to a more universal medicine applicable for a wide variety of conditions in female patients, all attributed to dysfunction of the ovaries. Medical practice in the United States shows a similar pattern in the application of female sex hormones. By 1933 the American Council on Pharmacy and Chemistry described this practice in female sex hormone therapy:
Theelin [the name American scientists used for female sex hormones] and related preparations have been used in practically all the special ills the human female is heir to.
(Anonymous 1933)