Climacteric symptom formation: Donovan's contribution

Abstract

Engaged in evaluating the then newly introduced hormonal therapy of the climacteric syndrome, Donovan, late professor of obstetrics and gynaecology, of Rochester, NY, reached the conclusion that this complex of symptoms was only a clinical artifact. It was, he claimed, the result of the selective attention of doctors when securing medical histories. Though written 30 years ago, Donovan's paper is apparently still provocative enough to be regularly quoted. It has, however, never been closely examined. Looked at in a different light, Donovan's research appears even more interesting. The apparent paradoxes he reports disappear when it is remembered that symptoms are not data but means of communication. His perceptive picture of the influence of doctors on the formation of climacteric symptoms is especially convincing. Much of this is because the main conclusions of this research seem to have come almost as a surprise, forcing themselves on a worker engaged in a restricted field of his speciality. These circumstances probably also account for the reticence shown in drawing more general conclusions from its findings.