Katharina Dalton
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Katharina Dalton (11 November 1916 – 17 September 2004) was a British
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
and pioneer in the research of
premenstrual stress syndrome Premenstrual syndrome (PMS) refers to emotional and physical symptoms that regularly occur in the one to two weeks before the start of each menstrual period. Symptoms resolve around the time menstrual bleeding begins. Different women experienc ...
(PMS), coining the term, treating many women and testifying as an expert witness in influential court cases.


Background

Katharina Dorothea Kuipers was born in London on 11 November 1916 to parents Anna Knoester and Johannes Kuipers. Johannes Kuipers, a merchant and
freemason Freemasonry or Masonry refers to fraternal organisations that trace their origins to the local guilds of stonemasons that, from the end of the 13th century, regulated the qualifications of stonemasons and their interaction with authorities ...
, died when Dalton was young. Despite her family's financial troubles, Dalton attended the Royal Masonic School for Girls in London. As she grew, she wanted to be a doctor and, after winning a scholarship to the
London Foot Hospital The London Foot Hospital was founded in 1913 as The Pedic Clinic for Gratuitous Treatment of the Feet. It was the first free clinic for treatment of feet in England, and its School of Podiatric Medicine, which started as evening classes in 1919 ...
, first trained to be a
chiropodist Podiatry () or podiatric medicine () is a branch of medicine devoted to the study, diagnosis, medical and surgical treatment of disorders of the foot, ankle, and leg. A Doctor of Podiatric Medicine (DPM), or a podiatrist, is a healthcare ...
. Dalton married her first husband, Wilfred Thompson, in 1939, but he died in World War II, not long after their son was born. Dalton then decided to change medical speciality, and obtained a medical degree at the
Royal Free Hospital The Royal Free Hospital (also known simply as the Royal Free) is a major teaching hospital in the Hampstead area of the London Borough of Camden. The hospital is part of the Royal Free London NHS Foundation Trust, which also runs services at Barn ...
. Before graduating, she married Thomas Dalton, with whom she had three more children. Following the death of her husband Thomas in 1992, Katharina retired shortly after in 2000. She lived the rest of her days in Hereford and Poole, England and ultimately died on 17 September 2004.


Accomplishments

Dr. Dalton became involved in the study of PMS in 1948, when, as a pregnant 32-year-old medical student, she realized her monthly
migraine Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
headaches had disappeared. Consulting with
endocrinologist Endocrinology (from ''endocrine'' + '' -ology'') is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events ...
Dr.
Raymond Greene Charles Raymond Greene (17 April 1901 – 6 December 1982) was a British doctor and an accomplished Mountaineering, mountaineer. Biography Greene was born in Berkhamsted.progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...
, which drops before menstruation but soars during pregnancy. After further clinical study, Dalton and Greene published the theory in British medical journals in 1953 — first using the term "premenstrual syndrome" or PMS. Dalton treated numerous women after setting up her own practice and concluded that PMS was a cyclical hormonal illness occurring in the 14 days following
ovulation Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized ...
, with the most severe symptoms evident during the final four days before
menstruation Menstruation (also known as a period, among other colloquial terms) is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hor ...
. In direct conflict with the views of many of her male colleagues, Dalton said the symptoms were more physical than psychological and included migraine headaches,
asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...
,
epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical ...
,
skin lesions A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of this sy ...
, irritability, fatigue, and depression. In addition to her patients, she studied teenage schoolgirls, the mothers of abused children and women confined to prison for serious crimes, including murder. For example, she testified as an
expert witness An expert witness, particularly in common law countries such as the United Kingdom, Australia, and the United States, is a person whose opinion by virtue of education, training, certification, skills or experience, is accepted by the judge as ...
at the
Old Bailey The Central Criminal Court of England and Wales, commonly referred to as the Old Bailey after the street on which it stands, is a criminal court building in central London, one of several that house the Crown Court of England and Wales. The s ...
in the trial of Nicola Owen, who had burnt her parents' house down. Her research showed that during times of severe PMS, students'
academic performance Academic achievement or academic performance is the extent to which a student, teacher or institution has attained their short or long-term educational goals. Completion of educational benchmarks such as secondary school diplomas and bachelor's deg ...
dipped and women were more likely to abuse their children or commit crimes. From historic anecdotes, she even concluded that
Queen Victoria Victoria (Alexandrina Victoria; 24 May 1819 – 22 January 1901) was Queen of the United Kingdom of Great Britain and Ireland from 20 June 1837 until Death and state funeral of Queen Victoria, her death in 1901. Her reign of 63 years and 21 ...
suffered from PMS, as indicated by reports of her monthly screaming and throwing objects at her husband, Prince Albert. She is largely credited with developing the use of menstrual charts for the diagnosis of the disorder, and argued that the timing of PMS in women was associated with higher rates of suicide attempts, alcohol abuse and violent crimes. PMS, Dalton argued, was brought on primarily by deficiencies of progesterone and could be alleviated with
hormone therapy Hormone therapy or hormonal therapy is the use of hormones in medical treatment. Treatment with hormone antagonists may also be referred to as hormonal therapy or antihormone therapy. The most general classes of hormone therapy are oncologic horm ...
. She also believed that the hormone could be used to ease
postnatal depression Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and chan ...
. But today most experts disagree with those findings and instead rely on
selective serotonin reuptake inhibitors Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions. SSRIs increase the extracell ...
(SSRI) and other medications for the treatment of PMS. In her later works, Dalton helped demonstrate that depression and other disorders could be aggravated by PMS, particularly around the last few days of the menstrual cycle or the first days of menstruation. Dalton eventually became the first female president of the general practice section within the
Royal Society of Medicine The Royal Society of Medicine (RSM) is a medical society in the United Kingdom, headquartered in London. History The Society was established in 1805 as Medical and Chirurgical Society of London, meeting in two rooms in barristers’ chambers ...
. Another observation made by Dalton was that some symptoms of PMS, such as
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
,
edema Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...
, and
albumin Albumin is a family of globular proteins, the most common of which are the serum albumins. All the proteins of the albumin family are water-soluble, moderately soluble in concentrated salt solutions, and experience heat denaturation. Albumins ...
in the urine, were predictors of toxaemia during pregnancy. Patients were administered an initial dose of
progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...
during early symptoms and given continuous treatment if symptoms were still present. Using progesterone in trials in
maternity hospital A maternity hospital specializes in caring for women during pregnancy and childbirth. It also provides care for newborn infants, and may act as a centre for clinical training in midwifery and obstetrics. Formerly known as lying-in hospitals, most o ...
s, the incidence rate of toxemia dropped from 9 percent to 1 percent. Dalton refused use of
progestin A progestogen, also referred to as a progestagen, gestagen, or gestogen, is a type of medication which produces effects similar to those of the natural product, natural female sex hormone progesterone in the body. A progestin is a ''synthetic co ...
s (
synthetic Synthetic things are composed of multiple parts, often with the implication that they are artificial. In particular, 'synthetic' may refer to: Science * Synthetic chemical or compound, produced by the process of chemical synthesis * Synthetic o ...
progestogen Progestogens, also sometimes written progestagens or gestagens, are a class of natural or synthetic steroid hormones that bind to and activate the progesterone receptors (PR). Progesterone is the major and most important progestogen in the body. ...
s) in treatment as she believed they were the cause of side effects. She preferred bio-identical, or natural progesterone. In addition, Dalton only supported the use of natural progesterone as she claims that only natural progesterone fit progesterone receptors. Most of her treatments used generous doses of progesterone as she believed that there was no unsafe dose, with 400
milligrams The kilogram (also kilogramme) is the unit of mass in the International System of Units (SI), having the unit symbol kg. It is a widely used measure in science, engineering and commerce worldwide, and is often simply called a kilo colloquially. ...
via
suppository A suppository is a dosage form used to deliver medications by insertion into a body orifice where it dissolves or melts to exert local or systemic effects. There are three types of suppositories, each to insert into a different sections: rectal su ...
being the minimum dose. Other positive effects of progesterone include increased hair growth and treatment of
brain trauma A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic br ...
. After her work on PMS, she turned to
postpartum depression Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and chan ...
(PPD). The large drop in hormone levels after giving birth can cause new mothers to feel symptoms of tiredness, irritability, and depression, similar to PMS. According to Dalton, these symptoms are considered mild, whereas more severe symptoms can include anxiety as well as changes in personality. In addition, she states that approximately three in one thousand new mothers may experience more severe symptoms of PPD referred to as postpartum psychosis. Symptoms of this psychosis may include hallucinations, thoughts of suicide, and even thoughts of killing their newborn child. Dalton suggested using progesterone therapy to prevent this from happening, usually starting after the end of labour. Her proposed therapy was intended to help slow the speed at which the
progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...
hormone naturally drops. Katharina Dalton published many books including: ''The Menstrual Cycle'' (1969); ''Premenstrual Syndrome and Progesterone Therapy'' (1977); ''Once a Month: The Original Premenstrual Syndrome Handbook'' (1978), which became a best seller, and ''Depression after Childbirth: How to Recognize, Treat, and Prevent Postnatal Depression''.


Personal life

After the death of her first husband, Dalton married Tom Dalton, who died in 1992. She had four children, Michael, Thomas, Wendy, and Maureen. Dalton also had five grandchildren, including the British MEP Daniel Dalton. On 17 September 2004, Dalton died in
Poole Poole () is a large coastal town and seaport in Dorset, on the south coast of England. The town is east of Dorchester and adjoins Bournemouth to the east. Since 1 April 2019, the local authority is Bournemouth, Christchurch and Poole Counc ...
at the age of 87.


References


External links


The Times' obituary: Dr Katharina Dalton


NY Times obituary for Dr. Katharina Dalton

Los Angeles Times obituary for Dr. Katharina Dalton

"In Memory: Dr. Katharina Dalton"

"PMS Researcher Dies at 87" {{DEFAULTSORT:Dalton, Katharina 1916 births 2004 deaths 20th-century British medical doctors English medical writers Women medical writers Place of birth missing Place of death missing English women medical doctors 20th-century women physicians 20th-century British women writers 20th-century English women 20th-century English people