ABSTRACT
I. INTRODUCTION The cessation of menstruation is termed the menopause, the median age of which is 51 years in the United Kingdom, whereas the climacteric (or perimenopause) is the transitional period leading up to this, during which ovarian function ceases and symptoms of ovarian failure may become manifest. The sequelae of this decline in ovarian estrogen production can be classified into acute vasomotor symptoms (i.e., hot flushes and night sweats), intermediate symptoms (e.g., sleep disturbance, memory loss, and symptoms associated with atrophy of the lower urinary tract and loss of collagen from connective tissue), and the more chronic problems of osteoporosis and ischemic heart disease (Table 1). Presently, hormone replacement therapy (HRT) is the most effective intervention for the relief of estrogen-deficiency symptoms; if taken long-term, it will prevent postmenopausal osteoporosis.
