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The menopause and its treatment in perspective

1For either gender, ageing is the primary factor influencing disabilities related to cardiovascular disease, arthritis, Alzheimer’s disease, visual and hearing problems. As far as women are concerned it is expected that more such disabled women will live after the menopause, which is increasingly found to be a confounding variable and the treatment of which may profoundly influence the clinical progress of such disabilities. With the expected increase in postmenopausal population over the next 30 years, the health issues modulated by the menopause have moved from a peripheral medical interest into a central health care programme that commands a diVerent strategy for resource allocation and for service delivery. Pathophysiology of the menopause From the age of 35 years onwards there is a progressive increase in the level of follicle stimulating hormone indicating a reduced amount of eVective oestradiol and inhibin B production. 2