Abstract
THE RAPID increase in life expectancy of women and the increasing proportion of older persons in the population have stimulated increased attention to the proper management of the menopause. It seems appropriate to discuss not only the therapeutic problems arising at the time of cessation of the menses but also the management of the post-menopausal state. The fundamental change at the menopause is a decreasing frequency of ovulation followed later by a decline in estrogen production by the ovary. These events are reflected clinically by a change in the menses which may consist of sudden cessation of normal periods, irregular and profuse menstruation, or scanty and infrequent periods. Eventually permanent amenorrhea ensues. The other classic symptom of the menopause is the hot flash, which is usually described as a sudden sensation of heat in the face, neck, and chest associated with diffuse or patchy flushing of the skin, and
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