The menopause and hormone replacement therapy.

The menopause is the transition from the reproductive to the non-reproductive stage of life in women and is characterized clinically by permanent cessation of menstruation and biologically by loss of ovarian function. The menopause occurs around a mean age of 50 years; virtually all women by the age of 55 years or so will have experienced the menopause. The changes in birth and mortality rates over the last century and, in particular, the profound decline in maternal mortality in developed countries have resulted in an average life expectancy ofwomen ofabout 75 years; thus, most women will be postmenopausal for one third of their lifetime. Such women (9 million in England and Wales) now comprise about 18% of the total population. The aim of this review is to highlight current issues concerning the menopause and hormone replacement therapy, hence literature cited is not intended to be comprehensive but indicative. This article will briefly describe the epidemiology of the menopause, summarize the epidemiological data concerning hormone replacement therapy, the questions these raise and the implications these have concerning health in postmenopausal women.