Menopause is a normal biologic event marked for most women by the end of menstrual periods, and it signifies the depletion of functional ovarian follicles that are responsible for estradiol production. It is, in essence, the complementary event to menarche, the beginning of the menstrual years. Although the technical definition of menopause is the last menstrual period, the more clinically useful view is to consider the months or years surrounding this marker event.

There has been an explosion of interest among investigators, clinicians, and women themselves about all aspects of the menopause—endocrinologic, metabolic, pathologic, sociocultural, and psychological. Of particular interest for clinicians is the role of hormone replacement therapy (HRT) in the management of symptoms. This article presents an overview of each of these areas aimed at helping clinicians to respond better to inquiries from patients and to plan better for educational, screening, and preventive interventions.

Much contemporary interest in menopause is actually directed at the postmenopause and the medical illness common to postmenopausal women that may be affected by endogenous or exogenous hormones. The most commonly discussed conditions are osteoporosis, coronary heart disease, and breast and endometrial cancer; interest has emerged in the effects of hormones on Alzheimer's disease, and surely others will be added to this list as more epidemiologic studies look for associations. This article summarizes what is known about hormone therapy and these conditions.

Finally, women experience menopause as individuals, and care should be taken not to make inappropriate generalizations. For one, women become menopausal in a variety of ways, and for another, menopause is experienced across a wide age range, occasionally as early as the 30s or 40s, or as late as the 60s. Therefore, women face this event under variable life circumstances.