Is there a menopausal medicine? The past, the present and the future

The menopause is not a disease. However it is the onset of risks for the diseases that are more prevalent after the fifth decade of a woman's life. These are due both to the natural process of ageing and to the lack of the protective effect of estrogens that are then secreted in much lower amounts. Estrogen treatments after the menopause should not be considered as replacements, since hypoestrogenism is physiologic after age 50. They are only treatments with sex hormones, with specific indications, as there are also recommended treatments without hormones. This clarification of concepts is essential in order to emphasize that hormonal treatments after the menopause are not obligatory and may have good alternatives too. Thus, the ongoing discussion should not be about the pros and cons of long-term hormonal treatments but, instead, about what is best for the preservation of health, the prevention of diseases and the maintenance of a good quality of a woman's life after age 50. (C) 2002 Published by Elsevier Science Ireland Ltd.