The perimenopause: definitions, demography, and physiology.

The perimenopausal years should serve to remind patients and clinicians that this is a time for education. Certainly preventive health care education is important throughout life, but at the time of midlife, a review of the major health issues can be especially rewarding. The failure to respond appropriately (by either clinician or patient) easily leads to a loss of the patient from a practice, but equally, if not more importantly, is the probability that the loss of a patient from a practice means that another woman has lost her involvement in a preventive health care program. Contrary to popular opinion, the menopause is not a signal of impending decline, but rather a wonderful phenomenon that can signal the start of something positive, a good health program.