Menopause, a global perspective.

This paper attempts to provide a global perspective of the menopause as a period in a woman's life. It is growing in length, year after year and there is a need to place these years in the overall context of ageing. There are many fallacies about ageing. The most serious is the view describing old people exclusively as a burden for society, when in fact they can and should be considered as a resource. Women live longer almost everywhere in the world. Growing evidence indicates that the process of ageing differs in a considerable way in the two sexes. This difference may, at least in part, be due to sex-related differences in the regulation of stress response mediators. In addition, variability in the mitochondrial genome also displays a sex-specific impact on longevity. Restricting the discussion to longevity in the female, a paramount role must be given to sex hormones in improving a woman's ageing. Indeed, it is the fall in oestradiol production that qualitatively changes the ageing perspective in the human female, since oestrogen secretion plays a major role in guaranteeing a woman's psycho-physical equilibrium during the fertile period. These considerations represent the philosophical basis for post-menopausal hormone replacement therapy.