The menopause transition.

The menopause transition is a period of life during which a series of dynamic changes in physiology are taking place. There seems to be a transient increase in symptoms of many types, which are occasionally severe. There is a disproportionate burden of morbidity that seems to accrue to women of high body mass index and low socioeconomic status. Moreover, there are ethnic differences in hormones and symptoms that may reflect either basic biologic variation in hormone receptors and actions or the different social milieu that women in different ethnic groups experience. Current medical management of the perimenopause should include screen-ing for general health maintenance, avoidance of weight gain, and a holistic approach to symptoms.