The symptomatology of the menopausal period can vary greatly. Consequently, the quality of life is affected differently in different women. There are many women who transition into, and through the various phases of menopause, without hardly any complaints, while others can be almost completely incapacitated. Why this difference, is still largely unknown!

The earliest signs, related to menopause, are usually vasomotor symptoms, which, not infrequently, precede true menopause (the cessation of menses) by as many as 5-10 years. This means that women, who perceive themselves still to be long before menopause, already experience significant symptoms. Indeed, such women, often still menstruating in a rather regular pattern, are frequently the most symptomatic women. Because they don’t perceive themselves as “in menopause”, and because they are also often not diagnosed by their health care provider as in need of treatment, they not infrequently fall in between the cracks of the health care system and don’t receive the rather simple supportive care that can significantly enhance their quality of life during these very demanding years of early perimenopause.

The adjacent table summarizes many of the most classical vasomotor symptoms and some of their most dramatic consequences on quality of life.

Modified from Wysocki and Thorneycroft, The Forum 2005; 3:18-25

In a study of 2602 women above age 45 (remember, the average age of true menopause is 51-52 years!), hot flashes were the most frequently reported symptom (63%), followed by night sweats (48%), a symptom usually occurring a few years after the onset of hot flashes, and sleeping difficulties (41%). While roughly one third of studied women used no medications for relief of their symptoms, 46% utilized alternative treatments from the standard medical therapies usually prescribed by physicians (Keenean et al., Menopause 2003; 10:507-15).