The adaptive function of the menopause: a devil's advocate position

The menopause may be adaptive, in that it minimizes exposure to endogenous estrogen. However, ageist and sexist assumptions have distorted society's perceptions so that the menopause has come to be viewed as a "deficiency disease," best treated through the routine prescription of estrogen replacement therapy. Recent evidence suggests that menopausal discomfort has been exaggerated, and that most reported symptoms are not directly attributable to declining estrogen levels but to other biologic and social variables. A change in perspective might have the beneficial consequence of providing women with effective, and probably safer, forms of therapeutic intervention.