Pieter van Keep Memorial Lecture. Menopause--a modern perspective from a controversial history

The major milestones in the history of menopause provide a fascinating background to understanding current attitudes and prognosticating future trends in the perception and management of this event through which all women will inevitably pass. 'Menopause' is a word of multiple meanings. Once the subject of taboo; now almost in danger of overexposure. Once neglected, now recognized by multiple groups as the entry to a 'market'. The result is a new level of confusion and even exploitation in the minds of the health profession and the public alike. A historical survey of issues relating to the menopause is therefore an ideal vehicle for providing information and perspective into this fascinating and extremely important component of women's health care. One milestone on my personal historical journey is labeled 'Pieter van Keep', a time and a place where we met, forged an instant and remarkable friendship and during the course of an extraordinary day conceptualized a menopause club, ultimately the International Menopause Society (I.M.S.), a journal to become Maturitas, and an idea for enhanced quality years for women by primary preventative health care, utilizing menopause as a positive entry point. Achievement of the dream of wide scale introduction of preventive health care services to a properly informed public is certain to be as successful in reducing morbidity to older women as was the introduction years ago of proper prenatal care in reducing death and disability related to childbirth. Where we were, where we are generally and the I.M.S. specifically, and where the I.M.S. should position itself in the future is the focus of this lecture, my personal 'swan song' to the I.M.S.