The climacteric woman faces a variety of clinical problems that are thought to be associated with the decline in estrogen production and function that follows the menopause. These include osteoporosis, arteriosclerosis, mucous membrane deterioration, disorders of the skin and genitourinary system, as well as psychological difficulties. When one considers that at the time of the 1970 census, of the 104 million women in the United States 27 million were 50 years old or more—and each woman at age 50 has an expectation of living an additional 28 years—the magnitude of the public health challenge that the menopause presents can be appreciated. In reaction to this challenge and despite the fact that the mechanisms by which the disorders of aging relate (if at all) to waning estrogen are either unknown, uncertain, or disputed, the use of empiric estrogen "replacement" therapy has been advocated to relieve or retard some or all of
Kase N. Estrogens and the Menopause. JAMA. 1974;227(3):318–319. doi:10.1001/jama.1974.03230160046013
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