The effects of hormonal gyrations during the years surrounding menopause can be extremely powerful and disconcerting. This is especially true if a woman interprets the changes as signaling the "end of life" rather than a "change of life." Three or four generations ago menopause did signal the beginning of the end. In 1900, the average age of menopause was 46, and the life expectancy of women was 51. But today, most women can expect to live one-third of their lives after menopause. According to medical expert Dr. Leon Speroff, "the menopause should and can mark the beginning of a new and promising period of life, relatively free from previous obligations, ready for new career choices, more education, and new ventures."

Many of the upsets of the menopausal period can be regarded as temporary inconveniences that most women find they can manage quite well on their own. A good understanding of what is happening to your body and how other women cope with these changes can help with the adjustment. So can an understanding doctor who can make recommendations tailored to your particular problems, health history, and life-style.

There is no totally "normal" menopause; each woman experiences this transition somewhat differently. A woman's final menstrual period commonly occurs between ages 45 and 55, but the process that leads up to menopause occurs gradually, easing the body's adjustment to shifting hormonal patterns. Women are affected in varying degrees by the uncomfortable symptoms that can accompany menopause, such as irregular menstrual cycles, hot flashes, disturbed sleep patterns, vaginal discomfort, and the emotional difficulties these problems can cause.

Some women barely notice the changes and experience no interruption in their daily routines, but about 60 percent of women approaching the age of menopause experience some symptoms due to biochemical changes taking place within. Symptoms often subside naturally as the menopausal years progress. Other women experience symptoms suddenly or very intensely, and seek medical relief for their debilitating effect.

The discussion that follows focuses on the most common symptoms of the menopausal period and the non-pharmaceutical strategies that can relieve them. For more information on pharmaceutical remedies, see "Hormone Replacement Therapy: Weighing the Pros and Cons.''