Only in this century have so many women lived beyond reproductive age. Cultural upheavals in industrial nations have made reproduction an option, a hygienic issue, and the ending of reproductive capacity a crisis of aging. A woman's hormonal milieu changes during her climacteric and beyond with multiple potential symptomatic consequences. Treatment with hormones can ameliorate the symptoms of menopause and potentially decrease the risk for the long-term consequences of the menopause. Objective scientific data for absolutes regarding hormone replacement therapy are lacking, but, increasingly, this epoch in the physical and emotional life of a woman is being defined by new cultural expectations.