Nearly one-half of an American woman's life is spent after the cessation
of reproductive function. A woman of 40 years has an additional life
expectancy of nearly 40 years; a woman of 75, over 11 years. This
pattern of longevity is likely to continue, so that by the year 2000, it
has been estimated, 30 percent of the female population will be
postmenopausal. While it is difficult to separate the results of aging
from those of estrogen deprivation, it is important that we try to do
so, since the results of the latter are amenable to treatment. The
medical infirmities resulting from estrogen deprivation take a high toll
among postmenopausal women. Nearly 200,000 hip fractures occur annually
in this group, resulting in 15,000 deaths and a high morbidity rate.
Sleep disorders, compromised sexuality, psychomotor alterations of the
climacterium, and urinary tract disorders all contribute to a lowered
quality of life. Appropriate treatment of these disturbing
postmenopausal conditions requires an understanding of the underlying
bio- chemical, endocrinologic, psychologic, and pathophysiologic al-
terations of estrogen deprivation. Toward this end, the reader will find
herein chapters dealing with estrogen metabolism in the postmenopausal
female, end-organ response to estrogen deprivation, and bone metabolism
and osteoporosis. Next, the reader will find chapters dealing with
specific or- gans, organ systems, or conditions related to the quality
of life; for example, sexuality, urinary tract problems, sleep
disorders, the breast, sports and exercise, the climacteric, and the
psycho- biology of the menopause.
