On menopause

It was a welcome surprise to see a full-page series of articles on menopause (Sunday, Jan. 26). I applaud your interesting and thorough reporting as well as your willingness to feature information about often ignored midlife women's issues. However, I think some points need clarification.

First, ovaries do not, as suggested, "stop functioning" at menopause. Rather than a sudden change, the process begins in a woman's mid-20s and estrogen then slowly decreases throughout her life. Menopause is not sudden "ovarian failure", which causes unnecessary alarm for many women.

The articles also referred to the "symptoms" of menopause. This term is incorrect. Menopause is not a disease with symptoms, but rather is a biological process with "signs". And menopause depends upon individual factors: lifestyle, heredity, diet, personality and body type. And as with any process, self- knowledge, education, understanding, and acceptance can ease the transition.

One article also said "another inevitable symptom of menopause brought about by low level estrogen is vaginal dryness," and the article suggested using an estrogen cream to counteract this "inevitable symptom". Vaginal dryness is not inevitable, and to suggest that it is, along with your words about how to "cope" when menopause "strikes" will only serve to alarm people unnecessarily. Your strong words and misinformation may only serve to isolate further the women (and men) you are intending to educate. Vaginal dryness may occur during menopause, but there are water-based products available which are cheaper and more natural than estrogen creams.

Your articles rightly referred to the fact that menopause carries the unspoken social stigma: You are getting old. But, this normal process can instead be seen as a time for creative growth and change. In fact, Margaret Mead referred to "post- menopausal zest", and I understand exactly what she means. For myself and many middle-aged women with whom I come into contact, menopause is a powerful, exciting experience. Many midlife women utilize menopause as a time to focus energy on the things which are really important.

Midlife is not, however, always easy for women and families. A lack of information and lack of self-understanding are among the factors which can exacerbate discomfort and signs of menopause. Women who experience problems certainly need help, and your articles are a welcome step in educating people that support is available. Yet it is important to realize that the media's coverage of menopause can also have negative side effects. For example, so-called "remedies" for menopause in pill and cream form are everywhere. Menopause is big business, particularly as the "baby boom" generation enters midlife.

Women must take responsibility and inform others that menopause is not a disease, and often it does not require medical intervention. We must educate men and women of all social classes, in all cultures, from all walks of life to correct misconceptions surrounding menopause. We must emphasize that Hormone Replacement Therapy is a choice, not a mandatory action. To begin this process, try reading some of the many excellent books on menopause and share your knowledge with friends. The caring support of other midlife women is the best therapy available, and it costs absolutely nothing.

TONI HARDY

ICAC Workshop/Training Coordinator

Jakarta

We used some terms in the articles on menopause based on a series of interviews with a number of medical experts and research on the subject. We don't intend to alarm people but to increase their awareness of various problems which are likely to be faced by women entering menopause.

-- The Editor