The term menopause refers to the final cessation of menstruation, either as a normal part of aging (loss of all follicles and ovarian function) or as the result of surgical removal of both ovaries. The average age at menopause in Western societies is 50-52 years. Menopause is associated with a loss of menstruation hormone levels, leading to potential problems of hot flashes, increased risk for osteoporosis, heart disease, Alzheimer's disease, dry vangina, night sweats, and decreased interest in sex. Hormone therapy improves emotions, decreased vasomotor symptoms, somatic symptoms, depression and reduces the risk of death and disability associated with osteoporosis and coronary heart disease. Quality of life is very important for women at the menopause and estrogen replacement therapy (ERT) offers substantial improvement in many aspects.