The real time has come now that every gynecologist should take the word ‘Menopause’ more seriously. Reading, research and attending seminars will make them ready to be the best counselor for such aging women. If all doctors are properly trained as far as the management of menopause is concerned, more and more women will be benefited.

The purpose of writing this small booklet on menopause is for the busy gynecologists who are little away from treating this special group of patients of menopause. We are sure after reading this booklet in one single sitting, it will boost up tons of confidence regarding the subject and thousands of menopausal patients will be benefited by one single reader.

This small booklet is the result of knowledge gained after reading a large number of books on this subject ranging from Indian authors to International authors, publications of our FOGSI, journals, recent advances added with the personal experience gained by private practice and treating patients for a number of years, 8attending, and participating in workshops and seminars on this interesting subject.

For the details of each chapter, readers are requested to go through the textbooks.

Wishing you a good and grand new reading.

We are extremely thankful to Dr Khayati Trivedi, a graduate in Ayurvedic medicine for writing a chapter on Ayurvedic and Menopause.

We are also extremely thankful to Dr Milan Ganatra, a graduate in Homeopathic medicine for writing a chapter on Homeopathic and Menopause.

We are thankful to Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, for constant encouragement and provoking us to write this book.

Our better halves Mrs Jyoti Shah, Dr Nimish Trivedi (MCh Neurosurgeon) and Dr Dharmesh Solanki (DM Cardiologist) have provided us constant encouragement to come up with this novel subject.

We are thankful to our Trustees, Superintendent, Medical Director to encourage us to write this book. We are also thankful to number of other friends who helped us in many ways.

This clarifies that one-third of women's lifespan is again without hormones as it is in first fifteen years of her life known as pre-pubertal age. In lighter tone, 11menopause can be called as puberty PHASE-II. Third span of the life of every woman, i.e. from 45 years onwards, is very important phase, as she is experiencing physical and mental rest from her social jobs. She has passed her teenage life, enjoyed her marital and sexual life and has bared the stress of obstetric carrier-the most dangerous and risky phase of her life. It's all over; she is physically and mentally relaxed. And, one day suddenly she starts experiencing the difference; the difference is experienced by the things not happening in her body, i.e. menstruation. The world of women is being changed now. They do not want to be a silent sufferer of all these unpleasant and unwanted but compulsory troubles. They want themselves educated, to understand why and how it occurs and what the remedy for it is.

All these questions stimulated the gynecologist—the medical troubleshooters of women's health problems-to study more and more about the term menopause.12

Menopause is a normal, natural event—defined as the final menstrual period (FMP). It represents the permanent cessation of menstrual period, due to loss of ovarian follicular function usually due to aging. Ovary is the only gland in the body that stops acting before the life ends. Menopause can occur naturally-spontaneously to all women at around 50 years. It can be induced by medical intervention like surgically removed ovaries, chemotherapy or by pelvic radiation.

An estimated 6000 US women reach menopause every day (over 2 millions per year). In India, considering the population as one thousand millions, more than 10,000 women are entering the world of menopause daily. This is really alarming….

During the transition from the reproductive years to menopause and beyond, a woman experiences many physical and mental changes. She tries her level best to cope up all those changes in her own manner. May be because she does not know exactly whom to and where to inform and seek for help. Most of our colleagues are busy serving infertile couples and pregnant women. So, the need has been rightly arise for an experienced, matured group of gynecologist who can devote their time to understand and solve the problems of such millions of women in our society. Thanks to the researchers and active pharmaceutical groups to think constantly about this sector of senior women and coming out with many natural and synthetic molecules to relieve such harsh symptoms of today's era's elderly women.

The term climacteric describes the period when ovarian activity diminishes and there is loss of fertility and occurrence of menopause.13

More and more awareness of this phase of women's life has started gaining in Indian women of urban as well as rural population. This awareness is highly appreciable and eye opener for those who are thinking about the management of menopausal symptoms seriously.

The aim of this book is to stimulate interest in the word “Menopause” among both the groups of gynecologist—the seniors and the juniors. Awareness for menopause, why it occurs, what is the expectation 14of a woman approaching menopause, her experiences after the age of 45 years should be made more customized in a correct way to the society. Such women will then start coming to the doctors for their all problems of menopause, which otherwise they think it is useless to discuss them with the doctors.

Many times it also happens that such patients visit the gynecologist, but the doctor being busy with other medical or surgical practice may not pay much attention to her problems, they do not listen to them and internally they know that they can hardly help them. May be because of lack of latest knowledge in this field of menopause they do such things indecently. But by writing such books, we have humbly tried as a first step to provide the full primary knowledge about menopause, its physiology, symptomatology and its management in the most satisfying way. The book has been written in such a way that it can be read in one sitting. It can be kept in consulting room and revise more often for the management point of view. Few cartoons and caricatures are inserted to arouse you and keeping up the interest in the book.