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Dr. Lax began the panel discussion by placing menopause in a historic perspective. She pointed out that menstruation and menopause were scientifically understood and explained only after the discovery of the active ovarian hormone estrogen in the 1920s. Thereafter, hormone replacement therapy (HRT) brought about the amelioration of the most pervasive symptoms which, with varying intensity, affect about 75 percent of women. About 25 percent of women have no symptoms (Mullen and Mitchell, 1976).
How a woman responds to the changes brought about by menopause depends on her individual psychic makeup and on sociocultural factors. The significance of stereotypes, unconsciously internalized, is very powerful in determining the roles and the goals to which a woman will aspire.
While many cultures throughout the world still dictate a role for menopausal women, women in the Western world have a wide range of medical, psychic, and social options available.
Analysis of women during the menopausal phase indicates that it is typical for women to attempt to deny the bodily changes and concomitant affective reactions of menopause. The conflicts women experience are frequently expressed in their dreams and associations. Bodily changes accounting for the disequilibrium of the menopausal phase have a profound effect on a woman's psychic reality even when the physiological symptoms are alleviated by HRT.
Denial is women's primary defense, evoked by feelings of loss and limitation imposed by the menopause. Denial is often expressed by an increased level of activity, a career shift, a belief that one can “reinvent oneself.” Such behavior, an enactment