There is a historical literature on the menopause, although this has been bound within the taboo that the subject has always represented. The availability of Hormone Replacement Therapy has played a part in challenging the taboo of the menopause so that it can now be more openly addressed. This paper presents clinical material collected over considerable time that mirrors both the emergence of the subject into greater focus and the development of the author as a clinician. Originally a research project during training, it offers an economic model of working through a potentially painful life event, to discover creative opportunities. This involves acknowledging some of the emotional difficulties that include dealing with issues such as loss, envy and death. Whether the patient brings this passage to treatment as a problem, or whether it occurs during the course of treatment for other, overt reasons, it offers women a chance to negotiate a greater psychological maturity by making use of an in-built biological advantage.