If it is intuitively correct to defer to outside authority figures, indulge in wishful thinking about eternal youth and beauty, and that life-long chemical obliteration of a natural life process is good, proper and necessary, then you will be making the right choices for yourself to take menopausal drugs as this is how vast majority of MDs in America also present their use.  Christiane Northrup only asks you survey and inventory your life -in its entire context- before you assign blame and fault to one particular organ system or seek answers in pharmaceutically shrouded denial. 

        As, I think, the oldest woman here (63) and more than likely the longest postmeno, I would like to offer my perspective on this. 

        Joan speaks of "menopausal" drugs but given the varying definitions of menopausal I'm going to split them into perimenopausal and postmenopausal. Personally I never experienced perimenopausal drugs, had years of postmenopausal drug-free stability then two sorties into "preventative" HRT, the first the standard Premarin and Provera, the second "natural" i.e. estradiol (Estraderm) and micronised oil-based progesterone (Prometrium). This gives me I think a unique advantage, in that I have two stable baselines and can not only compare the effect of HRT v. no HRT but P&P. v  E&NP. 

        Many people have given reports on the physiological pharmacological effects of these drugs, though usually these are muddied by the uncertainty about the varying levels of endogenous hormones. I shall not repeat these except to say that P&P was an experience I was happy to abandon - because of the provera. E&P caused me no physical difficulties so it was on  purely philosophical grounds because of their psychological/emotional effects that I started to cut back on them. Interestingly, the induced periods started to become uncomfortable around the same time and an ultrasound revealed multiple small fibroids - but this was not why I started to quit (slowly, after my experience quitting P&P) 

        So what are these emotional/psychological effects for me?  I became much more focussed and inclined to nitpick. I was more interested in things being logically correct than them being morally right or kind. I was more interested in the topic than the person. In short I was heading back to the me that was before meno - the me that people feared and misunderstood and accused of hostility when I intended none. Sure I got things done faster, was more efficient and would have made a mighty fine business woman (assuming I could keep any customers/clients!) but what the heck I'm retired! My work now is to support and guide. I have said repeatedly (see dejanews) that I've doubted the desirability of sharpened cognition for me, largely because a sharper focus reduces the field of vision - I was beginning to fail to see the forest for the trees. 

        Age brings greater experience and with it the possibility of wisdom which I am inclined to define as a greater "knowing" as opposed to "knowing about", an ability to realize the total interconnectedness of everything, and particularly, a tolerance born of vision of the greater picture. I had, and have, some of this but the the big "but" is that while on HRT (E&NP) I found myself fighting my "own" hormones. I knew what was right (wisdom-wise) but my hormonal altered brain didn't want to pay attention. I found myself disapproving of myself and increasingly convinced that for me at least  taking hormones for no other reasons than the doctors thought it would be good for me in the future was not the way to go. Many older women have reasonably decided that they don't want to continue having periods, but I haven't heard anybody say (that's not to say they haven't thought it) that they don't want to stay middle-aged. The way I saw it, that is what HRT was doing to me. Heavens I was even having "perimenopausal" doubts and mood swings... 

        As for perimenopausal use of drugs - unless the physical symptoms are truly unbearable, I think the use of drugs must be counterproductive. I had an emotionally painful peri which forced me into deep contemplation and reading in an attempt to explain and relieve the pain and I emerged greatly freed and much more "together". 

     Joan speaks above of "pharmaceutically shrouded denial". I think she's meaning denial of aging - I wasn't doing that (OK Joan, I know - not consciously anyway;-) but I can certainly imagine drugs doing a great deal of shrouding of whatever - if the (emotional) pain is tempered the inner work becomes avoidable.  My emotional problems had been ignorable until the hormonal shifting exacerbated them. 

    I do believe that (nonphysical) discomfort (to the level of suffering if necessary)  is necessary for growth, masochistic though it may sound at first hearing. I'm not setting out to seek suffering, but without it, I for one will stagnate. Accordingly, MY view is that NO WAY should drugs be taken just because one is 50 or one's FSH is the arbitrarily determined magic number. I see that as a sure way to ongoing doubt and fear of what is ahead - a chemically induced limbo in fact. ;

 vlhb00n