Years of involvement, firsthand experience and research at the Menopause Clinic of the Groote Schuur Hospital, Cape Town, exist as the background to this book. The Clinic itself, however, as one of the first in the world to be established, if not the first, has a story and a lesson of its own to offer, and is therefore deserving of a brief description as the preface to the book. In 1967, shortly after Christiaan Barnard had completed the historical first human heart transplant at the Groote Schuur Hospital, I happened to be in West Berlin and was invited to visit a major international pharmaceutical firm. A new female hormone was mentioned, and thereby started my interest in the subject. Upon my return to Cape Town, I spent many hours in the large medical school library and completely surveyed the menopause literature to 1967. I was stunned by its general inadequacy and was bitten by a challenge to clarify what menopause really was, and to define the proper place of hormone replacement therapy.

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