Symptoms tend to lie, in the sense that their severity does not equate with or reflect the severity of the hormonal changes that underlie them or of the menopausal health risks that they directly fuel.

 About one third of women experience no noticeable symptoms of menopause. This does not mean that they have been fortunate enough to evade the menopause are its associated long-term complications. Those who congratulate themselves on avoiding the menopause are incorrect. And when drugs or hormones are used to control hot flashes, the fact that the flashes have been reduced or eliminated does not imply that equally beneficial effects will accrue in terms of long-term complications. Even those who reject treatments for flushing ultimately escape from them, & in symptomatic women flushes can be controlled with just tiny amounts of hormone, doses so low that they can do little or nothing to reduce long-term complications. Fortunes are being made marketing herbal products for the control of flushing and indeed they are effective, though to a degree no better than that of placebo.