This chapter presents the factors relevant to assessing sleep problems in the menopausal transition that have changed over time. Expectations regarding menopause have changed over time, particularly since the advent of hormone replacement therapy. Increasing interest in reproductive aging and the advent of women's health as a specialty has led to a great deal of research on the menopausal transition. It is possible that there has been an increase in sleep disturbances in women across all menopausal status categories, but that the rank order of increasing prevalence of sleep problems among pre-, peri-, and post-menopausal women prevails. Preliminary analyses from the "Sleep in Midlife Woman" sub study, with biannual in-home polysomnography, continue to support the hypothesis that the risk of sleep apnea increases with advancement through the menopausal transition. There are important clinical implications from current thinking on sleep in the menopausal transition.

This chapter presents a discussion between experts on ageing. Data from women who have late menopause suggest they have better health fitness afterwards. That is, they live longer and appear to be healthier. On the topic of association between longevity and late age at childbirth, Jane Preston says that women did not have more children within their extended fertile period so they were not becoming more fecund during that time. Everything about ageing that we understand from animal models, and human populations, suggests that the menopause has not evolved as a result of some killer gene. Ageing is seen as a non-adaptive process by which repair mechanisms and other mechanisms just fail to be supportive at a sufficient level to keep us going a bit longer. All ageing theories are non-adaptive and ageing is a by-product of what has gone on earlier.