WOMEN'S MIDLIFE HEALTH: Reframing Menopause


  • Mary Ellen Rousseau CNM, MS

    Associate Professor, Corresponding authorSearch for more papers by this author
    • Mary Ellen Rousseau completed her midwifery training and master's degree at Columbia University in 1975. She is an associate professor at the Yale School of Nursing and a nurse-midwife at Yale New Haven Hospital where she runs the Women's Midlife Clinic.

  • CNMs/CMs and midwives as used herein refer to those midwifery practitioners who are certified by the American College of Nurse-Midwives (ACNM) or the ACNM Certification Council, Inc; midwifery refers to the profession as practiced in accordance with the standards promulgated by the ACNM.

Yale University School of Nursing, 100 Church Street South, P.O. Box 9740, New Haven, CT 06536-0740.


In primary care and gynecologic settings, midwives will manage the care of women during the perimenopause transition as well as throughout the postmenopausal period. As such, they will need to understand the issues that are at the heart of the debate regarding menopause and aging. This article reviews the endocrinology of menopause, the history of menopause treatment in this century, and the various physical, psychological, and role changes that accompany the developmental processes of menopause. Bleeding pattern changes, hot flashes, sleep disturbances, and genital, skin, and weight changes are discussed. Sexuality, breast, cardiovascular, skeletal, as well as hormone therapy issues are examined. The basics of the midlife health office visit are included.