The menopause is an inevitable event in the lives of all women. For some, it is very positive, ending menstruation, the need for contraception and the threat of unwanted pregnancy. But for others, it is a time of unpredictable hormone activity, and troublesome and unpleasant symptoms that seriously compromise quality of life. This article discusses the options available to women to manage their health and well-being during the menopausal transition or perimenopause.