The peri-menopause is emerging more and more as a subject for study by the doctor, the psychologist, the social worker, the gerontologist, the clinical chemist, the public health specialist, the sociologist, the psychiatrist and the experimental pathologist. The results of studies are gradually becoming known to the public, particularly to the prospective clients, ageing women. Women have begun to ask for treatment and they will most likely determine whether oestrogen replacement therapy comes into vogue. Psychosomatics in peri-menopause is an important sub ject, since the life-span of the woman has extended to nearly twice that of her fertile period. The life-expectancy for women in industralized countries is now some 70-75 years. This means that most can now expect to spend one third of their lives in the post-menopause. Consequently, there is now much more time than before in which to notice, experience and be bothered by peri menopausal changes. Moreover modern medicine has much more to oner than mere moral support to sufferers from ailments connected with progressing ovarian failure during peri-menopause. Although we cannot promise eternal youth - as Wilson does -there are more possibilities for treatment than 10 years ago."

A. A. Haspe/s It is with pleasure that I welcome you, on behalf of Professor Rolland and myself, to Amsterdam for this International Symposium on 'Benefits and Risks of Hormonal Contraception'. As a means offamily planning the pill is about 25 years old - a timespan which has been characterized by an enormous increase in public interest and concern with family health and family-planning. Undoubtedly we have learned a lot over the last 25 years. As you see in Figure 1, in the seventies in Holland relatively more fertile women used the pill than in any other country in the world. In 1974 new combination pills were introduced containing less than 50 JAg of ethinyl estradiol. In 1981 50 % of Dutch pill users took a sub-50 (Figure 2). The same is true for the Scandi navian countries. In our own University Clinic 95 % of pill-users take a sub-50 pill; only 5 % use a 50 JAg pill on medical indication. This decrease in estrogen dosage, which is usually accompanied by a decrease of progestational component as well, has resulted in a decrease of thromboembolic disease. Factors that are still important to consider are diabetes mellitus, hypertension, adipositas and smoking. Good selection of patients together with the prescribing where possible of sub-50 pills may result in the numbers of compli cations and side-effects being close to those encountered in the control group.