Background: To describe the incidence and understanding of early postmenopausal symptoms in rural Xhosa women.

Methods: After written informed consent, 137 women were interviewed within five years after natural menopause using the Greene Climacteric Scale. Body mass indices were calculated, and blood levels of FSH, LH and oestradiol were determined.

Results: The mean age of menopause was 50 years amongst the 118 women who met the study criteria. Ninety-four (80%) patients experienced hot flushes, with 20% describing them as extreme. Sixty-nine percent of patients experienced nocturnal sweating. Most of the women (111; 94%) had never heard of hormonal therapy. Serum oestradiol levels rose with increasing body mass index, but did not achieve significance.

Conclusions: These rural South African women experienced the menopause at a comparable age to Caucasian women. Although they had a high incidence of vasomotor symptoms, they were unaware of the potential benefits of hormonal therapy.