This issue contains a wide range of exciting articles, involving diverse aspects of postreproductive health, from evolutionary theory, DNA genetic sructure to micronutrients and quality of life measurement.

Selenium, an essential micronutrient; has received considerable attention for its antioxidant properties and effect on glucose homeostasis and lipids; the paper by Placido Llaneza and colleagues evaluates whether there exists a relation between serum selenium levels and quality of life in overweight and obese postmenopausal women. Additional research will be necessary, with longitudinal design studies.

In an important and original study into the genetics of natural menopause, Mendoza et al. initially confirmed prevailing views that no single genetic locus was significantly associated with age at natural menopause (ANM). They go on to examine the significance of potential interactions between nine genetic markers (point mutations giving rise to ‘single nucleotide polymorphisms’) at six genetic loci, including two (NRIP and BMP15) that the authors newly propose as candidate genes for involvement in ANM. They found several statistically significant associations between these genetic markers, and again newly demonstrate what appears to be a significant role in determining ANM for specific polymorphisms within the NRIP and BMP15 genes. They conclude that complex genetic interactions between estrogen-related genes may contribute to ANM. The findings introduce new possibilities for further research, in particular the relevance of the newly linked loci, NRIP and BMP15, would appear to merit further large-scale purpose-designed studies.

Indeed, one reviewer would recommend that geneticists extend such studies to include the influence of human endogenous retroviruses (HERVs), which are proving to be significant in placentation, pregnancy and human embryology. The potential for estrogens and other female hormones to act as signals, coupled with the fact there are endocrine receptors on most, if not all, HERVs would lead to one question whether HERVs might also be involved in menarche, the menopause and other aspects of the female reproductive cycle.

The menopause competence framework, from the Royal College of Nursing, described by Philomena McFall and Kathy Abernethy in their editorial and article will help nurses identify their level of practice and define personal education and development needs. This can only improve standards of holistic care for women across all settings. The framework is a dynamic document that will hopefully evolve as it is used. Comments and suggestions are welcomed.

With the increasing incidence and mortality rates from endometrial cancer in the UK, guidelines for investigating postmenopausal bleeding (PMB) are regularly formulated and reviewed. Gale and Dey address the impact of postmenopausal bleeding on clinical services and review the currently available modalities of investigation. While PMB is considered by clinicians as predictive of endometrial cancer, women's understanding of postmenopausal bleeding and endometrial cancer is yet to be addressed. The authors review the few studies published on women's knowledge of the topic and conclude that there is a need to raise women's awareness and to further develop care pathways.

With the increasing maternal age in Western societies and the ever advancing assisted reproduction techniques (ARTs), the clinical management of pregnant women of this age group pose several challenges to obstetricians. Tower proposes that the risks and complications of pregnancy in women of these age groups should be distinctively considered according to whether the pregnancy was a result of ART or spontaneous. She provides an in-depth analytical comparison of the risk association in each case and suggests that in the absence of evidence to guide the best practice, management of pregnancy in this age group should be on a case-by-case basis.

The association of endometriosis, its management and the menopause continues to raise debates and often various concerns. Palep-Singh and Gupta address these concerns and review the perceived adverse effects of estrogen therapy after endometriosis in the menopause and critically appraise the evidence. They conclude that the beneficial effects of HRT on quality of life should outweigh the low chance of recurrence.

The menopause is an isolated event in a much wider process that was an evolutionary adaptation essential for survival in the Pliocene. As a reproductive strategy it is largely vestigial in the 21st century, part of an era that has seen a doubling of the average human longevity compared with that of the past. Laurence Shaw and Sebastian Shaw's paper on the evolution and anthropology of the menopause has common themes with Simon Brown's news on the EEC's realization of the demographics of 21st century ageing and the menopause. Though a world away from WHI, or God forbid, the Mellon women study, Shaw poses very pertinent questions as to our long-term management of postreproductive women's health over prolonged life span. Evolution and genetic selection are similar themes in the Mendoza and Shaw articles, though approaching the topic from very different angles.