The climacteric is characterised by a variety of distressing subjective symptoms, the most disruptive being the episodic vasomotor symptoms of hot flushes and sweating, which are experienced by 50% to 70% of women.1 Although the exact cause of these symptoms is not known, several theories have been suggested, including oestrogen deficiency,2 alteration in the hypothalamic thermoregulatory centre,3 and changes in the peripheral and central mechanisms dependent on prostaglandins that stimulate the release of gonadotrophins through the hypothalamus.4,5