Objectives: To investigate the attitudes and symptoms associated with the menopausal transition in Guatemalan and Costa Rican women and the therapies used to treat these symptoms. Methods: As part of an NIH funded project, interviews of women, midwives, healers and medical personnel were performed. Plants used to treat menopause were collected in Guatemala and Costa Rica, extracted and tested. Results: Women living in Central America have a more positive attitude toward menopause that their U.S. counterparts. While women in Guatemala have slightly fewer symptoms, women in Costa Rica have menopausal symptoms similar to that observed in U.S. women. However, neither women from Guatemala nor Costa Rica use HRT extensively and use herbal products instead to treat the symptoms associated with menopause. Plant species used as symptomatic treatment were collected and tested for potential biological activities. Many of the herbal remedies were active in multiple bioassays, suggesting a pleotropic and plausible mechanism of action for the treatment of anxiety, depression, vasomotor symptoms associated with the menopausal transition. Conclusions: Women in Central American countries have similar symptoms during menopause as their U.S, counterparts but have a more positive outlook on the transition, as it marks an end to the reproductive years and allows for more sexual freedom. These women however, do not use HRT to any great extent, but opt for more natural therapies such as herbal medicines and massage. Many of the herbal products used appear to have a plausible mechanism of action
