Dr Margaret Smith has lived and worked in Perth for nearly 40 years and is well known to several thousand women whose babies she has delivered or whose hot flushes she has treated.

Graduating in medicine in Adelaide over 50 years ago she has seen enormous changes in her profession and in the acceptance of women doctors.

These memoirs tell of her journey in time and place and may at times seem judgemental in comparing Now with Then but it is, after all, just one woman's story.

There are some graphic stories of obstetric difficulties, especially in New Guinea, and her own near-death encounter, but these are leavened with much fun and laughter. Philosophy, music and many magnificent friendships have made the whole journey worthwhile and worth recording.

Her previous book "Is it Me or My Hormones?" co-authored with Patricia Michalka has been widely read by women and found helpful also by some husbands.

From the Prologue of Now & Then

'... I remembered two occasions when I was being propelled along a corridor at the end of which was a yellow door. There was no handle on this door. I knew that to go through I would have to push the door. Each time that I tried, I felt myself literally hauled back into darkness.'

'... the body being propelled along the corridor felt insubstantial, more like a puffball in a dust storm than a solid body. I did not know what was on the other side of the yellow door but I know that I had no fear of going there and that I was aware of what was happening...'

By Dr Margaret Smith & Patricia Michalka

This is the question most asked by women in their middle years (ages 35 to 55) who are experiencing physical and emotional changes.

This widely acclaimed book, initially self-published by gynaecologist Dr Margaret Smith and psychotherapist Patricia Michalka, Is It Me or My Hormones? achieved widespread endorsement from doctors, counsellors and readers for its relevant, compassionate approach to the lives of women.

This revised, updated edition includes developments in the prescribing of Hormone Replacement Therapy. Experience has shown Margaret Smith and Patricia Michalka that not all women need or want hormone therapy at this time and, indeed, not everything that happens at this time of life is due to hormones. In this book, the authors draw on their own experiences and those of their clients to help explain how to sort out the confusion caused by the interaction of hormones and life events.

Their writing reflects the rich tapestry of so many lives, full of humour, confusion, clarity, compassion and practical guidance – both medical and psychological.

From the Introduction to Is it Me or My Hormones?

'Is it me or my hormones?’ is the question most commonly asked by women in their middle years. One woman in midlife said it all when she exclaimed, ‘If it’s not menopause then I must be going insane’.

In this book we explain how symptoms due to hormone deficiency need to be differentiated from symptoms with medical or emotional causes so that appropriate treatment can be given.

Hormones begin to change and then decline from 35 to 55 during what is called perimenopause. We have therefore included stories from women of all these ages, not just from women who are going through menopause.

In the medical world, before 1960, menopause was hardly mentioned. Now it is acknowledged, although some critics believe that the medical profession has attempted to take over this natural process, which is known as the medicalisation of menopause. Management of menopause benefits from appropriate medical assessment, including mental and emotional factors as well as the physical. Menopause is neither a medical nor a mental condition, but a natural stage in life that all women go through, although it may be associated with medical problems. About 50 percent of women have no physical or emotional trouble at all. However, many women do need emotional support and counselling, but they are not being heard, nor are they having their questions answered.

… Hormone deficiency is only one aspect of menopause; therefore, HRT is only one aspect of management. Other medical conditions may need to be defined and treated…But as well as physical and hormonal changes there are emotional responses that can threaten to overwhelm us. If these are understood and dealt with we need not feel helpless. Later we will look at attitudes and perception, about how we see others and ourselves, and examine our behaviour and the choices we make.’