The decline in gonadal hormones during menopause gives rise to a wide range of physiological and psychological changes with the potential to significantly impact a woman's health and quality of life. Most notable among these are menopausal vasomotor symptoms, hot flushes and night sweats, along with mood and sleep disturbances. Given the biological and social significance of menopause, it is remarkable that the language used to describe this event and its associated symptoms is inconsistent. This review traces the history of Western medical writing about menopause-associated vasomotor symptoms and considers how terminology has contributed to the current confusion regarding symptoms and symptom reporting. Although hormone therapy is the only treatment for menopausal symptoms currently approved by the U.S. Food and Drug Administration, other forms of therapy are under evaluation. Agreement about the definition of menopause and its associated symptoms is critically important for the design and evaluation of new therapies and for the optimal treatment of women during this important phase of their lives.