An attempt to correlate postmenopausal symptoms with the vaginal maturation index and plasma levels of estrogen was made in a group of patients with surgical menopause. The group was followed up monthly for 6 months in a double-blind study during which the patients received equine esterified estrogen and synthetic esterfield estrogens. No statistical difference in plasma levels of estrogen was found between the group of patients with symptoms and the patients without symptoms, with or without estrogen therapy. There was no correlation of the maturation index with the presence or absence of symptoms or with the estrogen plasma levels.