BOOK REVIEW : Menopause Meets Its Match: Gail Sheehy : THE SILENT PASSAGE: MENOPAUSE <i> by Gail Sheehy</i> ; Random House $16; 161 pages

With the publication of “Passages” in 1984, Gail Sheehy catapulted to literary journalism’s front ranks. But she apparently overlooked an important transition in that book, one unique to women, which recently caught her by surprise. She chronicled it last fall in an article in Vanity Fair, which she has expanded into this slim volume, “The Silent Passage: Menopause.”

Vanity Fair’s editors hawked their chutzpah at “breaking the last taboo.” Until her courageous effort, Sheehy suggests, menopause was a word seldom uttered aloud, certainly not in mixed company. She attributes this silence to “menophobia,” fear of menopause.

I do not doubt that the people Sheehy talks about--”recognizably high-powered media women on the shady side of 40”--share this fear. But how, then, can one account for the existence of the many “menopause clinics” she seems to have visited around the country? Did they dare use “the word,” much less attract the clientele she interviews?

Sheehy’s book has the strengths and weaknesses of the original article. Fast-paced and anecdotal, studded with celebrity names, it is an easy read. It is also an often useful account of the physiological and medical aspects of women’s third “blood mystery” (the other two are menstruation and pregnancy). Although Sheehy disclaims any scientific rigor in her approach, she manages to interview more than 100 women from all walks of life.

Yet aside from the occasional nod to a nurse from an Italian-American family, or a waitress in a coffee shop, she is writing about women who “identify themselves by their husband’s achievements” or other fast-trackers like herself.

Women who are movers and shakers, she suggests, weather “the Change” with less dejection “than middle-class housewives who are over-involved with their children.” (Whatever that means in this era of familial disintegration.)

While criticizing Americans who fervently worship youth, Sheehy rejects the notion that growing old must be a process of deterioration. Women are luckier than men, she tells us, because they can use hormone replacement therapy and enter “a second adulthood,” in which they will thrive as never before: free from the dangers of brittle bones, stroke or heart attack that have made earlier generations of women frail and demented in their later years.

Some readers may enjoy reading about prominent women who have been embarrassed by “hot flashes.” They may not be offended by Sheehy’s reference to “a Seattle divorcee,” as if post-marital status was part of physiology. Would we talk about a “widower’s prostate”?

These stylistic matters notwithstanding, Sheehy does a service by defining menopause as the gradual cessation of a woman’s reproductive possibilities. She makes it clear that menopause is natural, not a disease, and that it can start any time in a woman’s 40s and last as long as 10 years. She lists the various symptoms experienced either in combination, one at a time, or, in about 5% of the population, not at all. Most important, she stresses that the experience differs for every woman.

A call to arms, “The Silent Passage” reminds women that they are health consumers, entitled to know a good deal more about their bodies than most know now. She predicts that as baby-boomers begin seeing gynecologists in their later years, they will by sheer force of numbers demand that more attention be paid to menopause, just as they have made similar demands about every other “passage” in their lives.

Sheehy insists that for most women, the phase of life that menopause introduces--which she notes is about as long as the reproductive years for most women--offers both better sex and better intellectual achievement, provided they take hormone replacement therapy. (Sheehy quotes one woman so satisfied that she “can actually sense her right and left brains, working in synchrony,” as if they ever worked autonomously).

Although it is true that statistically women--along with men--are more susceptible to heart attacks and strokes than to cancer (one out of nine women, for instance will experience breast cancer, and one in two will have a heart attack or stroke), I suspect that she overstates the risks, both cosmetic and life-threatening, of doing without estrogen.

Sheehy warns that “most middle-class and low-income women” who don’t consult health professionals about menopause “often follow blindly a path that, unbeknown to the older women, may have been responsible for untold deficits of mental and physical well-being.”

“The Silent Passage” is bound to generate controversy over Sheehy’s hard-sell of hormone replacement. But it will be useful, if only to force gynecologists to treat their middle-aged patients with more respect as they prepare for the inevitable assault on their offices that this volume is bound to precipitate.