Whether women embrace it or curse it, this natural hormone change is inevitable. It results in the end of menstruation, as the cyclical production of oestrogen ceases.

Hot flushes - 70% of menopausal women have hot flushes every day. They can cause great distress, and often go hand in hand with night sweats.

Headaches, dizziness and insomnia - These vary from mild to incapacitating, and can contribute significantly to menopausal depression if they persist.

Incontinence -and painful sex - These are the result of the loss of collagen from the tissues, causing the gento-urinary tract to become less elastic.

Poor memory, lack of concentration, vagueness and irritability are common symptoms of oestrogen deficiency. Men often say that women go slightly dotty around this time, but whether this is due to hormonal changes or other factors is debatable.

Oestrogen depletion can cause vaginal dryness, stress incontinence, recurring cystitis, genital prolapse and dyspareunia, among others. Psychological changes include mild depression, poor memory, headaches, irritability and anxiety.

The treatment of menopause has a lot of clamour from the pro and anti lobbies. The pressure is on many women to decide whether to go at it alone or to be eased into the 'change' with the assistance of hormone replacement therapy (HRT).

Although the decision to treat healthy menopausal women for lengthy periods of times have always been controversial, HRT does have a number of benefits. It not only improves symptoms such as hot flushes and night sweats, but it also protects against degeneration of the nervous system (which can cause Alzheimer's Disease), coronary heart disease and osteoporosis.

Possible side effects include nausea, water retention, bloating, leg cramps, and headaches. There is also a small risk of malignancy in the breast and deep vein thrombosis.. The decision to use hormone replacement therapy is an individual one and the final decision should be a consensus between patient and doctor