The Ancient Greeks called the menopause “a step on the ladder to achieving wisdom” which must be a better way of looking at it than “the beginning of the end” as some perhaps do. In modern times we might define the menopause as a time during which as a result of ovarian failure the levels of oestrogen and progesterone in a woman’s body fall to a point where menstruation ceases and she is no longer fertile. The menopause does not happen suddenly. For many months a woman in her late forties or early fifties might notice a change in her menstrual cycle. The number of days between periods may lengthen and symptoms during the pre-menstrual phase may become increasingly troublesome. What may have been mild, pre-menstrual symptoms in her younger years can become much more severe with mood swings, forgetfulness, anxiety and even depression. Physical symptoms such as palpitations, headaches, flushing and sweats may gradually become more apparent. Typically the hot sweats and emotional lability become much worse soon after periods have stopped. For a few years after menstruation has ceased the symptoms may persist and may still be cyclical in nature, but gradually as hormone levels decline and the underlying cyclical changes level out the symptoms diminish and may disappear all together. As soon as oestrogen levels start falling there is an increasing tendency to loose calcium from bone and this is a major cause of osteoporosis and fractures in later life. Because of this Doctors generally recommend the use of hormone replacement therapy (HRT) from an early stage. Unfortunately it is no longer thought safe to use such treatment for much more than five years and certainly no longer than ten years because of a small increase in the risk of breast cancer that has been shown to occur as a result of prolonged use of HRT. The most important way of helping yourself cope with the menopause is to eat a healthy diet rich in foods containing phyto-oestrogens, calcium and vitamin D. Drink plenty of water and not too much tea, coffee and alcohol and take exercise every day. There are many natural products that can help you along the way including herbs such as Agnus Castus, Sage, Black Cohosh, Dong-Quai, and Soya Isoflavones. Supplements including Calcium, Vitamin D, Magnesium and Zinc are worthwhile.