At around age 50, a woman’s ovaries start to produce less oestrogen and eventually cease producing oestrogen altogether. Oestrogen is the hormone that is normally responsible for female characteristics, including the regulation of normal monthly menstruation. It is still produced in small amounts by other parts of the body, so it does not disappear from the blood stream altogether.

As the levels of oestrogen decline, monthly menstrual bleeding becomes irregular and eventually stops.  The last menstrual period is called "menopause".

When most people talk about menopause, however, they are usually referring to the time around menopause (the so called perimenopause, or climacteric), when bleeding is irregular and certain other symptoms may be experienced as a consequence of the declining oestrogen levels.

Side effects may include bloating, breast tenderness, headaches, nausea, the return of vaginal bleeding and may cause hypertension in some patients. All will be reversed as soon as HT is stopped.

Breast tenderness and bloating

What are hot flushes?

Experiencing hot flushes (also called flashes) is the feature that has made the menopause famous because it’s the most common symptom. 75- 80% of women suffer these feelings of intense heat over the trunk and face with an accompanying flushing of the skin.

A hot flush generally lasts less than five minutes, and the sweating that accompanies this “attack” usually starts a minute after the feeling of palpitations.

A hot flush may be followed by a chill and some women may become aware that their heart is beating fast or hard and they may feel anxious.