I'm Dr Dawn Harper.

I'm a GP with a particular interest in women's health.

The most common symptoms of the menopause

are hot flushes, night sweats, mood swings and a lack of confidence,

but I see all sorts of other symptoms which are perhaps less well known.

That's anything from dry skin, dry hair,

sleep problems, vaginal dryness, weight gain, joint pains and aches.

To be honest with you, almost anything could be attributed to the menopause.

It may not be, but if you're at that age and experiencing new symptoms,

it's well worth having a chat with your doctor just in case.

About ten years ago, I would have pretty much put HRT in the water

for menopausal women.

Over recent years, we've seen an awful lot of headlines

which have frightened lots of ladies.

That doesn't mean to say that I rule it out completely,

and it is still the right choice for some women

in a low dose for a short period of time.

Rather than ruling it out completely,

I do encourage women to chat to me about it,

because we do know that long-term HRT

increases your risks of breast cancer and of heart disease,

but we also know that it does some very good things, too.

Life is not black and white. It's shades of grey.

So your own doctor will be able to assess your own risks

and tell you whether HRT could be for you.

If HRT is not an option for you,

there are lots of other things that we can do.

With the demise and the headlines,

lots and lots has been written and said about the risks

of breast cancer and heart disease associated with HRT.

But one thing that we perhaps haven't communicated quite so well

is that in terms of HRT, the clock only starts ticking at 50.

So if you're one of those ladies

who's had a hysterectomy and her ovaries removed in her 40s,

it's actually quite safe for you to take your HRT until 50

and then you can have a think again.

A very common but sadly not-talked-about problem

associated with the menopause is vaginal dryness.

Even in patients who I know quite well,

I find that actually it only comes up as a subject when I do a smear test

and they find it quite uncomfortable.

Too many women out there are either not enjoying their sex life

or have given up on a sex life completely

because of vaginal dryness associated with the menopause.

Even if you don't want to consider HRT,

you can have local oestrogen

in the form of pellets or cream that you place into the vagina.

It's not absorbed into the body,

so it doesn't have any of the risks associated with HRT,

but it really can make an enormous difference

to plumping up the tissues around the vagina,

increasing the normal secretions and making your sex life normal again.

Mood swings can be more difficult to control.

If you're sleep deprived or feeling unsexy with hot flushes,

you're much more likely to be moody, so often it's a multifactorial thing.

Vitamin B6 has helped some of my patients.

And occasionally I have put people on antidepressant medication

and they have had great results.

The menopause for a lot of women is a feeling of "it's all over".

Nobody, or very few women, miss their periods per se.

But the significance of their periods stopping

and feeling that they are moving into the twilight of their life

can be quite a difficult time for some women.

That certainly affects their emotions and their moods and relationships.

It's very complex.

It can take quite a lot of fine-tuning to get the treatment right,

but it doesn't mean to say that you should just put up with it.