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What is it? When does it occur? Physical symptoms

Emotional symptoms Hormone replacement therapy Nutrition

Self-help Advice and support

HRT can help your body to adjust to lower levels of oestrogen and progesterone, helping to alleviate symptoms such as hot flushes.

Before deciding whether HRT is for you, talk to your GP about the risks of taking it or not. Make sure he or she is aware of any existing medical problems, such as high blood pressure, liver disease, endometrial cancer or a previous deep vein thrombosis (DVT).

Recently, research has raised concerns about HRT (for example, about a possible increase in the risk of breast cancer or heart disease) and currently it's recommended that HRT is used to provide short-term relief of menopausal symptoms, and that HRT drugs should only be offered in the lowest doses and for the shortest time possible.

HRT can take several different forms - tablets, implants, creams, pessaries and patches. The type will be tailored to your individual needs. Some women need specific methods - if, for example, you're an insulin-dependent diabetic, skin patches are preferred. The treatment comes in different combinations of oestrogen and progesterone and in different strengths.

In general, the benefits should kick in within one to two weeks. You'll be monitored by your GP to make sure there are no problems and minimal side-effects. Initial side-effects such as breast tenderness and nausea should settle. Bloating can occur, but changing the type of HRT can help. You may also experience weight gain, although this isn't necessarily due to HRT. There may also be other more transitory side-effects, such as headaches, low backache, irritability or heavy bleeding.

With some types of HRT you have a period, with others you don't. Any bleeding that occurs when it shouldn't, or significant changes in the pattern or severity, should be reported to your GP straightaway, as should any shortness of breath, coughing or chest pains. If you have a painful or swollen red leg, stop the HRT immediately and consult your GP.

Make sure you get enough calcium and vitamin D in your diet to reduce the risk of osteoporosis

Make sure you get enough calcium and vitamin D in your diet to reduce the risk of osteoporosis. As a general rule of thumb, the recommendation is at least 1,000mg of calcium a day from food or supplements. Your doctor should be able to advise you if supplements are necessary.

Essential fatty acids (EFAs), such as those found in nuts, seeds and oily fish, can be very useful if the skin becomes dry or if you suffer from joint pains. The best EFAs are those from the omega-3 and omega-6 families, which are found in pumpkin seeds, oily fish, walnuts, linseeds, dark green vegetables and oils such as sesame, walnut, soya and sunflower. EFAs can also help prevent vaginal dryness and bladder infections, as well as increasing your mental and physical energy.

Natural plant oestrogens in the form of soya beans, alfalfa sprouts or linseeds are a useful supplement, as long as you aren't already on an oestrogen replacement therapy. Make sure you get instructions from a reputable source.

Evening primrose oil and vitamin E have been suggested as a preventive measure for hot flushes, but there is little evidence to show they work.