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Menopause: step-by-step

by Suzannah Olivier
continued from page 1
Step one: peri-menopause
This is the pre-menopausal stage during which hormone levels are changing. Oestrogen gradually declines, progesterone is often produced erratically and only during cycles when an egg is released, and follicle stimulating hormone (FSH) is triggered by low oestrogen causing hot flushes. Usually the peri-menopause starts in a woman's mid-40s. For some it is much earlier and can follow a mother's pattern. During this phase some cycles are 'anovulatory', meaning an egg is not produced, while other cycles produce more than one egg making twins more likely if conception does take place.

Signs of peri-menopause
Early signs of the peri-menopause might be the length of time between periods altering or periods becoming heavier or lighter. Here are some other telltale signs:

  • Hot flushes
    These can be very troublesome for women who experience them several times daily, and they can be worse at night. To reduce their severity, eat a diet which features soya products and wholewheat foods - studies show an effect after four to eight weeks. Hot flushes are less of a problem in vegetarian societies, so a diet high in pulses and vegetables may help. Caffeine and alcohol can be frequent triggers. Regular exercise has a short-term worsening effect but a longer-term dampening effect on hot flushes. High levels of vitamin E have been reported to help, but avoid this if you are taking blood thinning medication such as warfarin.

    Sage is a prime herbal remedy for reducing night sweats. Drink a sage tea made from sage leaves steeped in boiling water for five minutes, three times daily. Black cohosh and dong quai are the herbs most frequently taken during the peri-menopause which have a wide range of beneficial effects on symptoms. As with all herbs it is best to seek professional advice from a herbalist, especially if you are taking other medications.

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