Have you been experiencing hot flashes? Night sweats? Insomnia? Anxiety or mood swings?  these and other symptoms may be due to hormonal imbalances and can occur during menopause or peri-menopause, which is the ten to fifteen year period that leads up to the menopause. these symptoms can make you feel desperate, or at least annoyed. Know that you are not alone with your symptoms and that relief is in sight.

Chinese medicine offers wonderful natural treatments for menopause. One of my favorite herbal remedies for treating menopausal symptoms, is Zhi Bai Di Huang Wan. This formula tonifies kidney yin and clears the excess heat from the body, relieving night sweats and often helping with insomnia, dry skin, irritability and other problems.

What is kidney yin deficiency?  Kidney yin deficiency is the primary cause of menopausal symptoms, according to Chinese medicine. In Chinese medicine, the kidneys, in particular kidney yin, are responsible for birth, growth and reproduction. As the yin of that organ declines, so does the kidney’s ability to support a woman’s reproductive cycle. Yin, among other attributes, is the cooling and moistening element in Chinese Medicine; yin steadily declines as women age and approach menopause. Yin deficiency makes us more prone to dry skin, hair, eyes; day and night sweats; bone loss; stress; and other symptoms. Acupuncture and Chinese herbs can help support our bodies as we go through these changes by smoothing our energy or qi, building our yin, and strengthening our bodies.

During  menopause, and preferably before, women can also ease this transition by eating a balanced diet with plenty of fresh vegetables, fruits and healthy fats, such as those found in olive oil, fish oil and flaxseeds. getting regular exercise and practicing regular relaxation techniques such as meditation, qi gong or tai chi is also very beneficial.

The dominating solution prescribed by GPs is hormone replacement therapy (HRT) – but it is considered by many to be controversial.“

When HRT emerged in the Sixties, it was a breakthrough for women,” says Sovra Whitcroft, consultant gynaecologist and obstetrician at the Surrey Park Clinic, Guildford. “But the doses of oestrogen were strong and carried side effects. through the Seventies to the Nineties, combinations of oestrogen and progesterone were developed, and HRT was seen as a panacea enabling post-menopausal women to have a better quality of life.

“Then, in 2003, the results of the Million Women Study suggested that HRT given to older women increased their risk of breast cancer. Suddenly, HRT fell out of fashion.

“Now, studies are coming through which show that when correctly prescribed – especially to women in the peri-menopause, before oestrogen levels have fallen too far – HRT can not only be safe, but also protective, keeping bones strong and potentially lowering the risk of heart disease.”

The key, Whitcroft explains, is to tailor the amount of oestrogen arriving in the body: “The level of oestrogen in HRT is designed to reduce or stop altogether the symptoms of the menopause outlined above, such as hot flushes, night sweats, mood swings, etc. It does not restore oestrogen to pre-menopause levels, but it does mimic the action and effects of the natural oestrogen molecule.”

You also need to add in progesterone to protect the uterus from cancer.

Whitcroft points out that not all women are suitable for HRT (if you have a family history of breast cancer, it is unlikely you would be offered it), nor does everyone need it. “Complementary treatments such as reflexology or acupuncture can help many women,” she says. “But there are a number of women whose symptoms are so severe they do need medication. It’s a balance between quality of life and overall risk.”

And she adds that many women on HRT are at lower risk, statistically, of breast cancer, because they become much more body aware, visit the GP or specialist regularly, and keep up to date with their smear tests, breast checks and blood pressure monitoring.

Certainly, self-management is key to controlling symptoms – whether that means going to the doctor or simply trying different supplements until you find one that works for your body.

Nutritional therapist Angela Falaschi believes that “It is vital to take charge of your health and to eat well during the peri-menopause when hormone levels start to fluctuate.”

She explains: “Hot flushes are one of the most common and distressing symptoms of the menopause, with extreme highs and lows in temperature causing episodes of profuse sweating. While there are practical ways of coping with this, such as wearing cotton clothes and multiple thin layers that can easily be removed, or carrying cool wipes, there are also a number of foods and supplements that may support this time.

“I often recommend getting vitamins E and C with bioflavonoids (the natural, usually yellow pigments in fruits and vegetables) mid-morning with fruit and supplementing the diet with isoflavonoids (naturally occurring compounds) by incorporating chick peas, soya, lentils and pumpkin seeds into your meals.

“Eating boron-rich foods, such as leafy green vegetables, fruit and nuts, will help balance oestrogen levels while the phyto-oestrogens (nutrients that mimic hormonal action) in soya beans may also help to reduce hot flushes.”

For anyone who is desperate for night-time relief, there are practical solutions too, such as new bedding designed to help sleep. The Cool Pad pillow topper (£29.95) and the Cool Pad mattress topper (£59.95), both available from personalcooling.co.uk, use gel technology to dissipate heat away from the body, ensuring a cool, comfortable sleep without night sweats. The pillow topper can even be stored in the fridge to make it cooler when needed.

Perfect Balance microfibre duvets (£55) and pillows (£30), both from finebedding.co.uk, contain a fibre blend called Lysoft, which can wick humidity away from the body by absorbing and dispersing excess humidity. It can even be worth trying a silk pillowcase for comfort if you’re really struggling at night, as the texture can be particularly cooling (SilkPerfect Premier pillow cases, £29.90, from silkperfect.com).

Simple hydrating sprays such as Eau Thermale Avène Spring Water Spray (50ml spray, £3.15, from pharmacies) can alleviate the sensation of heat, too, during the day, and are ideal if you’re in the office and don’t want to keep throwing the windows open. Or try a specially designed product such as Feminée Cooling Mist (£4.99, amazon.co.uk) which has the added benefit of a soothing aroma of lavender and pumpkin.

Whichever survival techniques you prefer, you should still, says Angela Falaschi, increase your intake of fruit and vegetables and eat more nuts and seeds (especially sunflower and pumpkin, which contain zinc to help support hormonal function).

“Eat only lean protein and low-fat foods and drink plenty of water. Reduce sugar, ice-cream, soft drinks, jam, tea and coffee, white flour and alcohol. Also avoid spicy, salty food and very hot drinks. Limit red meat and try to limit or avoid fried foods.”

Dr Nicolas Perricone, the US dermatologist, devotes a chapter in his latest book Forever Young (£17.99, perriconemd.co.uk) to making a strategy for the menopause years. ‘‘Women now spend one-third to one-half of their lives in post-menopause,’’ he says. ‘‘nothing can compare with untreated menopause as a model for accelerated ageing (although high levels of anxiety and diabetes come close).’’

Like Angela, he is concerned that we improve our daily diet: his programme includes a diet that is low in animal protein and high in fresh vegetables and cold-water fish such as salmon or mackerel.

‘‘For women over 50, hot flushes are experienced by approximately 75 per cent of US women compared to 25 per cent of Asian women,” he says. “this may be attributable to differences in diet, with Americans consuming a diet much higher in meat and animal fats and lower in vegetables, fruit and fibre than Asian women do.’’

And take heart, agree the experts. “The menopause should not be seen as a dead end,” says Sovra Whitcroft. “a lot of women find it liberating: no more periods or contraception to worry about. And it’s a chance to take stock and then stay on top of their health as they age. some will never even have a symptom and feel wonderful instead.”

‘‘Menopause does not mean farewell to femininity and glamour, health and wellbeing,” emphasises Dr Perricone. “It can symbolise a milestone in your life, one that motivates you to achieve a new level of health, beauty, wisdom and spirituality.”

The last words should go to Jenni Murray: ‘‘We should talk about it – menopause can be a daunting time, but you can get through this. I know, because after my own years of trial and error, the hot flushes and night sweats did go, as did the depression. And what’s more, the libido improved.’’

• For more information on tackling the menopause, visit thesurreyparkclinic.co.uk and angelafalaschi.com

A vaccination for all females

Pharmacist Elaine Hartley explains the Boots cervical cancer vaccination service

As part of its vaccination schedule, the NHS now offers immunisation against HPV strains 16 and 18 — which are responsible for 70 per cent of cervical cancers — to all girls aged between 12 and 18.

However, women of any age who are sexually active should also consider getting the jab, says Boots pharmacist Elaine Hartley. “this is the second most common female cancer,” she explains. “in the UK, eight women a day are diagnosed with it and three women will die from it.”

Screened for through the national smear test programme, cervical cancer is caused by a persistent viral infection which is transmitted by skin-to-skin contact.

“There is no doubt the jab has been a breakthrough,” says Elaine. “a course of three injections (which cost £99 each at Boots) can protect you for life.”

Moreover, the pharmacist who will give you the injection (in a private consulting room) also offers a lifestyle consultation around sexual health, alcohol and smoking — all of which are risk factors for contracting the disease. Because other viruses cause around 30 per cent of cases, vaccinated women will still need regular smear tests.”

Many mothers who have seen their younger daughters vaccinated through school are keen to get their older girls protected,” she says. “Women in their early twenties can be at risk: your GP can’t offer the vaccine to over-18s, yet women aren’t eligible to join the smear programme until they are 25.”

Older women who are still active sexually, and not in a monogamous relationship, may also wish to consider vaccination, although Elaine points out that the immune response it creates is less pronounced in women aged 45-55, and it is not offered to those over 55.

• Find out more at boots.com; for facts on cervical cancer, visit eveappeal.org.uk

Women’s health supplements

Seven Seas Femibion Balance (60 tablets, £10.20; seven-seas.com). Containing magnesium and vitamin B6, this supplement is aimed at women who are pre-menopause, as it has been formulated to help maintain healthy nutrition balance throughout your monthly cycle. It may be useful for women who have heavy periods.

Wellwoman Tricologic (60 tablets, £35.74; vitabiotics.co.uk). Hair loss is common post menopause. this supplement contains 26 nutrients, including biomarine collagen, L-Cystine and special plant derived nutrients such as grape seed extract. The nutrients are delivered via the blood stream directly to the hair roots for maximum benefit, to help maintain scalp health and hair follicle metabolism, and counteract the effects of ageing on hair.

Bassett’s Healthy Balance (30 tablets, £7.15; bassettsvitamins.co.uk). Ideal for younger women, these multivitamins contain Evening Primrose and Starflower Oil plus B vitamins to support hormonal health.

Imedeen Time Perfection (60 tablets, £40.84; imedeen.co.uk). another supplement containing fish proteins, Imedeen aims to protect your skin against the effects of natural collagen loss, which leads to wrinkles, maintaining skin moisture and texture.

Perfect Harmony (30 tablets, £19.95; lookandhealth.co.uk). Herbal formula containing extracts of chaste tree (said to help regulate mood swings), red clover (believed to help regulate hormones associated with menopausal symptoms), wild yam (said to help alleviate painful spasms associated with the reproductive system) and dong quai (believed to further stabilise hormonal imbalances). It is designed to be used as an alternative to HRT.