Menopause is one of the major milestones in a woman's life. It can bring about emotions like anxiety, panic, depression and the hollow feeling that the best years of our life now lie behind us.

These are normal feelings and in actuality, armed with the knowledge of what to expect from menopause and how to best deal with it, going through the menopause need not be traumatic.

The menopause usually sets in around the age of fifty - a woman's biological clock will stop ticking and this in itself signals the end of her fertile years and the loss of the oestrogen and progesterone. In a nutshell, at around age fifty, a woman's ovaries just run out of follicles (eggs). The follicles are responsible for producing most of the oestrogen and all of the progesterone in a woman's body.

The word 'menopause' itself means the stopping of menstrual bleeding. When this stops, it is also a sign that the production of oestrogen has fallen to reduced levels. This is caused by the ovaries being unable to produce the sex hormones oestrogen and progesterone.

The first symptoms of menopause tend to be the onset of hot flushes (also referred to as hot flashes in the US). These can affect up to 80% of menopausal women. When a woman has a hot flush it makes her feel extremely hot and flustered. They can also be associated with a feeling of dizziness, heart palpitations and itchy sensations under the skin.

Hot flushes are caused by the body's thermostat (which is controlled by the hypothalamus) not being able to function properly when it is deprived of oestrogen.

Other signs of impending menopause are:

• Vaginal Dryness - More than 50% of menopausal women have problems caused by
  vaginal dryness. This is especially troubling during sexual intercourse when
  there is not enough lubrication which causes pain and discomfort during sex.
• Emotional Changes - It is common for women to experience mental and emotional changes at the time of the menopause. Depression and anxiety are the two most common problems experienced. Some may find themselves suffering from mood swings, becoming irritable and suffering from panic attacks. Sometimes these changes manifest on a physical level, with women suffering from a complete loss of libido and, in severe cases, becoming totally unresponsive sexually.
• Dry skin - the skin on our faces and bodies is sensitive to oestrogen and without this the skin becomes thinner and more fragile, less capable of retaining moisture and more susceptible to developing broken capillaries.
• Aches and Pains - Oestrogen deficiency can also result in body aches
  and pains. Some women complain of frequent headaches, and pains in joints
  or the back and neck.
• Bladder Problems - It is not uncommon for menopausal women to complain of the
  urge to frequently empty their bladder. Some also experience problems
  with stress incontinence (which reduces the ability to control urine flow)
  whilst others are more prone to bladder infections such as cystitis.

Above: Breton Eve by Paul Gauguin 1889