Menopause

Firstly, what is menopause and how does it affect women and men?

"Menopause is when a woman stops having periods, and basically she stops having periods because she runs out of eggs," says Beverley Vollenhoven, professor of obstetrics at Monash University.

Generally speaking, most women stop producing eggs in their mid to late forties, which is when menopause usually begins. Hormonal changes, such as a drop in oestrogen, can cause side effects such as night sweats, hot flushes and seesawing emotions.

Like premenstrual tension (PMT), menopause mood swings have earned it a fearsome reputation. "I can be quite happy and reasonable one minute, and a sobbing mess the next," says Helen Kolhagen.

Then there's the hot flushes and sweating you may also have to contend with. Helen along with Maria Karambelas and Debra Lawton are all going through menopause but are handling it in different ways:

• Debra's on hormone replacement therapy.
• Helen's using herbal remedies.
• Maria's not taking anything and has chosen to tough it out.

So which one's best?

"I was having some really awful symptoms. I was having night sweats, mood swings, hot flushes," says Debra.

In fact her symptoms were so extreme that Debra chose the somewhat controversial Hormone Replacement Therapy (HRT) and has been taking it for the past couple of years. Debra has the standard form which includes oestrogen replacement from a patch.

Although Debra's happy with HRT, there has been a lot of debate as to whether or not it increases your medical risks in other areas. "There are a small number of women who should not be taking hormone therapy. These are women who have had a recent diagnosis of breast cancer, women who have also had recent diagnosis of cancer of the endometrium, or the lining of the uterus. Some women have very serious problems with clotting in their blood and those women are at greater risk of having a clot if they take hormone therapy — but these are the minority of women," Professor Vollenhoven says.

So, if you don't have a family history of these things, you may be a suitable candidate for a short course of HRT.

Maria, who has been menopausal for six months, decided not to take anything for her symptoms. "I don't really want to go down the HRT road. I'd rather do it naturally which means take each day as it comes really."

Yes, she's doing it tough, but ultimately, it's her choice: "I think if you're mentally prepared and you tell yourself 'well, these things are going to happen, you've just got to deal with it' it kind of helps a bit — well it does for me anyway."

Our last study, Helen, hit menopause 18 months ago. "I've got the sweats, the night sweats particularly. I get very crotchety and cantankerous, very difficult to live with at times, mood swings and very, very teary."

To help her cope, Helen takes a herbal remedy called a phytoestrogen which "just seems to smooth out the rough bits, the ups and downs."

According to Sydney naturopath Melanie Koeman, phytoestrogens, along with a long list of herbal remedies like black cohosh and St Johns wort, can relieve symptoms. "Phytoestrogens can help to benefit a woman in transition through menopause, because they help to balance, in a sense, the drop in oestrogen that we experience as we go through menopause.

If you are considering this as an option, just make sure you check with a qualified herbalist before taking anything.

So, which treatment works best? It depends on your preference, but there is one cure that outruns all the rest — exercise.

"Exercise is the best medicine. If I could package exercise in a pill it would fix most menopausal problems," says Melanie.

Exercise has proven to be so good that it could almost be hailed as a cure-all. Studies have shown that it increases women's natural oestrogen levels, but more importantly, exercise boosts neurotransmitter release. This greatly reduces anxiety and depression as well as lowering the risk of osteoporosis, heart disease and diabetes.

"I was never a great exerciser and initially the exercise made a huge amount of difference. I felt so much better," says Helen.

But what about those who haven't yet hit menopause? According to psychologist Dr Mandy Deeks half the battle is being mentally prepared. "The perception of women is often that it's negative and they get to menopause and think 'this is not so bad, this is good'."

Here are some practical tips from Dr Deeks:

• For hot flushes try a personal fan and a spray bottle of water.
• For night sweats use two single doonas so you can regulate your temperature without disturbing your partner.
• Avoiding caffeine, alcohol and spicy foods can help reduce hot flushes.
• Try keeping your stress levels down.
• Get plenty of exercise.

Whatever you do, be ready for the long haul because on average symptoms last three to five years!

Men too have a role to play in this as well — just ask Maria's husband Bill: "Make them feel that there's nothing wrong with them. So when I see Maria perspiring a bit, I just go up to her and say 'honey, is it me or is it too hot in here?'"

Fast facts

• Does male menopause exist? Not really — the word 'menopause' means the end of periods, which men don't have. Men's testosterone levels do drop one percent per year after the age of 30 but there is no evidence this causes any changes in behaviour.