Angela is 53 years old. Her last menstrual bleed was a couple of years ago, and she thinks she has coped quite well. She has experienced some flushes and occasional night sweats, and, although these continue, she feels well and copes with them.
Her job as a personal assistant is unaffected, and she puts up amicably with shared jokes around the office about open windows and fans on desks. Some of her friends are using hormone replacement therapy (HRT) and have no symptoms at all, but Angela prefers to 'let nature run its course' and is not keen to use a medicine to control something that is natural, unless necessary. However, she does want to be responsible and look after her health, so she explores the local health food store or pharmacist for supplements and advice.
Angela's story is familiar to many women in the UK. Menopause typically occurs around the age of 51 years, but anything between 48 years and 56 years is considered normal. The last menstrual period marks the actual start of menopause, but by definition this cannot be confirmed until 12 months without a natural period has elapsed.