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‘A healthy diet and exercise regimen will ensure your body will be better equipped to stabilise your hormone levels naturally,’ she says.

Research the pros and cons, then talk to your GP about whether you want HRT and whether you are suitable for it.’ (It is not always advised if you are a heavy smoker, very overweight, or at high risk of stroke or have high blood pressure.)Gabrielle Downey, consultant gynaecologist at City Hospital in Birmingham, says that if your GP won’t prescribe HRT, ask them if there is a menopause specialist in your area, or whether any of the GPs in the practice have specialist menopause training (for a list of menopause clinics, see

Many specialists believe that giving HRT via the skin is safer.

The private clinics argue that they offer an individually tailored cocktail of hormones (including testosterone in the mix if required) in a single cream or daily lozenge which dissolves against the gum.

‘The dose can be tweaked to suit the patient,’ says Dr Amalia Annaradnam, a GP at the Marion Gluck clinic.

Haitham Hamoda, a consultant gynaecologist who leads the menopause unit at King’s College Hospital London, and is a member of the British Menopause Society’s Medical Advisory Council, speaks for many of his peers when he says the health risks of HRT are actually ‘very small when put into context’. Some women do not like the idea of taking hormones, and aren’t willing to consider any risk at all.