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Is there a magic pill that addresses all our issues in the perimenopause and menopause? The answer is yes, and no.

Yes, because for the majority of us, replacement of estrogen will remedy most of our symptoms in a way that no other singular intervention can. It will take care of our hot flushes, night sweats, vaginal dryness, bladder issues, bone density, as well as our heart disease and stroke risk. The order in which these symptoms manifest themselves will be different for each woman as every symptom has a different hormonal reserve and milieu.

In addition, as we grow older we will all suffer the visible or invisible toll that estrogen depletion takes on the female body. All of us will be at increased risk of heart attacks and strokes after menopause. There will be a 5% drop in our bone density in the first year of menopause. Bone density will continue to decrease by 1% every year after that. So is estrogen replacement all that we can or need to do?

The answer is no. Each woman is an individual and so is her hormonal balance; what may work for one woman may not for another. Treatment should, therefore, not only be individualised to each woman’s hormonal requirement, but should also address her current health, lifestyle and nutritional status.

In fact, there are no real shortcuts. We will all have our own issues in the perimenopause and menopause. If we do not look at the bigger picture and address all the issues that need to be corrected then the success of any treatment will be limited. Women have to be empowered to make positive choices. It is not about putting plasters on symptoms, but about improving function at the cellular level, which means taking a long, hard look at what we choose to eat and how we choose to live.

When we are going through the change we have to embrace it and nurture it. It is our second spring and the only way is forward. If we do not invest in weight loss, low sugar diets, cutting back alcohol, quitting smoking, energy balancing, yoga, exercise and stress reduction then we are not giving ourselves the best possible chance. Modern medicine has to be about an integrated approach; about preservation of health, about disease prevention and about the choices we have.