Our essential Q&A reveals how menopause can have a devastating effect 

Revelations that Nicola Bulley was battling alcohol issues following an early menopause has thrown a fresh spotlight on the effects of the condition:

What is the menopause?

Menopause occurs when your periods stop permanently, marked by the point when a woman hasn’t had one for 12 months in a row.

It usually happens between the ages of 45 and 55, with 51 being the UK average.

It is a normal part of ageing and occurs because the ovaries stop producing eggs. As a result, levels of the hormones the ovaries produce drop.

Potential side effects of HRT?

HRT replaces the hormones that a woman’s body stops producing due to the menopause, such as oestrogen and progestogen. Side effects can include bloating, breast tenderness or swelling, nausea, cramps, headaches, indigestion, bleeding, depression and acne.

The NHS advises people who suffer side effects to try to persevere for three months if possible as they can stop as the body gets used to the medication.

Do benefits outweigh risks?

For many women struggling with menopause symptoms the answer is yes.

HRT has been hailed as life-changing by women who say it has let them regain energy levels and live an active life.

In addition to HRT, women suffering from mental health symptoms may be offered cognitive behavioural therapy. There are also moisturisers and lubricants to ease discomfort.

How many take the drug?

Nearly two million women in England are taking HRT, which can come as patches, gels or tablets. HRT use jumped by 35 per cent in the last year, as women have sought prescriptions to ease symptoms.

What’s an early menopause?

Roughly one in 20 women will experience an early menopause, when periods stop before the age of 45.

Signs can include having irregular menstrual cycles over a few years, spotting between periods and changes in monthly bleeding.

Early menopause can increase the risk of osteoporosis (weak bones), heart disease, depression, dementia and Parkinson’s. Sufferers also tend to experience menopause symptoms more severely.

Early menopause is different to premature menopause, which is the term used for when a woman’s periods stop before the age of 40. This only affects around 1 per cent of women.

Symptoms?

Nearly nine in ten women suffer from symptoms. Mental health symptoms include changes to mood, such as anxiety and low self-esteem, as well as memory or concentration problems.

Hot flushes, sleeping difficulties, heart palpations, headaches and muscle and joint pain are among the physical symptoms. As are weight gain and a reduced sex drive.

Symptoms usually start before the menopause officially begins, as periods become irregular. This is the perimenopause.