Menopause can be a distressing time for some women while others sail through it.

In many cultures, women regard it as a natural process to which the mind and body gradually adapt.

As oestrogen and progesterone are the active female hormones which affect menstruation, the softness of mucous membranes and skin and the stability of nervous tissue and bones, their reduced production can cause a disturbance in other bodily functions and the ageing process.

The production of these hormones also depends on the state of hypothalamus, pituitary gland, the adrenal gland and ovaries.

Many other factors can affect perimenopause (the time before and during the change). The most common symptoms are irregular periods, hot flushes and mood swings with depression, irritability, forgetfulness and disturbed sleep.

Doctors can request a blood test to check your hormone profile. I also believe it is important to check your thyroid, cholesterol and blood sugar levels in case of diabetes.

Hormone Replacement Therapy has helped countless women but major worries over its side-effects, such as those highlighted in the Million Women Study published this week, have made women seek natural ways to deal with the change.

Ayurvedic medicine describes an holistic approach which includes taking herbs and minerals, yoga, meditation and pranayam (yogic breathing), regular massage with aromatic oils, a wholesome diet and joining in rituals such as traditional dancing.

Ayurvedic herbs which are well established as women's tonics are:

1. Shatavari (meaning strength of a hundred brides or, more prosaically, asparagus racemosus root) is a sexual rejuvenator for women. It contains natural plant sterols, saponins and glucosides, which help the production of hormones and also nourish the body tissues. Shatavari is a soothing herb which improves the reproductive function of the ovary and testes and maintains the vitality of the skin, the lining of urinary organs and vaginal dryness.

2. Aloe vera or kumari (young lady) has been used in Ayurvedic medicine for thousands of years. Kumari asav is a formulation made from aloe vera juice and 30 other herbs which help the mind, nerves and heart.

3. Ashwagandha (withania somnifera) restores sexual strength in men and women and is a natural anti-depressant. It is often combined with the herbs jatamansi, shankha pushpi and sarpagandha for their calming action to treat anxiety, depression and mood swings.

4. Vidari kand (wild yam) contains precursors of female hormones and soya, oats and other grains containing isoflavones, which are very useful.

I have prepared a menopause tea combining all these herbs and a number of women are taking this with good effect. It is available from the Wish House Clinic on 01273 430022.

Happiness of body, mind and spirit is the key to a healthy menopause and natural health into old age, so nourish each one.

Dr Milind Jani works as a conventional and holistic GP and Dr Asmita Jani as Ayurvedic Consultant from 3 Eaton Gardens, Hove.

Call them on: 01273 777448 or e-mail: milind.jani@ntlworld.com