I haven't had a period in months but had one start yesterday. I am 50, peri-menopausal, and work long hours on my feet as a server. I am bleeding heavily and became very dangerously dizzy while trying to do some light yoga this morning. Does this sound typical of someone going through menopausal fatigue?

It sounds as if either or both of your iron levels and blood pressure levels have fallen badly. This is not an unusual picture, but it shouldn't be seen as just something to put up with during the menopause - these symptoms are debilitating and cause anxiety, which in itself is not healthy! You may find that you don't get any more periods, but if you do and they are this heavy then take action.

Firstly, start taking a natural iron tonic such as Floradix or Feroglobin to counter the blood loss. You may need something to stem the bleeding, so check out Boots Pharmaceutical Cyklo-F Heavy Period Relief, which is just taken temporarily.

Secondly, check that you are not dehydrated - this, together with low iron, will contribute to low blood pressure. Concern is usually over high blood pressure, but low blood pressure is actually quite common and will make you feel light headed, dizzy, and possibly even likely to faint.

Thirdly, start practising breathing exercises - as you do yoga I am sure you know some simple ones that are easy to do several times a day wherever you happen to be. Something as simple as counting to 3 on the in breath and out breath will improve circulation to the head if you're feeling weak or faint. Keeping the circulation healthy is useful also because hormones circulate in the bloodstream.

Eileen Durward