I have always been very slim and a size 10. I lead a healthy lifestyle; I eat sensibly, I cycle, I walk, I don't smoke, and I drink in moderation. I had a subtotal hysterectomy 2 years ago, and I have a horrible spare tyre around my middle which I cannot shift. This increases with almost constant bloating and awful flatulence. I am always in discomfort under the border of my right ribs, and I cannot fasten any of my trousers. My blood tests were all normal. I am desperate to shift this weight and reduce the bloating. My sweats come and go, and are unpredictable. My IBS symptoms also seem exacerbated and I am trying to avoid chemical HRT. Please let me have your advice.

Hormonal changes can often affect the metabolism and carbohydrate digestion, and many women find that weight becomes an issue in the menopause.

It often seems that no matter how little you eat and how much you exercise, it makes no difference!

I tend to suggest cutting carbohydrates right down and increasing your intake of good quality protein and vegtables - this can often help quite quickly.

Read more about it in the 'Low GL' Diet - you can get books on this from Amazon.

Sensible exercise is important but don't go overboard. The menopause puts tremendous strain on the body generally and, if you push yourself too hard, the body can go into 'survival mode' and reduce the metabolism further!

Try eating little and often with snacks between meals such as nuts, seeds, dried fruit, plain yogurt etc.

Bloating can often be helped with Molkosan Fruit and I would also suggest a short course of probiotics - hormonal changes can affect the level of friendly bacteria in the gut contributing to the bloating.

However, any bloating that is continual or causes pain should be checked out by your doctor as well. You may also find sage helpful for the flushes.

Eileen Durward