I'm 48 years old and over the last few weeks I have noticed that I seem to perspire a lot, to the extent where I look as though I've done a workout at the gym. I feel very tired although I do exercise; I dance once a weekk and I go road running at least three times a week. I'm a DVT patient and I can't take HRT. Can you help me?

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

I would suggest stopping the strenuous exercise for a few weeks until your body has had a good rest but you can do gentle exercises to keep your fitness up, such as swimming and yoga.

I would also recommend a gentle iron supplement; if you exercise a lot you may be slightly deficient and that can cause fatigue as well.

If you wish to continue to exercise hard during the menopause, it is very important that you make sure that your nutritional needs are met. The need for proteins, vitamins and minerals goes sky high at this time so I would recommend that you add in a special sports protein shake to your daily diet.

If you don't get enough you can end up running on empty and could end up seriously fatigued!

In the meantime, you may find sage helpful for the flushes.

Eileen Durward