I am 53 years old and I am still having regular periods, although twice recently I have gotten a double period. I did miss one period nine months ago as well. I have been getting lower back and groin pain for the last few months, alongside nausea and feeling out of sorts. I am fit for my age - I bicylcle 180 miles per week on average - and I have regular physical and GYN check-ups. I had been blaming the backache on the cycling, but I have never had this problem before, and the backache appears to be worse at different times of the month, especially the day before and during my period. My only real menopausal symptom before this was some hot flushes at night. I am sleeping a lot recently, about 9 hours a night! I have been worried that there is something terribly wrong with me. Could this all be menopause related and, if so, how much longer might it go on?

Hormonal changes often start well before the menopause and are often undetectable - you would still get regular periods etc.

However, at some point the changes will start to affect the body in many different ways. As you have found, your periods are having the odd blip and other symptoms such as joint pain can surface.

Many of the symptoms are due to falling or fluctuating oestrogen, and this can affect the joints, digestion, skin, nervous system, mood etc.. So in effect you are still getting reasonably regular periods but are starting to notice some body changes such as the joint pain.

Blood tests to see where you are hormonally are not particularly accurate, and do depend on your hormone balance on the day. If you were having a high oestrogen day your test would come back negative!

It does seem like you are starting the approach to the menopause and you are in the average age range which is 45-55. How long this will take is anyone's guess. Unfortunately, it is impossible to say as each woman will have her own unique menopause and timescale, but on average peri-menopause from the start of changes to when your periods stop for good, is about 2 years but can be up to 5 for some women.

At this time I would suggest some kind of phyto-oestrogen supplement such as Black Cohosh, Red Clover or a fermented soya supplement - it must be fermented to be of any help! All of these supplements gently raise and balance oestrogen and can minimise symptoms.

Looking after yourself well is really important and can make all the difference between a bad and good menopause so having a healthy, varied diet with lots of water (especially for the joints as low oestrogen dehydrates the joints leading to pain and inflammation), can help.

Remember to take plenty of rest and relaxation as your body is going through tremendous stress with the hormonal changes and needs rest to help rebalance itself.

Exercise sensibly and be careful of pushing yourself physically as the stress of the menopause itself 'eats  up' your mineral reserves and daily vitamins. If you exercise too hard that just about triples your nutritional needs, so you can end up really depleted and this will cause fatigue, low mood, muscle pains and can trigger flushes as well.

If you need to exercise a lot, it is important to take a properly formulated sport's nutritional supplement. I would also recommend a daily protein powder shake, but make sure that it does not have lots of sugar or artificial sweeteners in it.

Eileen Durward