World Menopause Day was last week, a day to educate and inform everyone about a subject which will directly affect half the population at some point and indirectly affect everyone.

It’s one of those subjects that people are generally reluctant to talk about – especially men.

I had to give a great amount of thought as to how to cover this subject, purely because I didn’t want to ‘mansplain’ something of such importance to my female readers.

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However, the whole point of this column is to get people talking about, sometimes, difficult subjects that can affect our mental well-being.

So I am grateful for the input from two female doctor colleagues of mine for this week’s column.

Perhaps first we should make sure everyone understands that 'the menopause' is actually a three-stage process which starts for most in mid-life but can vary a great deal.

Perimenopause is a seven to 14-year process when the body gradually makes less and less oestrogen.

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This continues until the last one or two years of perimenopause until hormone levels drop rapidly and the well-known symptoms of:

Hot flushes - these can last a few seconds to several minutes or longer, several times a day or a few times a month;

Night sweats - hot flushes during sleep can result in night sweats. Sleep problems can occur because of night sweats causing irritability and daytime tiredness;

Cold flushes - chills, cold feet, and shivering particularly after a hot flash;

Vaginal changes -vaginal dryness, discomfort during sex, low libido, and an urgent need to urinate are common symptoms; and

Emotional changes - these may include mild depression, mood swings, and irritability.

Twelve months after the last period is menopause, a dot on the map between perimenopause and postmenopause.

Postmenopause, the symptoms that started in peri-menopause may persist in a milder form and continue for a while but decrease in frequency and intensity.

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Some women sail through it, and many don’t. Their bodies go through this gradual change for a decade and the effects of these changes can directly affect the mental health and well-being of many women.

It can be a time of questioning and soul-searching for many as these changes happen. Some can begin to question their femininity or even their purpose.

They can feel insecure and disconnected from those around them. Many try to manage the whole situation without any support, feeling that they will not be understood.

This can be made worse by one of the major physical symptoms - sleepless nights. Sleep is absolutely vital to all our physical and mental health; prolonged periods of disturbed sleep can affect us badly.

Couple this with all the other physical effects and it soon becomes apparent just how much a woman’s overall health can suffer at this time.

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Dr Denise Billen-Mejia

"The physical changes a woman experiences at this time often occur at the same time her children are going through puberty and her parents and in-laws are ageing and perhaps needing more help.

"She is part of the sandwich generation and may delay seeking help for herself because she is so concerned for other family members. Self-care is important for everyone, but women need to advocate for their needs."

Dr Sandra McCutcheon

"I am wearing 'M-plates'. The M stands for 'mindful-menopause'. Menopause is a new experience in my life and I am using my skills of mindfulness to kindly observe the changes in my mind, mood and body.

"It's really tricky at times, so that's why I'm tuning in more and more to self-compassion."

If you feel you are in a mental health crisis or emergency and may be in danger of causing harm to yourself or others then please contact your GP, Samaritans on 116 123 or attend A&E.