Menopause is the period in a woman’s life, usually occurring between the ages of 45 and 55, when her ovaries stop producing eggs as well as less oestrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether. The symptoms of menopause are caused by changes in levels of oestrogen and progesterone. Specific symptoms and severity varies from woman to woman. Menopause symptoms may last five years or longer. Common symptoms include: heart pounding or racing; hot flashes; night sweats; skin flushing; and sleeping problems. There may be a variety of additional symptoms, including: headaches; joint aches and pains; mood swings, irritability and depression; vaginal dryness and painful sex; and decreased interest in sex. One management option is hormone replacement therapy (HRT). It may not be suitable for all women as HRT carries the risk of developing breast cancer, heart attacks, strokes and blood clots. Ways of reducing the risk and still getting the benefits of HRT may be required. As alternatives to HRT, there are medications available to help with mood swings, hot flashes and other symptoms. These include low doses of some antidepressants. Acupuncture has also proved successful for some women. Symptoms may also be reduced by lifestyle changes, including: avoiding caffeine, alcohol and spicy foods; dressing lightly and in layers; regular exercise, and using relaxation techniques; Kegel exercises to strengthen vaginal and pelvic muscles; and remaining sexually active.