These are symptoms that do not appear until some time after the menopause, but which tend to get more noticeable and troublesome as the years go by:

• bladder problems, such as stress incontinence, and needing to empty the bladder frequently and without warning

• recurrent bacterial infections of the vagina and urethra (the passage through which urine is discharged)

• vaginal dryness

• pain during sexual intercourse

• generalised muscle aches and pains

• thinning skin and hair

• Bleeding and shrinking gums sometimes improve with HRT.

• Many women experience ill-defined muscle and joint pains around the time of the menopause, especially in their hands, wrists, elbows, knees, shoulders and lower back. These are often misdiagnosed as arthritis, and this particular type of joint pain usually improves with HRT. Women whose arthritis gets worse around the time of the menopause may find HRT brings some improvement.

• The causes of hair loss and brittle nails are not very well understood; these problems may be linked more to increasing age than to a fall in hormone levels.

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• HRT QUESTION: WHEN SHOULD PREVENTION OF OSTEOPOROSIS START?
• HOW TO IMPROVE SEX DURING AND AFTER MENOAUSE: HORMONE THERAPY
• HORMONES USED FOR OSTEOPOROSIS
• HRT: WHAT ARE PROGESTERONE AND PROGESTOGEN?