At 43, I'm suffering night sweats and insomnia

Q. At 43, I have night sweats before my period, insomnia a day or two before, and I’m so restless my husband moves to the sofa. Can you suggest any supplements or other natural remedies?

A. ‘The first step is to get a diagnosis,’ says consultant gynaecologist Michael Dooley. ‘Your symptoms could be due to several causes or a mixture.’ So do book in with your GP for tests (see below) and meanwhile try these simple shifts.

Keep a diary or follow a (free) period tracker app (eg Period Tracker Lite): this gives invaluable information for your doctor and helps you feel in control.

Changes in your periods and night sweats indicate hormonal imbalance: this could be early symptoms of menopause (perimenopause). Your GP will probably do blood tests for hormone levels (FSH – follicle stimulating hormone – and oestradiol), which signpost the stage of menopause and any significant hormonal deficiency. This should be done in the early part of the cycle and will need to be repeated, due to hormonal fluctuations.

Symptoms in the latter half of your cycle suggest premenstrual syndrome (PMS). This is common in perimenopause and is likely to be connected to falling oestrogen levels, so adding oestrogen (as a patch or gel) for the second part of your cycle – or the whole – may help. This is HRT (Hormone Replacement Therapy) rather than a natural remedy, but it’s often useful to see how a patient responds over two or three months to confirm the diagnosis. You can always review then.

Your symptoms might also suggest thyroid problems: difficulty sleeping, mood swings and sensitivity to heat may be linked to an over-active (hyper-) thyroid. Discuss with your doctor.

Supplements may be useful: try Biocare Femforte 1, a multivitamin/mineral suitable for women of all ages/£23.65 for 90 tablets - buy here; Lamberts Vitamin B6/£4.60 for 100 tablets - buy here; DynoMins Magnesium/£14.95 for 90 tablets - buy here; and IdealOmega3/£23.70 for 60 capsules - buy here. Additionally, Sage Complex, an herbal blend, has helped many women around menopause/£23.95 for 90 capsules - buy here.

Yoga has been shown to help: try slower forms of yoga (eg Iyengar, www.iyengaryoga.org.uk).

Avoid coffee, caffeinated drinks (also chocolate), and alcohol. Sip plenty of still water during the day and keep a glass by your bed.

Keep blood sugar levels steady by eating every two to three hours (wholesome snacks between meals, not confectionery!).

Read Your Change Your Choice by Michael Dooley and me. Your Change Your Choice /£8.45 - buy here.

A DARLING DUCK

Don't tell, but we’re longing to find a Cuddleduck in our Christmas stockings. They’re designed for babies (and toddlers) but this natural rubber quacker (free of chemical nasties such as phthalates, and with child-safe paint) is so adorable we’ve all fallen for him. Squeeze him and he squeaks, and even squirts wax. Cuddleduck/£5.99 - buy here.

A MASSAGE MADE IN HEAVEN

There’s nothing more attractive than bright skin. But somehow dull days often mean a dull complexion and with party season coming up, it’s time to prep.

Facialist Annee de Mamiel, who’s trained in Traditional Chinese Medicine and acupuncture, recommends giving yourself a short facial massage every evening. ‘Stimulating the microcirculation gives a radiant glow, fine lines are reduced and by moving the lymph you reduce puffiness.’ Annee recommends using facial oil at night (I love her organic seasonal oils/from £58 for 20 ml - buy here).

Smooth 4-5 drops facial oil on to cleansed face and neck.
Cup your hands over your nose and mouth and breath in deeply for a count of three, then exhale slowly to a count of five.
Repeat three times to release tension.
Using small circular upwards movements massage your jawline from the point of your chin to your ear. Then from the corners of your mouth over your cheeks to ear lobe. Next from the base of your nose to the top of your ear.
Continue until the oil is absorbed (or your fingers are tired).

NB Annee also suggests eating lots of healthy soups made with red, orange and yellow veggies, which are rich in skin-nourishing beta-carotene (a precursor of vitamin A).

THE HEALING POWER OF PILATES

The benefits of Pilates – an exercise method which develops strength, flexibility and coordination – now include help for pre- and post breast cancer care. Ten Pilates in London offers a one-on-one, individualised course designed for women undergoing mastectomy to help prevent lymphoedema (long term swelling where lymph nodes have been removed in the arm) and also to regain shoulder movement. Additionally, master trainer Amy Ryan has compiled a series of exercises to follow at home, on www.tenpilates.com. One hour Pilates lessons with Amy Ryan/approximately £100 - call 020-7495 8642.

PS Pippa Middleton credits her super-toned figure to regular Pilates sessions.