My name's Richard Anderson, I'm Professor of Clinical Reproductive Science at the University of Edinburgh.
I also work at the Royal Infirmary as a specialist in Infertility and Reproductive Endocrinology.
One of the key functions of the ovaries is to produce the hormones, and that's basically oestrogen,
which is the immediate cause of your periods.
But it's now very well recognised that oestrogen is important for all sorts of other aspects of your health,
now and for the longer term.
The most established benefit of oestrogen is keeping your bones strong and healthy.
That's why in older women, you'll often see or hear about them getting osteoporosis and thinning of the bones.
That's really an inevitable consequence of oestrogen deficiency but it can be pretty well completely reversed
with hormone replacement, with taking oestrogen, combined with things like exercise
and calcium and vitamin D in the diet as well.
So oestrogen is very important in protecting your bones against premature osteoporosis and early fractures.
There are all sorts of other things that oestrogen is now increasingly thought to have a major affect
in maintaining women's long-term health.
A particular issue here is heart disease, and protecting against early heart disease in healthy young women
up until the age of the menopause.
And there's also some evidence that oestrogen is important in preventing aging of the brain.
Keeping your brain healthy for as long as possible is clearly a very important thing that we all want to try and do.
Another common problem is sexual function.
So, after the menopause and after not producing the hormones,
you can get a lot of problems with vaginal dryness
and this can lead to difficulties with sex and often very sore vaginal penetration.
And that will also impact on how interested you are in sex, because of course if it's painful,
it's not something you want to do and this can lead on to relationship difficulties as well.
Many of these symptoms are very readily addressible,
so they reflect a lack of oestrogen production from the ovaries and so hormone replacements with oestrogen,
or oestrogen with progesterone, can often be very, very effective in restoring these problems.
There are a variety of ways in which you can take hormone replacement therapy.
Perhaps the most common is tablets and that's pretty straight forward.
Unlike the combined pill, when you have a week off every month,
with HRT, you tend to take a tablet every single day.
If you've not had a hysterectomy, if you've still got your womb,
then you will need to have some of the hormone progesterone, as well as oestrogen,
that will give you a period every so often, not necessarily every month, but at intervals.
So that's an important part of that.
As well as tablets, many women take HRT in the form of patches.
That can be very, very successful as well.
There is perhaps some evidence that actually, patches are slightly better
at reducing the risk of blood clots and things,
but actually it generally boils down to the individual's preferences as to whether
they'd prefer to take a pill a day or a patch.
And some women do find patches difficult with irritation on the skin from where the patch has been applied
or they do a lot of sports, they do a lot of swimming, and they find that it's just a bit awkward.
But if patches suit you, then they're a great way of taking the hormones.
Sometimes the sexual side of things, with the vaginal dryness,
that needs some local oestrogen treatment into the vagina as well as tablets or patches,
just to really get things back to normal.
Sometimes the patches and tables don't give quite enough hormone production
to really get the vagina back to how it was beforehand.
Don't be afraid of asking your doctor and discussing these things because they'll be very keen to help you
and there are lots of remedies available.
HRT has had a bit of a bad press over the last few years,
with studies in older women showing increased risk of breast cancer, and particularly, blood clots.
But it's important to remember that those studies largely included women
who were already some years after a natural menopause,
so were already into their later fifties and even into their sixties.
That's a very different situation from younger women in their twenties, thirties and forties taking HRT,
who are intrinsically healthier, and are also taking hormones that they ought to be producing anyway,
but they're not because of the treatment they've had.
After treatment, it may be that your cycles are back to normal and everything seems to be great,
and your fertility is probably going to be unaffected.
But if you are worried, if your periods have not come back or they're irregular,
or you've been trying to get pregnant and it's not worked out,
then do speak to your doctor about this because they can do some assessments,
they can refer you on to a reproductive medicines specialist team if necessary
and there's lots of help that can be brought out to help you through this difficult time.
Sometimes it may just be a matter of thinking actually, there's some tests that are reassuring
and that things should work out.
But they can also identify where there are problems and then you can get on with the right treatments as soon as possible.