Ask Megan Sheppard: I’m 45 and have started to get the occasional hot flush.

Peri-menopausal changes can begin anywhere from the age of 35 onwards as levels of progesterone and oestrogen typically begin to decline. Taking steps to support your hormonal health naturally at this stage should help you to transition more easily.
Hot flushes are one of many symptoms that occur during this time of change, along with fatigue, insomnia, memory loss, headaches, mood swings, breast tenderness, weight gain, vaginal dryness, bladder problems, bloating, osteoporosis, decreased libido, and changes in skin, hair, teeth and nails.
Hot flushes and night sweats are the most common symptoms, experienced by three-quarters of women going through menopause. Sage (Salvia officinalis) has been proven in clinical trials to reduce the incidence of hot flushes.
A Vogel’s Menoforce, in particular, showed a 56% reduction in hot flushes in a randomised, double-blind, placebo-controlled trial. Menoforce Sage tincture tablets are made with an extract of sage herb obtained from freshly harvested, organically cultivated sage.
Each tablet contains 51mg of concentrated dried tincture from fresh sage (Salvia officinalis) leaves, which is equivalent to 3,400mg of tincture of fresh sage herb. Even better, you only need to take a single tablet daily. Menoforce costs €17.55 for 30 tablets, or €44.95 for 90 tablets.
I have found that cold-pressed wheatgerm oil greatly enhances the action of any herbal menopause formulation. The herbs themselves provide the building blocks for hormonal balance, while the wheatgerm oil contains active ingredients that act as a catalyst to chemically convert the precursors into the hormones that should ease your symptoms.
To address your sex drive concerns, I would suggest the traditional Chinese adaptogen, Dong quai, which has a tonic action on the reproductive system. Dong quai not only works by balancing hormonal health, it also helps to increase vaginal lubrication.
Yet another adaptogenic herb which helps nourish the body, balance hormones, and restores sex drive is the Andean superfood, maca. This root vegetable is a complete protein and high in many vitamins and minerals, including calcium and zinc. Zinc is important for healthy libido functioning in both genders, with zinc deficiency being one of the most common causes of a decrease in sex drive. Maca increases energy levels, improves mood, and is a powerful antioxidant.
Key nutrients for strengthening the blood vessels include the antioxidant vitamins A, C, and E along with the mineral selenium. Vitamin C, in particular, is indicated where the nosebleeds occur spontaneously.
Foods rich in vitamin C include kiwi, citrus fruits, melons, strawberries, tomatoes, broccoli, cabbage, red capsicum. Of course, she can simply take a vitamin C supplement — look out for one with bioflavonoids and get your daughter to take 3,000mg daily in divided doses of 500-1,000mg.
Vitamin K is also very important, since it helps blood to clot effectively. If your daughter has trouble with heavy or prolonged periods, bleeding gums, and a tendency to bruise easily then she may have a deficiency in this nutrient, and will benefit from supplementation with vitamin K1.
She will need to take 50-100ug (micrograms) daily. Foods rich in vitamin K include leafy green vegetables, alfalfa sprouts, raw milk and yoghurt, broccoli, Brussels sprouts, cabbage, cauliflower, oats and rye. These are worth adding in where possible to bolster her levels of vitamin K1.
If she does experience a nosebleed that seems heavier than usual or lasts for more than a minute then please do see a doctor.