As I am now well and truly in pre-menopause, I thought it was time I dealt with some of the issues surrounding it. So number one on the list is the dreaded hot flush.

My mum suffered terribly with these, for about 10 years. We'd be walking round town and she'd come over hot and faint, dizzy and sick, and have to sit down. I got very used as a young girl to dealing with her, as she used to panic in these moments. She began her menopause young, at 36, with the whole thing finished by 40, but her flushes continued for years.

Since we are very similar types physically, I was rather dreading going through the same routine, but my early menopause has been shelved by 15 years of the Pill, so I reckon I'll only be having it a couple of years younger than most women.

The hot flushes are a bitch, though. I was troubled with them briefly a couple of years ago and took Evening Primrose Oil for a few weeks until they went away, but they returned with a vengeance a couple of weeks back, and this time they were pissed off.

No-one ever told me that they feel like the flu. Not 'hot', but a raging torrent of intense, burning fever, with your heart palpitating and your head pounding, something like a panic attack. They were coming every 50 minutes and lasting about four minutes, which was taxing, to say the least - no sooner had I got over one then another one was up on the horizon. 

Increasing my dose of EPO didn't work, so I began to search around for other solutions. I can't have HRT, and would be wary of it even if I could, so I asked around my older girlfriends and came up with two herbs - Borage oil and Black Cohosh. The Borage oil has worked pretty well and the little sods are now down to 2-3 weak flushes a day, of short duration, and about the same at night. 

The night issue is a thorny one, though. I invested in some wicking pyjamas (review to follow), which are great, but suddenly both our memory foam mattress topper and our goose feather duvet seem impossible to tolerate. I haven't quite decided on the solution yet, but I think it might well be a wool topper (the memory foam needs replacing and the DH has always hated it), and a wool combination duvet for its better wicking qualities. 

Will report back. 

Oh well, it comes to us all I guess. Last week I had my first hot flush.

To tell the truth, I'm surprised it's taken so long. Given that my mother and sister began pre-menopause at 36, I'm lucky to have held it off so long, but the Pill has done a lot to help that. 

But one thing that is taking me by surprise about ageing generally is how un-gradual it is. 

You'd think, wouldn't you, that you'd go from no flushes to maybe one every so often - say one a week. Then two a week, then one a day. But it doesn't work like that, at least not with me. 

Just as I woke up one day with a sudden crop of lines around my eyes, and just as last winter I suddenly ached in every joint badly all at once, my hot flushes began five days ago and it's wham-bam 6-10 a day right from the get-go. 

Luckily for me, they're pretty minor affairs. I feel dizzy, of course, and a bit sick - it's rather like you feel when you have a virus - but they only last 30 seconds or so and then they're gone. I sneaked a peek at myself in the mirror during them, too, and I can see that I go bright red - as is my wont, this actually makes me look slightly healthier. 

Oh la, I guess it's time to denicher the evening primrose oil, or see if I can track down some Agnus Castus.

Menopause here we come.  

The pre-menopause (or perimenopause) begins for most Western women at about the age of 37 or 38 and usually lasts for about ten years, give or take. That means many of us are in pre-menopause throughout our 40s.

What causes pre-menopause is simply that your ovarian hormone production is starting to decline and fluctuate, leading to a range of side effects. Some women get heavier periods, while others might skip periods altogether. For myself, at the age of 44, I recently had the first late period of my life, and very strange it felt too, knocking me quite out of kilter.

Much of the information you can obtain about pre-menopause is depressing and frightening, focusing on the wide range of unpleasant symptoms women experience. Some women get mainly physical symptoms such as night sweats, hot flushes or cold extremities, and many have difficulty sleeping, but for many women the psychological effects are worse than the physical ones, including disorientation, dizziness, and weepiness and over-emotionality.

Because of these changes and how terrible they can make you feel, pre-menopause is traditionally seen as a tough time in a woman's life. However, there is a strong argument that really we should be grateful for it.

Pre-menopause is your body's way of slowing down the major changes that will occur once the menopause has hit fully. No-one wants all those changes at once, the way you can get them after hysterectomy or cancer treatment and moving gradually into menopause enables you to adjust to your new self over a period of time.

Your 40s is an opportunity to get ready for menopause and to make this important transition in your life more manageable and tolerable.

Strategies

Obviously, once you start to get symptoms (see below for a link to a full list), the first thing you should do is consult your doctor. Some symptoms can be relieved with low-dose oral oestrogen, or progesterone cream; herbal remedies that balance the hormones can be very helpful, particularly Agnus Castus; soy supplements contain a phyto-oestrogen and can help relieve many mild symptoms from headaches to vaginal dryness. It is pointless to suffer in silence when there are remedies at hand - we are not our mothers and the medical profession has found great remedies in the past couple of decades.

However, this stage in your life is also a time to take control of some things yourself, which can help you feel more in charge at a time when you may be vulnerable.

Yoga and meditation are tremendously helpful in keeping your body flexible and your mind calm, and yoga also increases progesterone production, which balances your hormone levels. Physical exertion - particularly walking, running and other weight-bearing forms of exercise - will help keep your bones strong and are also mentally calming. You can help to balance your own hormones by switching to a better diet, cutting out refined wheat products and sugars - and stopping smoking if you haven't done so already.

Lastly, remember that menopause is nature's gift. It is her way of keeping you alive after your procreative usefulness has ended, and will enable you to pass on your wisdom and experience to a new generation. Like grief, every woman who lives long enough goes through this and you will cope with it, as millions of others have done before you.

* NB: due to physical changes that take place with your ovarian follicles, multiple pregnancies become more likely during pre-menopause. Do not stop using contraception.

* For a technical explanation of how pre-menopause works, click here

* For a chart of symptoms along with ways to deal with them, click here