Menopause is the hardest teacher I’ve met. Harder than fame

– Tori Amos, singer-songwriter

No one likes to be reminded of increasing age and for women the menopause is perhaps the most obvious indication. Symptoms can begin in the mid to late 40s and may grumble on for years before one enters the full menopause; for others, the experience is relatively short-lived and trouble-free – those are the lucky ones!

The main symptoms of the menopause are well-documented – the hot flushes (an unpleasant creeping feeling of intense warmth that quickly spreads across your whole body and face) and night (and day) sweats, increased anxiety, insomnia and tiredness, brain fog, mood swings, aching limbs…..

There are days when you wake from a night disturbed by hot flushes and poor-quality sleep and wonder how you will get through the day, functioning on the most basic level, let alone trying to practise and refine complex music. In addition to long periods of inadequate sleep, I also experienced unpleasant joint pain in the ankles and wrists which made sitting at and playing the piano uncomfortable.

Hot flushes overwhelm one at unexpected moments and in a performance situation can be deeply distracting, especially if accompanied by perspiration (itself a symptom of performance anxiety), which can make fingers slippery, turning the keyboard into a skating rink.

‘Brain Fog’ is perhaps the most debilitating, especially if you are used to being alert and ‘on the ball’. It can cause problems with memory, concentration and motor skills – all significant functions for a musician – and can affect mood, leading to negative thoughts, anxiety and depression. It is thought by researchers to be caused by hormone changes in the body: falling estrogen levels can actually affect the way in which the neurotransmitters work in the brain, which causes slower transmissions and slower nerve contacts.

With this cocktail of symptoms, motivating oneself to practise and work can feel like a Sisyphean task. Fortunately, there are self-help remedies, HRT and lifestyle changes which can help alleviate or manage the symptoms of menopause, enabling one to function as near to normal as possible.

The following have worked for me:

Hot flushes: loose, light clothing, especially for concerts helps a lot. I always have a handkerchief to hand when performing (it can be left discreetly on or in the piano). I also carry a rosewater facial spray which gives a nice cooling spritz on the face and helps create a sensation of cooling down. A small fan can also help (handbag size battery operated fan or a Spanish style fan). Try to avoid hot flush dietary triggers such as alcohol or chocolate.

Tiredness: sometimes one just has to give in to the tiredness and take a break or even a short power nap. Regular exercise can also help regulate sleep.

Aching limbs and joints: evening primrose oil relieved these unpleasant symptoms for me, in a matter of days. If the body hurts, don’t push it to practise too much but rather aim for “little and often”. Warm up properly and never play through pain

Brain Fog: the good news is that this symptom tends to pass as hormone levels settle or are regulated with HRT. Self-help solutions include staying well-hydrated and avoiding dips in blood sugar levels. Quality sleep helps too, and on the days when I feel particularly “foggy”, I try not to overload myself with too many commitments or work projects, take plenty of breaks, and pace myself so I don’t feel overwhelmed.

Above all be kind to yourself, and seek medical advice if you are finding the symptoms particularly troublesome.

In common with other women friends of the same age, despite the unpleasant symptoms of the menopause, I have entered my 50s with a new energy (mental and physical), greater creativity and a strong sense of self-determination, self-worth and confidence, and I hope others feel the same.