• Migraine responds unpredictably to HRT, and your doctor may suggest you try it for a month or two to start with to see how it affects you. If you develop migraine for the first time during or after the menopause, then it may be

Some women find it returns during the days in each month when they are taking progestogen. Unfortunately, in these cases, changing to a different type of progestogen will probably not bring much improvement.

• Women who are overweight can usually take HRT, but very overweight women have a higher-than-average level of oestrogen, and increasing this level with HRT can increase the risk of breast cancer. However, these women, because of their higher oestrogen levels, tend to be less troubled by menopausal symptoms, and are at low risk of developing osteoporosis.

• There is no reason why smokers shouldn’t take HRT, although some doctors advise them to give up smoking while they are on it. Smoking reduces oestrogen levels.

• Varicose veins are not usually connected with deep vein thrombosis, and if this is so for you then there is no reason why you can’t take HRT unless they are acutely inflamed (phlebitis). Superficial inflammation of varicose veins is not a contraindication.

Between 10 and 20 per cent of post-menopausal women have significant contraindications to HRT, and the majority of them have menopausal symptoms that cause them long- or short-term embarrassment or distress. They need treatment to cope with the hot flushes, etc, and to increase their sense of wellbeing, yet many doctors aren’t particularly helpful.

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