Menopause is a dirty word for women of all ages, but women in their 30s often try to avoid thinking about it altogether.
Play the word association game and you get old, infertile, past it, cranky, unreasonable. It's safe to say that few women actually look forward to menopause.
But whatever your feelings about this time of life, this is what you should know before it arrives:
1. 8 years in a leaky boat
Menopause lasts significantly longer than we used to believe. Christchurch obstetrician-gynaecologist Olivia Smart says women go through eight years of hormonal fluctuations until menstruation ends when they are 51, on average.
Ask your mother when she experienced menopause, because chances are you will have a similar experience.
And if your mum was aged 40 or younger when her periods stopped, you should talk to your GP about your own fertility, and how you can protect your bone and heart health if you also hit menopause early.
2. Cheer up lady, it's not that bad
The general perception is that menopause is a miserable experience you would not wish on anyone, and let's be clear — it's no pony ride.
"It's a very real issue for women in their 40s," says Smart. "A lot have to hold down a job and manage young families but there is this huge change looming which might effect their quality of life.
"It could be a crippling blow from a mental health perspective or on a cognitive level. The only comfort is that there are very good treatments available."
Some of those treatments are hormonal (we will get to HRT momentarily) and some are not, but the good news is that innovation is improving the quality of life for menopausal women every year.
3. HRT is not evil
The perception of hormone replacement treatment has changed wildly over time. Once treated as a near-miraculous way of extending youth and treating the symptoms of menopause, it got a lot of bad publicity in the early 2000s when research linked it to breast cancer and heart disease.
"Using HRT for a short period of time [five years or less] is a safe thing to do," says Smart. "The safety data is pretty reassuring around that. It's about seeing a practitioner who is experienced and has the up-to-date information.
4. Heavy going
It's true that a lot of women gain weight at menopause and that their body shape changes, with a thickening of the waist and extra pockets of fat collecting around their hips and bums.
Smart advises women still in their 30s to maintain a healthy weight, eat foods rich in calcium, do weight-reistance exercises, and do exercises that promote cardiovascular health.
The better the shape you are in approaching menopause, the better you will be able to cope with it.
5. Is it just me, or is it hot in here?
Hot flushes are the gift that keeps on giving, sometimes for several years. Most people know that hot flushes are a sudden temperature rise, signalled by red, sometimes blotchy skin.
However, these symptoms may be accompanied by heart palpitations, dizziness and a general sense of unwellness.
If hot flashes are a significant issue for you and you don't want to take hormones, it is possible to inject the neck in a procedure called a stellate ganglion block, says Smart. This can reduce the number and severity of hot flushes a woman experiences
6. Not quite the Sahara, but ...
One of the lesser-known downsides to menopause is vaginal dryness, which is uncomfortable and can make sex painful. The traditional treatment is flaxseed oil, evening primrose oil and lube.
A low-dose topical oestrogen cream can help, but for women who want to avoid the fuss and the hormones, a laser treatment is available which increases collagen production at the site.
While menopause is the end of menstruation, perimenopause is the phase before it. But for convenience sake we tend to refer to the whole transition as menopause.
"Over the age of 45, irregular bleeding should be checked out by your doctor," says Smart. "Endometrial cancers are one of the most common cancers in women, and we are picking them up in women in their 30s and 40s."
8. The neverending period
In some cases, women have really long periods that go one for a month or more.
"If your body fails to release an egg and then the body is not getting signals that it needs to stop the cycle and start again, then you get this continuous bleeding for weeks on end," says Smart.
There is medication available to stop the bleeding, so don't suffer in silence. Ask your GP for help.