Her menopause programme aims to tackle symptoms such as hot flashes, night sweats, weight gain or insomnia, using everything from nutritional consultations and alternative therapies, such as acupuncture or hypnotherapy, to gynaecological referrals.

"It's about looking after yourself," says West. "Having regular health check-ups, improving your diet to include foods that contain phytoestrogens [compounds similar to the hormone oestrogen, levels of which drop in menopausal women] and doing regular weight-bearing exercise for bone density."

Ruth Carr, 58, a PA from London, was suffering badly from hot flushes, weight gain and bloating. She was on hormone replacement therapy (HRT) and hated it. The menopause programme, she says "changed my life".

She was advised to make simple lifestyle changes: 30 minutes on a mini trampoline each morning, no caffeine or fizzy drinks, no carbohydrates in the late evenings, regular pelvic scans, mammograms and health checks. "I learnt that I have to look after myself," she says. In five months, she has dropped both a dress size and the HRT. She has no bloating and experiences very few hot flushes.

"All clients vary," says West. "Some choose to take a completely natural approach, others try a more integrated strategy, combining medical treatments with nutritional and complementary therapies."

"I was suffering from Peter Pan syndrome," says Sonia Cadman, 40. "With all the Botox and creams and youthful clothes it's easy to carry on feeling thirtyish for ever." Unable to become pregnant at 39, she saw a fertility specialist for tests. "Within 10 minutes of my first visit, the doctor had told me I'd gone through the menopause so was incapable of conceiving and that my only hope was a donor egg."