I'm in my late 40s and perimenopausal. In the past few months, I've started to get joint pain in my hands. My work is computer-based, so I'm naturally concerned. What would you recommend?

The key is to approach your joint pain as a hormonal symptom. Ensuring that you are getting plenty of healthy fats in your diet is essential since they help to reduce inflammation and pain and manage other menopausal symptoms such as dry skin and brain fog.

Blood sugar imbalance is another issue at the root of many perimenopausal symptoms, particularly when it comes to inflammation, irritability, hot flushes and night sweats. This is managed relatively easily through dietary tweaks and can be supported through natural supplementation if sugar cravings are a bigger issue.

A modified ketogenic eating style seems to work well for many women managing menopause symptoms and helps reduce inflammation. Ensure you eat enough protein and get in quality carbohydrates in the form of whole vegetables and some fruits, nuts, seeds, avocado, and healthy oils such as hempseed, olive, and coconut.

Cinnamon or cassia sticks brewed with ginger root (fresh or dried) can be beneficial in reducing pain and swelling in your joints and improving blood flow. These spices also help to balance blood sugar levels. You can also add a tablespoon of apple cider vinegar to the brew as it is rich in minerals - potassium, phosphorus, calcium, magnesium, natural silicon, pectin, and tartaric acids. A touch of honey can help with flavour and be of additional benefit as it  is a natural anti-inflammatory agent.

Supplement-wise, you would benefit from a curcumin and Boswellia blend. Curcumin is the active ingredient in turmeric root and has been shown to inhibit the production of the inflammatory agent nitric oxide. Boswellia works by opening up the blood vessels causing restriction and pain in the body and has been proven in clinical studies to be as powerful as ibuprofen and other over-the-counter pain relief.

You recently recommended a rub for pain. I have a bad hip and wonder if the rub would help. I'm 79 years old and find physio treatment quite good - I don't need a hip replacement. I am also taking a supplement, Jointace Max. Do you think this is a good idea?

It's good to hear that you are finding relief from the physio treatment. The supplement you are taking includes glucosamine, chondroitin, omega-3, turmeric, and collagen, along with vitamins C, D, E, trace minerals, and ginger – all of which are great for joint health and repair. 

The glucosamine and chondroitin should be of particular benefit. Glucosamine sulphate provides the joints with elements to repair cartilage, tendons and ligaments, and chondroitin sulphate attracts nutrients and fluids to the joints to increase lubrication and shock absorption capabilities.

The topical pain relief I recently recommended was Optima’s Glucosamine Joint Complex gel, which utilises glucosamine, MSM, Devil's Claw, menthol, and warming essential oils to improve blood flow, reduce inflammation, and encourage tissue repair. A 125ml tube costs €14.20 from health stores.

This gel should help to bring some relief in combination with the supplement you are taking. Other botanical ingredients to look for in a rub or balm for pain relief include cayenne (or the active ingredient capsaicin), ginger, arnica, and comfrey.

NOTE: The information contained in this column is not a substitute for medical advice. Always consult a doctor.

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