Common symptoms include hot flashes and vaginal dryness. There may also be sleep disturbances. The combination of these symptoms can cause anxiety or depression. Menopause is a natural process with treatments that focus on symptomatic relief. Vaginal dryness is treated with topical lubricants or oestrogen. Medications can reduce the severity and frequency of hot flushes. In special circumstances, oral hormone therapy may be used. Menopause is a point in time 12 months after a woman's last period. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition or perimenopause. The menopausal transition most often begins between ages 45 and 55.