What is Menopause?

Menopause is the natural point in life when a woman permanently stops having periods. It is diagnosed after 12 consecutive months without menstruation, usually occurring between ages 45 and 55. The average age in the UK is 51 but of course, no two women are the same. It marks the end of reproductive function and is associated with a decline in oestrogen levels. 

Menopause is usually a gradual process this involves the following:

  • Perimenopause: the period from the beginning of menopausal symptoms.
  • Post-menopause: defined when there have been no periods for twelve months or immediately after surgical removal of the ovaries.

Perimenopause refers to the transitional years leading up to menopause. It is characterised by fluctuating hormone levels, irregular periods, and a range of physical and emotional symptoms. This stage can begin several years before menopause and varies widely between individuals. 

Around 1 in 100 women become menopausal before the age of 40. This is known as premature ovarian insufficiency (POI), which can be caused by surgery, chemotherapy, radiotherapy, genetic, auto-immune or unknown reasons.

Our Menopause Service

We offer GP and consultant-led menopause clinics with BMS and FRSH registered menopause specialists and nutritional therapists. Our GPs, Claire Phipps and Alisha Esmail, are accredited BMS menopause specialists.

We treat each patient as an individual taking a holistic, evidence-based approach that addresses lifestyle, nutrition, hormonal and non-hormonal treatment options, and symptom management strategies. Whether you're navigating perimenopause or the postmenopausal years, we aim to provide empathetic, expert-led care that empowers you to make informed decisions about your wellbeing.

Your consultation will include practical advice, treatment recommendations, and long-term support for managing your health during this life stage. 

How do you diagnose menopause?

The diagnosis of menopause and the transitional process is dependent on the pattern of your periods and the symptoms experienced.
Measurements of hormone levels are not routinely done, but are most useful when early menopause or premature menopause is suspected, when fertility appears to be reduced or after hysterectomy with conservation of ovaries where there is no bleeding pattern to follow.
Common menopause symptoms and signs are:

  • Irregular periods, absent periods, heavy bleeding
  • Hot flushes
  • Night sweats
  • Tiredness
  • Mood changes including low mood, anxiety, irritability
  • Brain fog
  • Low self esteem
  • Decreased sex drive
  • Poor sleep
  • Bladder issues
  • Vaginal problems including increase in infections
  • Vaginal dryness and / or soreness
  • Changes in skin and hair
  • Joint pains

How can I improve symptoms of menopause?

Lifestyle: A healthy lifestyle can help reduce the symptoms of menopause and ensure healthy bones and heart. This can be done through the following:

  • Balanced Diet
  • Regular exercise
  • Reduction in caffeine and alcohol
  • No smoking
  • Reduction of stress levels

Complementary/Alternative Therapies: There are a number of therapies to consider including acupuncture, herbal remedies, aromatherapy, reflexology and homeopathy. These are becoming popular especially for symptomatic relief but there is limited scientific research to support their effect and safety.

Psychological therapies: Cognitive behavioural therapy (CBT) develops practical ways of managing problems and provides new coping skills and useful strategies for a range of menopausal symptoms including anxiety, hot flushes, night sweats and fatigue.

What are the menopause symptoms?

Symptoms can vary by individual, and can include: 

  • Hot flushes and night sweats 
  • Sleep disturbances 
  • Mood changes and anxiety 
  • Vaginal dryness or discomfort 
  • Decreased libido 
  • Brain fog or forgetfulness 
  • Fatigue and joint pain 
  • Weight changes 

How long do menopause symptoms last?

Symptoms may begin in perimenopause and last 4 to 8 years on average, although for some women they may resolve sooner or persist longer. 

When should I seek help?

If menopause symptoms are disrupting your quality of life, sleep, relationships, or emotional wellbeing, it is advisable to seek support from a menopause specialist. Early intervention can significantly improve comfort and long-term health outcomes. We also advise individuals to have consultations to learn more about how they might be able to support their perimenopause early, even if your quality of life is not significantly impacted, as knowledge is power.  
 

There are many different options to treat menopause symptoms, and you may be worried about using HRT or someone who has been told you cannot use HRT – please do not worry, there are options to be discussed and we can help you take control of your health, both now and future-proofing too.  

Can menopause affect mental health?

Yes. Hormonal changes can contribute to low mood, anxiety, irritability, and poor concentration. Psychological symptoms are often the first symptoms to be felt. These symptoms are common and treatable. A supportive, individualised care plan can make a significant difference. 

Why is weight gain common during menopause?

Oestrogen decline, reduced muscle mass, and metabolic changes can contribute to weight gain, particularly around the abdomen. Nutrition, resistance training, and tailored support can help mitigate these changes. 

Can menopause affect sexual health?

Yes. Lower oestrogen can lead to vaginal dryness, discomfort during intercourse, and reduced libido. Treatments such as local oestrogen therapy and lubricants can be helpful. We can also guide you through the option of testosterone if needed. 

Do I need contraception in perimenopause?

Contraception remains important during perimenopause, as pregnancy is still possible until menopause is confirmed. In a consultation, we will discuss your current contraceptive method, any changes in your cycle, and how these relate to both your contraceptive needs and menopause symptoms. We'll explore options that can offer both effective contraception and additional benefits, such as helping with heavy periods or providing hormone support, ensuring the approach is safe, suitable, and tailored to your individual health and lifestyle.

Book your Menopause appointment online

Menopause affects women very differently, make those later stages lighter with our menopausal care package.

Menopause Treatments & HRT

Hormone Replacement Therapy (HRT) is a common treatment that replaces declining levels of oestrogen (and sometimes progesterone). For most women, HRT is a safe and effective way to manage symptoms and reduce risks of osteoporosis and cardiovascular disease. Risks and benefits should be reviewed individually. 

HRT is one option to treat menopause symptoms, however some women choose not to take this and these are some of the alternatives available.  All of these can be discussed with our menopause specialist during your consultation.

  • Lifestyle changes (diet, exercise, stress management) 
  • Cognitive behavioural therapy (CBT) 
  • Non-hormonal medications for hot flushes or mood including newer non-hormonal medications for hot flushes and night sweats.  
  • Vaginal moisturisers and lubricants
  • Vaginal oestrogen treatments  

GP led Menopause Consultation

Book a 45 minute consultation with our GP that specialises in Menopause health.

£325

Consultant led Menopause Consultation

Book a 30 minute consultation with our consultants that specialise in menopause health.

£325

The WID-Easy Test – An Innovative Test for Post Menopausal Bleeding

 

The WID-easy test (also called WID-qEC in research) helps doctors more accurately assess women who are peri-menopausal or post-menopausal and experiencing abnormal uterine bleeding.

Compared to a standard transvaginal ultrasound (TVUS), the WID-easy test can reduce unnecessary follow-up procedures, such as hysteroscopies, by over 90%, while still detecting the same number of cancers.

London Gynaecology offers the non-invasive test. If you are in the peri/post menopausal stage of life facing abnormal bleeding, book a consultation with our menopause GPs to discuss test options.

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