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Menopause & Hormone Clinic

It is generally accepted that oestrogens abolish menopausal symptoms, increase bone density, reduce the incidence of heart attacks, strokes and Alzheimer’s disease and improve sexuality.

What happens at the Menopause Clinic

We will ask you to complete an online symptom questionnaire. This is confidential and will be stored in your patient notes for the doctor to review.

You may be asked to have some blood tests so that a baseline hormone profile can be reviewed and future improvements monitored along with symptom control.

Your symptoms will be assessed and your previous medical history will be discussed and noted.

You may require an examination and we may need your blood pressure, height and weight.

An individual treatment plan will be developed specifically for your symptoms offering tailored HRT where appropriate. This may include oestrogen, testosterone and progesterone.

We can prescribe your medications via our online Pharmacy or you may wish for your GP to be approached to prescribe for you.

Dr Fawcett’s lead of the Menopause Clinic provides a blended approach of hormone replacement therapy, nutritional guidance and lifestyle.

Our patients come from all across the country to seek our specialist advice.

We can offer remote consultations, on-going in clinic assessments and have recently introduced our remote service Menopause Triage for patients with less complex needs who have already researched their options and simply wish to start HRT or wish for access to testosterone replacement therapy, currently unavailable from GP’s.

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Common symptoms of Perimenopause and Menopause:

  • Hot flushes and sweats
  • Aching joints
  • Irregular periods
  • Vaginal dryness
  • Painful sex
  • Lack of libido

  • Low mood and depression
  • Weight gain
  • Irritability
  • Mood swings
  • Insomnia
  • Loss of collagen (dry hair, nails and skin)

Our Menopause Team

Dr Helen Fawcett

BMS Menopause Specialist – Advanced

Our Menopause & Hormone Clinics are led by Dr Helen Fawcett, a recognised BMS Menopause Specialist. Dr Fawcett has managed patients with hormone imbalance, peri-menopause and menopause symptoms for over 18 years.

Dr Joanne Horgan

BMS Menopause Specialist – Advanced

Member of The British Menopause Society

Dr Helen Duff

GP with a special interest in Menopause

Member of The British Menopause Society

Dr Rachel Tomlinson

GP with a special interest in Menopause

Member of The British Menopause Society

About Hormone Replacement Therapy

It is generally accepted that oestrogens abolish menopausal symptoms, increase bone density, reduce the incidence of heart attacks, strokes and Alzheimer’s disease and improve sexuality.

Oestrogen users also live about 1.5 years longer than non-users. If that is the case acceptance of oestrogen therapy should be simple but it is not. Only about 15% of women at risk take oestrogens and the vast majority abandon HRT within a year. This lack of continuity is due to a combination of things including breast cancer, fear of weight gain, reluctance to have periods or the PMS type symptoms that occur with cyclical progestogen. Also many women taking low does oestrogens do not feel any better and are therefore reluctant to take long-term therapy to prevent a fracture at the age of 85 which may not occur anyway.

There are many new formulations with using various routes of administration, various combinations which attempt to improve the well-being of menopausal women without side-effects or problems of bleeding. Thus therapy is becoming more complicated rather than more simple as we tailor treatment to the needs and response of the individual woman.

Oestrogen therapy for the over 60s is a very important area as these are often neglected in the belief that older osteoporotic bones do not respond to oestrogens. They do and they respond even better than the bones of younger postmenopausal women. In fact the lower the bone density the greater the increase with hormone therapy. It is these women which value low dose oestrogens and no-bleeding regimens. There is a view disputed by many, that oestrogen therapy should only be on ten years’ duration. If this is so it is possible that maximum cardiovascular and skeletal benefits with least side-effects would accrue by starting aged 60 rather than aged 50, but the 50 year old usually requires symptom relief during this decade.

Similarly, HRT for the peri-menopausal woman who is still having periods but suffering from depression, tiredness and loss of libido is another neglected area. These patients often have a long past history of hormone related depression i.e. postnatal depression or pre-menstrual depression.

Such patients suffer their worst depression in the one or two years before their periods stop but often need oestrogens instead of, or as well as, anti-depressant therapy.

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More about Menopause

What is the real story with the menopause and HRT? I thought it increased my chances of breast cancer?

In 2002 there was a study called the Women’s Health Initiative that was published that appeared to show that there was an increased risk of breast cancer and heart disease associated with taking HRT. This led to many people stopping HRT and a lot of women were indeed too frightened to take HRT in the future.

However this study was re-examined in 2017 and re-published and true analysis revealed that there was no statistically significant increased risk of breast cancer associated with the type of HRT taken by the patients in the study at that time.

It is generally accepted that oestrogens abolish menopausal symptoms, increase bone density, reduce the incidence of heart attacks, strokes and Alzheimer’s disease and improve sexuality.

Oestrogen users also live about 1.5 years longer than non-users.

With that being the case, acceptance of oestrogen therapy should be simple but it is not. Only about 15% of women at risk take oestrogens and the vast majority abandon HRT within a year. This lack of continuity is due to a combination of things including breast cancer, fear of weight gain, reluctance to have periods or the PMS type symptoms that occur with cyclical progestogen.

Oestrogen replacement can be started in the over 60’s and can be beneficial. We know that it has to be transdermal however not oral oestrogen when started over sixty and we know transdermal oestrogen will do no harm and can help symptoms.

Additionally there is a belief that older osteoporotic bones do not respond to oestrogens. They do and they respond even better than the bones of younger postmenopausal women. In fact the lower the bone density the greater the increase with hormone therapy.

Similarly, HRT for the peri-menopausal woman who are still having periods but suffering from depression, tiredness and loss of libido is another neglected area. These patients often have a long past history of hormone related depression i.e. postnatal depression or premenstrual depression. Such patients suffer their worst depression in the one or two years before their periods stop but often need oestrogens instead of, or as well as, antidepressant therapy.

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When should I expect the Menopause?

The menopause is defined as 1 year from your last period.On average women will start to go through the natural menopause in their late 40’s/early 50’s. The average age of the menopause being 51 years old in the UK. Sometimes menopause can happen prematurely, below the age of 40. This can be related to an illness like cancer where the hormones need to be suppressed or as a result of ovarian dysfunction. The symptoms will all be similar to varying degrees regardless of age.

Symptoms of the hormone changes that start to occur from 30+ through perimenopause at 40+ to menopause and beyond at 50+

  • Low mood – it is known that low mood can commence as the hormones start to change and may well appear 10 years prior in the run up to menopause
  • Mood disturbance – Mood swings are very common as Oestrogen levels drop
  • Anxiety – is a common problem for patients with hormone imbalance
  • Disrupted sleep – Waking and feeling like you have hardly slept is often a result of low testosterone
  • Hot flushes
  • Fatigue
  • Lack of libido – Sensation as much as desire can be subdued due to low testosterone levels
  • Aches & Pains – Patients often complain that they have aches and pains in joints. Due to low oestrogen levels the joints are less supple and lubricated
  • Urinary Symptoms – Incontinence – this embarrassing and sometimes debilitating symptom can be helped with Oestrogen replacement.

  • Other less known symptoms include: Persistent cough / restless legs / loss of mojo / paranoid feelings / loss of confidence / reduced memory concentration / disorientated – out of body feeling / clumsy / weight gain especially in the abdominal area / dizzy spells / spots / increased facial hair / bloating / abdominal pain / constipation and irritable bowl / snoring / shortness of breath / varicose & thread veins / skin discolouration / chest pain on exertion / fluid retention / breast tenderness / crawling skin / cold hands & feet / headaches / poor wound healing / dry itchy eyes / blurred vision / dry itchy ears / nose bleeds / eczema / Face / Eyes / Jowls / Neck / Decolletage / Tummy / Elbows / Hands / Thighs / Knees

When does Menopause finish?

Testosterone Replacement Therapy

I thought Testosterone was a male hormone?

Testosterone is a hormone found in both men and women. In younger females, testosterone levels can be higher than the oestrogen. As this declines symptoms of fatigue, loss of mojo and lack of sexual interest and sensation.
Testosterone replacement therapy is carried out off license, on a named patient basis and the dose is monitored carefully and kept low to avoid androgenic effects of increased facial hair, deepening voice and reduced scalp hair. These side effects are reversible if supplementation is reduced or stopped.

Testosterone is a hormone found in both men and women. In younger females testosterone levels can be higher than the oestrogen. As this declines symptoms of fatigue, poor sleep quality, reduced memory, concentration and attention and loss of motivation, loss of mojo and lack of sexual interest and sensation.

Will I put on weight with HRT?

You should not put on weight with HRT, as you are replacing a deficiency of hormones, rather than giving extra.

When will I stop HRT?

You can continue to use HRT long term. It was arbitrarily stopped after 5 or 10 years in the past because of the previously perceived risk of breast cancer. However, now we know that risk to be less significant following reanalysis of the WHI study of 2002, and that the benefits of HRT now outweigh the risks, we continue treatment long term. Long term benefits include symptom control, improvement in bladder and vaginal health, bone protection in osteoporosis, and reduction in cardiovascular disease.

If you’d like any advice concerning menopause and available treatments please get in touch to book your tailored consultation. Our team are friendly and welcoming, we’re always on hand to offer treatment information.

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Find the best solution for you

If you are not sure what treatments are for you then search your current symptoms to find the right treatment for you.

Regulated by The Care Quality Commission

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A modern and private independent healthcare clinic focusing on feMale health. We operate by appointment only to ensure a discreet and confidential service for our patients.

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The British Menopause Society

Not all clinics and doctors are recognised as specialists by The British Menopause Society (BMS), the authority for menopause and post-menopausal health in the UK.

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