Frequently Asked Questions

Menopause in women usually occurs between the ages of 45 and 55 years – with the average age in the United Kingdom being 51. However, it can occur earlier or later than this – every woman is different.

There is also a term known as perimenopause that refers to the transitional phase of life preceding menopause and this can start as early as ten years before menopause. During this time women have declining fertility and fluctuating hormone levels.

We only reach menopause when we have not had a period for 12 months.

Most women will experience menopausal symptoms.

Common symptoms include:

• hot flushes
• night sweats
• difficulty sleeping
• fatigue
• low mood
• anxiety / mood swings / low self-esteem
• problems with memory and concentration
• heart palpitations
• headaches and migraines
• muscle aches and joint pains
• dry and itchy skin
• recurrent urinary tract infections (UTI)

The main symptoms that affect women and their ability to function at work tend to be lack of sleep, fatigue, anxiety, depression, mood swings, low self-esteem, and a loss of confidence.

For the majority of women, these symptoms can be improved by taking Hormone Replacement Therapy (HRT).

HRT is a treatment used to relieve the symptoms of menopause. As the transition into menopause begins, the ovaries no longer produce high levels of oestrogen and progesterone, and changes in these hormone levels can cause uncomfortable symptoms.

HRT medication replaces the oestrogen that the body stops making during menopause, and most women who use HRT will take a combination of oestrogen and progesterone to relieve their symptoms.

Not all HRT is the same. We prescribe HRT regulated and recommended by The British Menopause Society (BMS).

Put simply, HRT is adding back the oestrogen that the body requires.

For most women, Hormone Replacement Therapy is an effective way of managing their menopause symptoms. It also provides other long-term health benefits such as reducing the risk of osteoporosis and heart disease. Some studies indicate that women who take HRT have a reduced risk of developing Alzheimer’s Disease and other types of dementia.

In general, the small risks associated with HRT are far outweighed by the benefits.

This will vary depending on the person. In general, improvements typically happen over the first couple of weeks and months. Most women find that hot flushes and night sweats usually stop within a few weeks of starting HRT, but other symptoms can take several months to settle.

Most women notice early on that they are sleeping better, and as a result of a good night’s sleep, their mood, fatigue, and concentration improve, and energy levels increase.

Many patients explain this improvement as “getting their mojo back”.

Our menopause services include follow up appointments with a menopause specialist three months after starting treatment. The specialist assesses symptoms against the initial consultation and helps adjust any treatment to improve any remaining symptoms.

For healthy women, the benefits of taking HRT outweighs any possible risks. Any increased risk of breast cancer needs to be seen in the context of improved health risks overall related to protection against cardiovascular disease and osteoporosis. The risk is related to the time HRT is taken and there’s very little increase in taking HRT for 5 years though it may increase if taking longer than this.

The risk also depends on the type of HRT. Oestrogen only confers no risk and may be protective. For combined HRT (oestrogen and progesterone) the risk is dependent on the progesterone chosen. We use a body identical natural micronised progesterone, with the lowest risk of all progesterones. The published risk is between 0 – 4 extra breast cancers for every 1000 women that use this HRT for 5 years.

The risks of other lifestyle factors are important. Drinking one large glass of wine per night increases the risk to 5 extra breast cancers per 1000 women for 5 years. If overweight with a BMI over 30, there is an increased risk of an extra 24 breast cancers per 1000 women over 5 years.

It may take around three months for your menopause symptoms to subside after beginning HRT, although improvements can often occur much sooner. Sometimes, the changes can be so gradual that you might not notice your symptoms easing until you reflect back on them over time.

As a first step, we’d recommend that you revisit your consultation letter as this can help identify any suggestions or changes that may still need to be considered.
If you’re not noticing any improvements after initiating or adjusting your HRT regimen, your symptoms are significantly impacting your day to day life and it’s been 4-6 weeks since all previous options have been explored, then it may be useful to arrange a consultation with your specialist to reassess your treatment plan

As hormone levels shift, a lot of women notice weight creeping up around the belly. This is called visceral fat and it settles around the internal organs and can increase the risk of heart disease, type 2 diabetes, and more. The primary cause of weight gain during menopause is a significant shift in hormone levels, particularly oestrogen, which leads to a variety of physical changes. Additionally, progesterone levels also decline, and this can lead to water retention and bloating, which can contribute to the feeling of weight gain.

Symptoms can begin earlier than expected and are often dismissed as stress or lifestyle factor. Perimenopause is defined by hormonal change and symptoms – not a number.

Women may put this down to being busy or having too much going on in their life – but it can actually be linked to fluctuating oestorgen levels, which can impact memory and cognitive clarity.

During (peri)menopause panic attacks may become more common or feel more intense. They often come on suddently and can involve a mix of physical and emotional symptoms, such as a racing heart, shortness of breath, diziness, or a sense of overwhelming fear. For many women these moments are linked to shifting hormone levels. When oestogen and progesterone fluctuate, they can heighten anxiety and trigger those overwhelming waves of panic. Hormone Replacement Therapy can help by bringing your hormones (and sense of calm) back into balance.

Hot flushes and night sweats are due to oestrogen levels dropping. HRT helps because it adds oestrogen back and oestrogen acts on the brain to help regulate body temperature.

Hot flushes and night sweats are due to oestrogen levels dropping. HRT helps because it adds oestrogen back and oestrogen acts on the brain to help regulate body temperature.

Oestrogen levels rise and fall unpredictably during peri(menopause). This is why symptoms can feel so inconsistent. Hormone Replacement Therapy (HRT) can help smooth these fluctuations, reducing symptoms significantly.

During (peri)menopause, the body processes alcohol differently – from blood sugar swings to hormone changes. Before menopause, your body may have handled alcohol more efficiently. But as oestrogen levels fall, alcohol can stay in the system longer, which means it effects can feel stronger – even if your drinking habits haven’t changed. The livers ability to break down alcohol may slow with age. This can lead to worse hangovers, nausea, or generally feeling ‘off’ the day after drinking. Alcohol can also cause spikes and dips in blood sugar. During (peri)menopause, insulin sensitivity can change too, making tiredness, headaches or brain fog more likely after drinking.

Yes! The British Menopause Society supports early intervention for (peri)menopause symptoms. And so do we!

Women often have more testosterone than oestrogen. As women age, especially during and after menopause, testosterone levels decline, and this can lead to symptoms such as fatigue, brain fog, low libido, poor sleep, and loss of muscle mass. Under professional guidance, Testosterone Replacement Therapy (TRT) can be safely tailored to suit individual needs to help counteract the symptoms.

It surprises a lot of women that testosterone replacement therapy may be suggested as part of their treatment plan. 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.
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 uncommon and are reversible if supplementation is reduced or stopped.

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

You can continue to use HRT long term. As we now know 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.
In the past it was arbitrarily stopped after 5 or 10 years because of the previously perceived risk of breast cancer. However, we now know that risk is less significant following a reanalysis of the 2002 Women’s Health Initiative (WHI) study.

You can continue to use HRT long term. As we now know 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.
In the past it was arbitrarily stopped after 5 or 10 years because of the previously perceived risk of breast cancer. However, we now know that risk is less significant following a reanalysis of the 2002 Women’s Health Initiative (WHI) study.

Aesthetic treatments are non-surgical or minimally invasive procedures designed to improve the appearance of the skin, face, or body. They may help address concerns such as aging skin, acne scars, pigmentation, unwanted hair, body contouring, and skin laxity.

Most aesthetic treatments are considered safe when performed by trained and qualified professionals. A consultation is important to determine the most appropriate treatment for your skin type, goals, and medical history.

A consultation with an aesthetic provider can help determine the best treatment plan based on your concerns, skin condition, goals, and lifestyle.

Yes. Many patients combine treatments as part of a customised treatment plan to address multiple concerns.

Yes. Consultations help determine treatment suitability, discuss expectations, review medical history, and create a personalised treatment plan.

There is no specific age requirement for many treatments. Some individuals seek preventive treatments in their 30s, while others focus on correction or rejuvenation later in life.

EndyMed Tighten is a non-invasive radiofrequency (RF) skin tightening treatment designed to improve skin laxity, stimulate collagen production, and create a firmer, smoother appearance.

The device delivers controlled radiofrequency energy into the deeper layers of the skin. This heat stimulates collagen remodeling and new collagen production, which helps tighten and rejuvenate the skin over time.

Treatment time depends on the area being treated. Most sessions take between 30 and 60 minutes.

6 treatments spaced 1–4 weeks apart. Your practitioner will recommend a personalised treatment plan based on your goals and skin condition.

Some patients notice a tightening effect shortly after treatment. Full results typically develop gradually over several weeks to months as collagen production increases.

Results vary depending on age, skin condition, and lifestyle. With proper skincare and maintenance treatments, results can last 6 months to over a year.

There is little to no downtime. Mild redness or warmth may occur immediately after treatment and usually resolves within half an hour.

Yes. Most patients return to work and regular activities immediately after the procedure.

Yes, EndyMed radiofrequency technology is generally considered safe for most skin types and tones.

Good candidates are individuals with mild to moderate skin laxity who want a non-surgical skin tightening option.

Yes. It is often combined with facials, microneedling, injectables, or other skin rejuvenation treatments as part of a customised treatment plan.

EndyMed Intensif is a minimally invasive radiofrequency microneedling treatment designed to improve skin texture, tighten skin, and stimulate collagen production.

The treatment combines microneedling with radiofrequency (RF) energy. Tiny needles create controlled microchannels in the skin while RF energy is delivered into deeper layers to stimulate collagen and elastin production.

A topical numbing cream is usually applied before treatment to improve comfort. Patients may feel heat, pressure, or mild pinching during the procedure.

Most appointments take around 90 minutes, including numbing time.

Many patients benefit from a series of 3-6 treatments spaced 4 weeks apart, depending on the condition being treated and desired results.

Some improvement may be visible within a few weeks, but optimal results typically develop gradually over 2–6 months as collagen remodeling continues.

Downtime is usually minimal to moderate. Patients commonly experience redness, swelling, and mild sensitivity for several days after treatment.

The skin may appear red and feel warm, similar to a mild sunburn. Tiny pinpoint marks or mild swelling may also occur temporarily.

Radiofrequency microneedling is generally considered safe for a wide range of skin tones when performed by a trained professional.

Good candidates are individuals looking to improve skin texture, acne scarring, fine lines, or mild skin laxity without surgery.

You can see a private GP regarding your health concerns and support with general health management. Some patients choose to visit a private GP for a second opinion, or they may prefer to see someone for  increased privacy time and confidentiality for sensitive health issues.

We offer convenient Private GP appointment times throughout the day, including weekends and outside of NHS hours, making it more convenient for patients with busy schedules.

If you live within a five-mile radius of Hartley Wintney or Farnham clinic, we can arrange Private GP home visits for those unable to travel due to illness or mobility issues. A doctor will telephone to assess the nature and urgency of the problem prior to an appointment being made.

No, private health insurance is not required to book a private GP appointment. You pay for the treatment you need.

No. You can choose to visit us for a private GP appointment at any time, and this will not affect registration with your NHS GP practice. We can write to your GP with appointment details if you are happy for us to do so.

Details of our private GP fees can be found on our price list page