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.

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 Utrogestan, 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.