Menopause support and HRT, a proper assessment, not a one-size prescription

What is menopause, and when does it happen?

Menopause is the point at which your periods have stopped for 12 consecutive months, marking the natural end of your reproductive years. In the UK the average age is 51, though for some women it happens earlier — sometimes naturally, sometimes as a result of surgery or cancer treatment. The years leading up to it, known as perimenopause, can bring symptoms even while periods are still happening, because oestrogen levels are starting to fluctuate.

The breadth of symptoms is wider than many people realise: hot flushes and night sweats are the most talked-about, but disrupted sleep, low mood, anxiety, memory lapses, joint aches, changes in libido, and vaginal dryness are equally common. Not every woman experiences all of these, and severity varies enormously.

How does HRT help?

Hormone replacement therapy replaces the oestrogen (and, where needed, progesterone) that the body is producing less of. Most women notice a significant reduction in hot flushes and night sweats, better sleep, improved mood, and relief from vaginal symptoms within a few weeks of starting. Long-term, HRT also helps protect bone density, reducing the risk of osteoporosis.

HRT comes in many forms — patches, gels, sprays, tablets, and vaginal preparations — and a range of hormone combinations depending on whether you still have a uterus and what suits your lifestyle. The prescriber will explain the options that are relevant to your situation inside the consultation.

What if I cannot or would rather not use HRT?

Non-hormonal approaches can also help with menopause symptoms. Certain prescription medicines originally developed for other purposes can reduce hot flushes and improve mood in women for whom HRT is not suitable — for example, those with a history of hormone-sensitive breast cancer. Vaginal moisturisers and lubricants (many available without a prescription) address local dryness. Lifestyle measures — staying cool, layered clothing, reducing alcohol and caffeine, regular exercise — can make a meaningful difference. The prescriber will discuss what is appropriate for you.

How the consultation works for menopause and HRT

The menopause consultation is more detailed than our other journeys because the assessment needs to be thorough. You will answer questions about your symptoms, your menstrual history, your personal and family medical history, and any other medicines you take. The prescriber uses all of this to recommend a starting regimen or, if HRT is not suitable, an appropriate non-hormonal option. There is no one-size prescription — every response is individual.

When to see your GP rather than using this service

An online menopause consultation suits women who are experiencing typical menopausal symptoms and are looking for assessment and treatment. See your GP first if you have had breast cancer or a hormone-sensitive cancer, a history of blood clots (deep-vein thrombosis or pulmonary embolism), stroke, severe liver disease, or any unexplained vaginal bleeding. Your GP may also be better placed to manage you if your situation is complex or your symptoms are atypical. We will refer you if the prescriber has any safety concerns.