Menopause

Dr. Aileen Billsdon McGrane

I see a number of women who are keen to discuss the menopause. There has been an increase in awareness in the media and more women than ever are being informed and empowered to manage this better. 

Joining me for a consultation gives you the time and space to explore your options and make a decision on the right management plan for you. There is plenty of time to listen to your concerns and answer your questions. It is only right that you understand what is happening in your body and can make an informed decision on how to navigate this challenge.

Dr. Billsdon-McGrane

Understanding Menopause

Menopause is when a woman’s ovaries stop producing the same levels of hormones and their periods stop. You are considered to be through the menopause after periods have stopped for more than 12 months.

We call the time leading up to this Peri-Menopause. Hormones are dropping at this point and symptoms can cause significant discomfort and disruption for a number of women. You are likely to be Peri-menopausal between the ages of 45 and 55 but if you experience symptoms out with these ages it is still worth reviewing your health and considering your options.

In the Peri-menopause periods often become more erratic and heavier. Other common symptoms of include hot flushes, night sweats, mood disturbance, anxiety, brain fog, vaginal dryness, urinary symptoms and lack of interest in sex. Symptoms affect a wide range of systems in the body as women have hormone receptors in all areas of the body. Lower hormone levels therefore mean a wide range of symptoms.

If you are experiencing these symptoms under the age of 40 you should definitely discuss them with a doctor as it could be a sign of Premature Ovarian Insufficiency (early menopause) which should be investigated and treated.

If your symptoms are affecting your quality of life at home or at work then it is also worth discussing your options so that you can try and get symptoms under control.

If you want to understand more about the options for managing the menopause or what your personal risks and benefits of treatment are then this can be discussed with a doctor.

Book a Menopause Appointment

What to expect from your appointment

Have a look at my blog post https://www.billsdonhealth.co.uk/how-to-get-the-most-out-of-your-appointment/

I will routinely ask your height, weight and blood pressure before prescribing HRT so please share this information if you have it available.

  • You will have time to discuss all of your symptoms
  • Your past medical history and family history will also be discussed
  • Blood tests will be arranged if needed
  • Private referrals can be given if further investigation or Specialist advice is required
  • The benefits, risks and side effects of different management options will be discussed
  • A shared decision will be made with you about the right option to choose
  • You will be given a private prescription if required
  • There will be an opportunity for you to ask questions
  • You will get a written plan sent to you after the appointment
  • Your NHS GP will be sent a letter giving them details of your care 

Most women do not require blood tests before starting HRT. They are sometimes needed depending on your age and may also be required if symptoms do not respond as expected and before considering using testosterone. Blood tests can be arranged when needed and this can be discussed during your appointment.

We will discuss the hormonal management of the menopause with Oestrogen, Progesterone and Testosterone. This is known as Hormone Replacement Therapy (HRT)

Alternative non-hormonal medicines for managing symptoms can be discussed.

Lifestyle changes and complementary therapies can also be discussed.

For those of you who have already done some research – I prescribe in line with the British Menopause Society guidelines for managing Menopause and will offer body-identical HRT as a first line option with topical oestrogen and micronised progesterone as this is the safest option. I am also happy to prescribe Testosterone where appropriate. 

The online pharmacy I use has a stock checker to ensure the options agreed are available.

Private prescriptions can be sent electronically to your local pharmacy or can be delivered to your address.  There is no additional charge for issuing prescriptions during appointments but the pharmacy will charge you for the cost of the medication and a delivery fee.

The cost of medication can be discussed at the time of your appointment once we know what is being prescribed.

Repeat prescriptions out with an appointment can be requested for a £15 administration charge.

If you want to discuss the menopause I would recommend an appointment time of at least 45 minutes.

If you want a more detailed review of your health and lifestyle at the same time you can book in for a 90 minute Integrative assessment and the impact of menopause on other health conditions will be discussed as part of this consultation.

Follow up appointments are normally after 3 months and will be a 15 minute review if straightforward or 30 minutes if needed.

If you have responded well after 3 months and no changes are required to your management then you only need reviewed every year.