What is your new patient procedure?
After booking an appointment with Everything Menopause you will receive a confirmation email from our partners at Heydoc with details of the clinic location, time, date and a pre-consultation questionnaire which we ask you to complete prior to your consultation. We currently see patients at the Wessex Nuffield Hospital in Chandlers Ford, SO53 2DW. If your appointment is remote, the email will include a link for the video consultation which you need to open at the time of your appointment and this will connect to a video call online.
After your consultation, it is likely that we will prescribe some HRT. We can arrange for your script to go to the Pharmacy at the Wessex Nuffield Hospital, or a pharmacy of your choice, or we can send it to an online pharmacy, called Pharmacierge, who will deliver the script to you. The medicines will need to be signed for and usually take a few days to arrive. The cost of these two different options is similar. We suggest a routine follow up at 3 months, to adjust doses, address any residual problems, and organise an ongoing script. Once a woman is established and happy on her HRT, she only requires annual follow up by a doctor. For many women, their NHS GP is happy to do this follow up, so repeat attendance with us is not required. However, some women like the continuity of care offered by Everything Menopause, and we are happy to continue to review these ladies at their request.
Please be aware that some NHS GPs are not happy to take on the prescribing of testosterone. This is because it is not a licensed medication. If we do decide to use testosterone, monitoring of the blood levels is required at various intervals to ensure we are giving you an appropriate dose. This will incur an additional cost, but can easily be arranged at the Wessex Nuffield Hospital.
What is the menopause and peri-menopause?
The menopause occurs when the ovaries stop producing eggs and periods stop. The menopause can be diagnosed at 12 months since the last period. The average age for women in the UK is 51 however symptoms can begin in the peri-menopause from around the age 45. Some women can go through the menopause early starting in their early 40's and some women can be even earlier known as Premature Ovarian Insufficiency (POI). In addition some women can go through an abrupt onset menopause secondary to surgery, radiotherapy or chemotherapy. Oestrogen is extremely important for our bodies and we know that women with POI or early menopause are at increased risk of cardiovascular disease and osteoporosis and these women should be prescribed HRT at least up until the age of the usual menopause.
What are the symptoms?
Symptoms can include hot flushes, night sweats, anxiety, low mood, low energy, poor motivation, sleep disturbances, joint pains, palpitations, changes to hair and skin, weight changes, urinary symptoms and vaginal dryness and pain. Oestrogen is required all over our body which helps to explain why the symptoms of the menopause can be so widespread.
Do you prescribe body identical HRT?
We aim to provide the safest form of HRT bespoke for each woman. In many cases this will be Body Identical HRT which means the constituent hormones match the hormones our bodies produce naturally. Body Identical HRT is the gold standard HRT supported by the National Institute of Clinical Excellence (NICE) and the British Menopause Society (BMS).
Do you prescribe testosterone?
Testosterone is an important hormone for both men and women. Many women find they benefit from testosterone to help their libido, concentration and energy levels. There are no licensed formulations of testosterone in the UK for women, however privately we can prescribe AndroFeme which is produced in Australia for menopausal women. Alternatively we can use other preparations off license which are available in the UK within the NHS.
Will I need a blood test before HRT is prescribed?
For most women blood tests are not required since the diagnosis of the menopause is a clinical one. There are however some cases where blood tests can support other diagnosis or changes to medication doses. If these are necessary then the doctor will discuss the options available to you. If you have been advised to have a routine blood test as part of ongoing monitoring (for testosterone treatment for example) then please email us and we can arrange this for you.
How much does HRT cost?
Currently, a bottle of Oestrogel, which will last one month, costs about £10, Oestrogen-only patches might be £12 for a month, patches that contain Oestrogen and Progestogen cost about £25 per month. Progestogen tablets cost about £10 per month. Utrogestan tablets might cost £12- £15 for 3 months. Testosterone can cost between £50 for 8 months and £100 for 4 months depending on the product that is chosen. Once we have established you on a regime that you feel is right for you, we are happy to refer you back to your NHS GP for further prescriptions. However, he/she might not be happy to continue to prescribe the Testosterone.
Where can I find out more about the menopause?
Please see our resources page for a selection of websites you may find useful for more extensive information about the menopause.
Are there any side effects of HRT?
Irregular bleeding can be a common side effect of starting HRT, if this does not settle after 3-6 months then investigations may be required to assess this further. Other side effects can include breast tenderness and bloating. These can be related to the hormones in the HRT, these usually settle with time or we can make minor changes to the HRT medications prescribed for you.
Can you organise DEXA scans?
We can refer you to our colleagues at The Wessex Nuffield for an assessment of bone density which can be of benefit to some women who may be at an increased risk of developing osteoporosis.
Can you fit Mirena coils?
We can refer you to our colleagues at The Wessex Nuffield for coil fittings when required.