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Patient guide

Menopause, with care that fits you.

Perimenopause and menopause are natural stages of life, but you don’t have to simply put up with the symptoms. Here’s what is happening, what can help, and how we plan your care together.

Book a consultationExplore your options

Common symptoms

Can be eased

Treatment

Hormonal or non-hormonal

  • ±51average age at menopause
  • 12 monthswithout a period marks menopause
  • Hormonaland non-hormonal options
  • Personalplans, reviewed as you go

Three stages, one natural transition.

Hormone levels don’t simply switch off. They change over several years, which is why symptoms can come and go. Choose a stage to learn more.

Your final periodPerimenopausePostmenopause35404550556065+OestrogenAge
Illustration, not to scale

Often from your 40s

Perimenopause

The years leading up to your final period. Oestrogen rises and falls unpredictably, so periods become irregular and symptoms such as hot flushes, poor sleep and mood changes can start.

What you may notice

  • Irregular periods
  • Hot flushes and night sweats
  • Changes in sleep and mood

Common symptoms, you’re not imagining them.

Everyone’s experience is different. Tick what you’ve noticed, then send the list with your booking so we can make the most of your consultation.

Your options, planned around you.

Whether MHT is right for you depends on your symptoms and medical history. Dr. Madri talks through the benefits and risks with you and plans your treatment individually.

  • Tablets
  • Patches
  • Gels

Often called HRT

Hormone therapy (MHT)

What it does
Replaces the oestrogen your body makes less of. It is the most effective treatment for hot flushes and night sweats, and it helps protect your bones.
Forms
Tablets by mouth, patches on the skin or gels rubbed into the skin
With a uterus
A progestogen is added to protect the lining of the uterus. A hormonal IUD can provide this.
Local relief
Low-dose vaginal oestrogen eases dryness and discomfort, with very little absorbed into the body
  • Lifestyle
  • CBT
  • Medicines

Hormone-free

Non-hormonal options

Lifestyle
Regular exercise, a set sleep routine, and less alcohol and caffeine can ease hot flushes and poor sleep.
CBT
Cognitive behavioural therapy offers practical techniques that help with hot flushes, sleep and mood.
Medicines
Certain non-hormonal prescription medicines can reduce hot flushes.
Good to know
A good choice if hormone therapy isn’t suitable for you, or if you’d prefer other options

Hormone therapy

Weighing it up, honestly.

Every decision about MHT is personal. These are the main points we talk through together.

For most women under 60, or within 10 years of menopause, the benefits of MHT outweigh the risks.

Benefits

  • Relieves hot flushes and night sweats
  • Can improve sleep, mood and wellbeing
  • Helps protect your bones
  • Eases vaginal dryness

To consider

  • Combined MHT is linked to a small increase in breast cancer risk, which depends on how long it is used.
  • Tablets slightly increase the risk of blood clots; patches and gels may have a reduced risk.
  • Your personal and family history, blood pressure and other health factors all shape what is right for you.

Your visit, step by step.

From your first conversation to ongoing care, this is how we work together.

  1. 01

    Conversation

    We talk about your symptoms, your periods, your health and family history, and what matters most to you.

  2. 02

    Assessment

    A check of your blood pressure and general health. Blood tests aren’t usually needed to diagnose menopause, but can help in some cases.

  3. 03

    Your plan

    Together we choose an approach that suits your symptoms, health and preferences, with time for every question.

  4. 04

    Follow-up

    We see you again after about three months to hear how you’re feeling and fine-tune your plan, then review it regularly.

Contracted with most medical aids.

The practice’s sunny courtyard with potted plants
A calm space to talk

Small steps, real difference.

Alongside any treatment, everyday habits can make symptoms easier to live with.

  • Move every day

    Regular activity, including strength and weight-bearing exercise, supports your mood, sleep and bones.

  • Keep cool

    Layers, a cool bedroom and a fan nearby help with hot flushes and night sweats.

  • Know your triggers

    Alcohol, caffeine, spicy food and stress can bring on hot flushes for some people.

  • Care for your bones

    Include calcium-rich foods and get enough vitamin D.

  • Stop smoking

    Quitting can reduce hot flushes and protects your heart and bones.

  • Protect your sleep

    A regular bedtime and a wind-down routine can ease sleep and mood symptoms.

See a doctor sooner if you notice

  • Any bleeding after menopause, 12 months or more after your last period
  • Very heavy periods, or bleeding between periods or after sex
  • Periods stopping, or menopause symptoms, before the age of 45
  • Low mood that doesn’t lift, or thoughts of harming yourself
  • On MHT: pain or swelling in one leg, chest pain or sudden shortness of breath
  • On MHT: unexpected bleeding after the first few months
WhatsApp 060 012 0681

In an emergency, go to your nearest emergency unit.

Your questions, answered.

How do I know if it’s perimenopause?

Changes in your periods together with symptoms such as hot flushes, poor sleep or mood changes, often in your 40s, are usually the first signs. We can usually tell from your symptoms; blood tests are only needed in some cases.

Am I too young or too old for MHT?

Age is one of the things we consider. For most women under 60, or within 10 years of their last period, the benefits outweigh the risks. If menopause comes early, hormone treatment is especially important for your bones and heart.

How long can I use MHT?

There is no fixed time limit. We review your treatment at least once a year and decide together whether to continue.

Do I still need contraception?

Yes, until menopause is confirmed: for 2 years after your last period if you are under 50, or 1 year if you are over 50. MHT is not a contraceptive, but a hormonal IUD can provide contraception and the progestogen part of MHT.

Will the symptoms go away on their own?

Many ease over a few years, but some, such as vaginal dryness, can continue or worsen without treatment. You don’t have to wait it out.

Does menopause affect my long-term health?

Lower oestrogen affects your bones and heart. A healthy lifestyle, regular check-ups and, for some, MHT help protect them.

Feel like yourself, again.

Book a consultation to talk about your symptoms and options. Bring your list and your questions; no question is too small.

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This guide offers general information and doesn’t replace a consultation with your doctor.

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