Here are the benefits of HRT:
- A significant reduction in heart disease and stroke (the most common cause of death in women post menopause)
- It reduces and often stops hot flushes and night sweats
- Reduces insomnia
- Reduces weight gain
- Improves mood disorders such as depression, irritability or anxiety
- Improves libido
- Improves vaginal dryness and urinary problems including incontinence
- Helps to maintain the collagen in the skin
- Reduces the loss of bone and invertebral discs
- Reduces aching joints and muscles
- Helps with migraine
- Helps with heavy or irregular periods
- Stimulates muscle repair with better mobility and power
- Helps with skin related issues like dryness, itchiness or tenderness
- Prevents osteoporosis
- Reduces accelerated furring of the arteries
- There is a possible reduction in Alzheimer’s disease
- It reduces the risk of colon cancer
Current thinking is that the risks connected with HRT treatment are minimal and the benefits are significant.
Why put up with all this when you don't have to? There is now no need to just get on with it - time to feel your old self again!
As you approach menopause in your forties your hormone levels become increasingly erratic and this is known as being in perimenopause. This time of life varies from woman to woman - for some it's 6 months, for some its 5 years. During this time women report
- flushes and sweats
- heart palpitations
- increased anxiety
- mood changes
- disturbed sleep
- reduced libido
Because these symptoms are intermittent and vary in intensity you may not realise that these are actually being caused by the wildly fluctuating hormones that signal perimenopause. Indeed it is not uncommon for these symptoms to be misdiagnosed as depression with anti-depressants offered as a "solution."
Fortunately you no longer just have to "get on with it" Research over the past 12 years has led to a change in medical thinking and the International Menopause Society now suggests that a low dose of hormones can provide more benefits than risks.
Coupled with lifestyle changes these not only help you manage the perimenopause more effectively; it can help you avoid some of the more distressing menopause symptoms you may experience in your 50's and reduce the risks of osteoporosis and heart disease in older age.
It's also suggested that those entering perimenopause with a strong family history of heart disease, stroke or osteoporosis should explore the possibility of taking low doses of HRT - even when there are apparently no menopausal symptoms
Technically menopause refers to the time in your life when you've not had a period for 12 months. Many unpleasant symptoms can present themselves at this time - and unfortunately some of these are ongoing.
This is because, as we age, there’s a naturally occurring decline in hormones such as oestrogen, progesterone and testosterone. When these are out of kilter we can experience all sorts of distressing consequences
The symptoms of menopause are many and varied and you may not realise at the time that these very disparate conditions are actually connected to a fundamental change in your hormones.
I list these below and have covered many of these in more detail in separate blog posts. Just click on the link to read more:
- Hot flushes, and night sweats
- Poor sleep
- Anxiety or feeling irritable or depressed
- ‘Brain Fog’, or poor memory
- Vaginal Dryness and Urinary problems
- Loss of Libido
- Weight gain
- Joint Pain or Menopausal Arthritis
- Itchy Skin
- Tension headaches and Migraine
- Prolapsed uterus, bladder or bowel
- Hair loss
This consultation forms the basis of the effective and bespoke management of menopause.
During a menopause assessment, we discuss:
- all of your symptoms
- menstrual history
- medical history
- gynaecological history
- family history of significant illness
We look at risk factors for other conditions including heart disease and osteoporosis and your weight and blood pressure will also be checked
We then discuss the best treatment option for you.
After 4 weeks we have a short telephone call ( included in the charge for the initial consultation ) to see how you are getting on and discuss any concerns. We normally then review 3 months after the initial consultation. Thereafter patients are welcome to continue to see me or I am happy to write to patients' GP's for them to continue.
Mammograms and bone density scans can be arranged and blood tests if necessary.
Blood tests to be discussed during consultation. This ranges from baseline hormone tests to a full profile including thyroid tests, diabetic check, liver and kidney function, cholesterol levels, vitamin D levels and blood profiles for anaemia and iron deficiency
From £90 to £300
Follow up consultation after 3 months
Once established on treatment, patients will be reviewed annually
Patients must be reviewed annually if prescriptions are being issued.
Annual review consultations : 30 minutes
Most women’s busy lives mean that multi-tasking trumps menopause challenges. Particularly when work and family commitments make it tricky to find the time to come into London during the working day.
Because of this I have launched remote video consultations which not only increase your access to menopause consultations but also provide a one to one opportunity to discuss your menopause problems with me - without having to travel.
A good talk about how you are feeling is not only helpful but can allow us to create an individual plan for you. This is an opportunity to review your health generally not just the menopause. It's an essential time of life to stop and take stock of where you are physically and emotionally. I am able to prescribe HRT for you and I can also write to your GP with details of what treatment I recommend for you.
This 45 minute consultation is charged at £300 and if you would subsequently like to have a personal follow up with me - including blood tests - this can also be arranged. Just get in touch to book your first remote appointment.
It's often easier to see things explained in a visual way so I have created a library of resources to help with this.
I also hope you will get a sense of the kind of person you will be talking to when you make an appointment to see me.
There is more information on menopause if you click on my blog page and select the purple tag "menopause" at the bottom of the page. This will bring up all the posts I have written on the subject.
For many women the menopause is something they ignore until it is upon them and then it may be a real shock to the system.
Suddenly the body you took for granted appears to be playing you up physically, mentally and emotionally.
Strangely this does not seem to have been a subject discussed with the sisterhood in your life (maybe because they have also ignored its approach or perhaps because they feel they just have to get on with it) so at this point you may take to the internet for answers to your menopause questions.
But in searching to find answers to questions like “How long this will last?” or “How can I best manage this time of my life” or “Should I take HRT” you appear to hit a wall of conflicting information and half answers.
For all of these reasons I have gained qualifications which allow me to arm my female patients with impartial and practical advice about perimenopause and menopause. I also became an associate specialist in the menopause at a London teaching hospital.
However I have identified a still growing need to give more women up to date advice and information which enables them to make informed decisions and for that reason I now offer an outreach programme of webinars and talks on menopause for groups of 20 or more women in and around Central London.
- Are you running a membership association or a networking group?
- Are you working in an organisation with many women?
- Are you looking to add value to a specific occasion aimed at women?
- Do you want to heighten the awareness of menopause for a particular sector?
My talks and webinars are likely to appeal to mature women of 40 plus who are concerned that their business and personal life should not be affected. You might like to read about the success of one such talk here and please see some testimonials below.
Testimonial from a retailer:
What a woman!...Steph has literally changed lives by empowering women and dispelling the myths of taking HRT. Over three evenings she spoke to around 150 women at our lingerie shop in South West London, answering all our questions bar none.
Her professionalism, charm, and wit soon put us all at ease as she spoke about what the menopause actually is, what happens to our bodies and the many options available to get us through what can be totally miserable time! Steph, Thank you!
Testimonial from an online course for physiotherapists
It was wonderful to have you present. It really did anchor the course and it was a really strong section. I have listened to many people present and you really stood out. You have a wonderful easy relaxed style. Hopefully you will join us again next time.
Testimonial from a hotel and spa
I just wanted to pass on my thanks to you both for running an exceptionally informative evening at Limewood. I was hesitant about attending and the evening was extremely worthwhile. It made me feel normal and I felt that you answered all aspects wonderfully, listening to all the different points of view and having good answers that didn’t leave the audience confused. Well done.
Testimonial from a Women's Networking Group
Dr Steph did a fireside chat with Saska from Mpowered for our OmniwomenUk Chapter on the subject of "Why the Menopause is a 30 Something Issue" With 50+ attendees virtually it was an inspiring session where Dr Steph busted myths, reassured the concerned and helped educate those that really hadn’t considered what the Menopause could mean for them.
She made everyone feel confident to face into the issue, not be fobbed off and to look forward to celebrating this stage of life. The Q&A was amazing with questions ranging from “what can I do with my lifestyle now to help my body to prepare” to “what are the links between other conditions like POI & endometria with early menopause”.
If you would like to find out more please get in touch.
There's no doubt we feel better when we look better! Fortunately improvements in skin health technologies have now led to a generation of treatments and products that originated in the fields of dermatology and plastic surgery. This means I can integrate their application within my private practice and make them available online.
Do you remember when you were a teenager and your moods swung from euphoric to depressed and back again with regular monotony? Although we didn’t know it at the time this was the result of hormonal mayhem when our reproductive hormones swung into action.
Unfortunately far too many of us forget how our hormones affect our moods, and getting hormone levels looked at is probably the very last thing women try when trying to address a bewildering variety of anxiety symptoms that seem to come out of the blue. These typically come on in your forties.
This may mean that you have to put extra effort into looking after yourself through the current pandemic. It’s important that you don’t automatically look after yourself last, so here are 10 practical things you can do
Indulge your curiosity
Laugh a lot
Although scientific evidence could be stronger, a variety of the medical benefits of laughter have been supported through research and virtually all studies of laughter and health indicate positive results. The authors of a small study in Jan 2019 linked to a number of such studies which claim that laughter has beneficial effects on
There are even studies which claim that laughter has a positive influence on the immune system In 1989 Psycho Neuro Immunologist, Dr Lee Berk of Loma University medical Centre California did a study on 10 healthy males in 1989 and saw that cortisol had decreased and that there were increased levels natural killer cells which attack tumour cells and virus.
Laughter Yoga classes started to appear in 1995 and many people seem to find them therapeutic. There are a number of laughter yoga sessions on YouTube which you might want to try here
Escape with a book
A good story can not only take you out of yourself it can provide you with an emotional connection to relatable characters and a stable source of companionship when you feel alone. The Guardian shared a reading list for these times here
Perhaps now is the time to try audio books company Audible which offer a 30 days trial. They are also streaming a whole collection of children’s stories for free whilst the schools are closed. These include a lot of literary classics that you have never quite got round to reading.
Get moving to shift your mood
Personal Coach Joe Wickes has a whole library of videos for every age group – from kids to seniors. These are completely free to access.
Remember the power of words
Think about picking a positive personal mantra and repeating it. These may be things “Like when one door closes another one opens” or a line from a favourite song or poem like “Every little thing gonna be alright” from Bob Marley’s Three Little Birds.
Try to use positive statements instead of negative ones like “I’m so stressed” this can make a big difference to how you feel and how others react to you.
Connect to talk, share and play
You’re not alone in this digital age. Free to download Houseparty lets you video chat in a group or even play games with up to 8 people via your smartphone. It’s been around since 2016 and was previously the province of mostly teens and twenties but we can all take advantage now ;-)
Learn New Skills
This keeps your mind focused and gives you a sense of purpose. There are any number of “How to videos” on You Tube and huge number of online courses offered via Coursera. This includes free ones which you can find here one of which is the science of Well-Being.
Get out in nature
According to Mind spending time in a green space or bringing nature into your everyday life can benefit both your mental and physical wellbeing. There are some nature ideas here
The Bumblebee Conservation Trust, Butterfly Conservation and Channel 5’s Dr Amir Khan have joined forces for people to become Nature Doctors in their own garden. Why not get involved? Check this out here
Mindfulness - to quiet a busy mind
Many people find this helpful – there is a very good Mindful Breathing Exercise here and there is a course here. Scroll down the bottom of the page to try the free introduction before deciding if you would like to pay the £30 joining fee
Don’t make a mountain out of a molehill
Use these 3 steps to help you keep perspective
- In your mind say “Stop – I am not going down that path again”
- Breathe deeply focusing on your breaths for a couple of minutes to calm yourself
- Refocus – talk to someone close to you to get a more grounded perspective or ask yourself “Will this matter in 5 years? Or 5 months?”
These are enormously challenging times so we will all feel some level of anxiety. However, if you were feeling terribly anxious before the coronavirus even appeared you may be suffering from a hormonal imbalance.
This could probably be addressed so don’t wait to seek treatment until your symptoms are so severe that you can’t function, please get in touch for a Menopause Consultation. Like my GP service this can be done via a remote consultation using online technology. The cost is £200.
If you want to see me for this or as a new patient because you are struggling to get advice from your usual GP about other health matters please ring for an appointment via 020 7935 3351 rather than e-mail.
I hope this helps, look after yourself.