Menopause | Private HRT Treatment

Menopause is when a woman stops having her menstrual cycle and is no longer able to get pregnant naturally. This is a natural part of the ageing process and occurs as the women’s oestrogen level declines. Once the ovaries stop producing as much oestrogen then an egg is no longer released each month.

The average age for menopause is around 51, however, it can happen at any time between the age of 45 to 55 years old. For some women, menopause can occur before they are 40 and this is considered premature menopause.

Menopause symptoms

Symptoms vary from woman to woman and can also range in severity. Symptoms often begin months or years before menstruation stops and can last for around 4 years post your last period. Some women can also experience them for much longer.

Common symptoms include:

  • Hot flushes
  • Night sweats
  • Low mood including depression and anxiety
  • Insomnia
  • Poor memory and concentration
  • Vaginal dryness and discomfort during sex
  • Reduced libido




Perimenopause is the first stage of menopause and refers to the changes in the body as key female hormones start to change. This transitionary period is usually when menopause symptoms start and can last for years. For most women, perimenopause can start as early as mid-30s and as late as mid-50s. For some, it only lasts a few months and for others, it can continue for between four and eight years.

The most common symptoms of perimenopause are:

  • Irregular periods
  • Hot flushes
  • Vaginal dryness (also known as vaginal atrophy)

This is because your ovaries are producing less oestrogen as your body prepares to stop releasing eggs. This is a natural progression of female ageing and the reproductive cycle. During perimenopause, though your fertility is decreasing, pregnancy is still possible. Therefore, if you are not planning to have any more children it is advisable to continue to use contraception. You’re into menopause once you have 12 consecutive months without a period.

How do your hormones change during perimenopause?

Oestrogen levels start to decline which throws off the balance with progesterone, which is also produced in the ovaries. As the two hormones are responsible for ovulation and menstruation, this causes an imbalance and leads to fluctuations in hormones levels impacting both physical symptoms and your mood.

Symptoms to look out for

Hormones fluctuations that cause irregular periods during perimenopause are completely normal. However, some conditions can cause abnormal menstrual bleeding and these need to be investigated. If you experience any of the following, then you should speak to a healthcare professional as soon as possible:

  • Experiencing pain during sex or spotting after sex
  • Spotting or bleeding after your period
  • Unusually heavy periods and/or blood clots
  • Period lasting several days longer than usual
  • Periods occurring closer together

Potential causes will be discussed with your doctor following examinations which sometimes include an ultrasound.


Diagnosing Perimenopause and Menopause

For most women, managing symptoms at home and with the help of your doctor is all that is required during this transitionary period. A formal diagnosis is provided if your symptoms are interfering with your everyday life want to rule out other causes of your symptoms. This can be done via a menopause test or blood profile.

Private Anti-Müllerian Hormone (AMH) Testing

AMH testing is used to measure fertility and is often used as a menopause test as it can also indicate when menopause is approaching or has started. This is done via a simple blood test.

The Anti-Müllerian hormone is produced by small follicles that grow in the ovary. The levels of AMH give us an indication of the number of eggs present in the ovaries. As menopause starts, the number of eggs declines until the supply runs out.

This test is not available on the NHS. We offer this blood test in clinic and as a home menopause test kit. To find out more click here

FSH (follicle stimulation hormone) Blood Tests

Testing the FSH levels can indicate whether you are in menopause if you have a consistently high level. However, testing FSH levels alone can be misleading if you are still within perimenopause when your hormone levels are still fluctuating. FSH levels are also affected by birth control pills or any hormone therapy, as well as hyperthyroidism (overactive thyroid) and high prolactin.


Treatment for perimenopause and menopause symptoms

If your symptoms are affecting your day-to-day life, then you can speak to one of our doctors about treatments to help ease the symptoms.

  • Hormone replacement therapy (HRT) – this relieves symptoms by replacing oestrogen. Options include tablets, skin patches, gels and implants.
  • Lubricants – this relieves symptoms of vaginal dryness. This includes oestrogen creams, lubricants and moisturisers.
  • Selective serotonin reuptake inhibitors (SSRIs) – these are widely used as antidepressants and anxiety medications that can help control low mood.
  • Talking therapy – this can also be used to help with low mood and anxiety

As well as the above treatment options, our GPs will also advise you on dietary and exercise needs as staying fit and healthy can help improve some menopausal symptoms.




Further reading

Menopause – NHS

What is Menopause? – National Institute of Aging

Early Menopause/Premature Menopause


Reviewed by: Dr Preethi Daniel, GP & Clinical Director at London Doctors Clinic

Published: April 2022

Review Date: April 2025