© 2023 Willow Health
The menopause occurs when ovaries stop producing eggs and your periods stop. The menopause technically is the day after having had no periods for 1 year. The average age of menopause is 51 years old. If menopause occurs between 40-45 years old this is known as early menopause. If menopause occurs under the age of 40, this is known as Premature Ovarian insufficiency (POI) and carries significant health risks such as increased risk of cardiovascular disease and osteoporosis. Therefore it is essential for people who have POI receive hormone replacement.
When your ovaries stop producing eggs, levels of oestrogen, progesterone and testosterone start to fall. Symptoms can begin many years before the menopause and can persist for years after. Perimenopause means “around the menopause” and it is simply a term used to describe the time experienced during this transition. During this time your periods can become irregular and you may start to develop other symptoms. Most symptoms of the perimenopause are caused by falling oestrogen levels.
There are a huge range of possible symptoms of the menopause. Some symptoms such as hot flushes are very common, others may come as a bit of a surprise.
Studies have shown that symptoms can last for 7-8 years on average. However some women report they have had symptoms for decades.
During our consultations, we will focus in on each of your symptoms and how they are impacting your life. There are simple lifestyle changes that can help manage symptoms. If you do commence HRT, most notice a difference in their symptoms within a few weeks, though it can take 2-3 months to notice the full effect. A review is required after 3 months to reassess your symptoms and adjust your HRT depending on your response. (This can be with your GP or specialist at Willow Health).
You can book an appointment online here.
You do not need a referral from your GP to have a consultation at Willow Health.
You will receive a link in your pre-consultation email. We recommend joining a few minutes before the start of the consultation to ensure all is working. After clicking “Start virtual consultation”, you will be taken through to meet the menopause specialist.
If the quality of the video or audio is affected we can move over to a telephone consultation instead. The menopause specialist will call you in this instance.
We will start by getting to know you, what you are experiencing and how this is impacting your life. We will take your blood pressure and record your height and weight. An examination can be offered depending on your symptoms. We can then discuss a personalised plan for you including lifestyle measures, and any medications/therapies we recommend.
Find out more about our consultations here.
You can follow up with your own GP or at Willow Health. We send a copy of our consultation to your GP to keep them fully informed and update them of any prescribed medication. This is imperative for your safety, as your GP needs to have the most up to date medical information. We do recommend a review at 3 months after starting HRT as it may need tweaked in some way according to your response.
If Willow Health continues to provide you with a prescription, an annual review will be required to ensure ongoing safe prescribing.
It can be really helpful for you to bring any medication that you take. If you have medical conditions, it can be useful for you to request a printed medical summary from your GP.
If you have already had blood tests done by your GP, please bring a copy of the results to your appointment.
As part of your pre-consultation email, you will be sent a symptom questionnaire. It can be helpful to have this completed for the appointment.
Yes. There is on street, free parking available in the surrounding streets in Bridge of Allan.
Yes. A condition of providing consultations at Willow Health is being able to have clear communication with your GP for safety reasons.
If you need to cancel, you can click the link in your booking confirmation. We will be in touch to either arrange refund or reschedule your appointment. If you need to rearrange, please email us at info@willow-health.co.uk. We have a 48 hour cancellation policy. This means that any cancellations or changes made with less than 48 hours’ notice will incur the full consultation fee.
Menopause care/treatment is not generally covered by private medical insurance companies but it is worth checking with them.
In most cases we diagnose the perimenopause and menopause based on you and your symptoms. It can some times be useful to do blood tests to exclude other causes of your symptoms, or if you are under 40 years old.
You can find out more about blood tests here.
Yes. If required we can arrange for you to attend your local phlebotomy clinic provided by Nationwide Pathology.
If you are taking oestrogel, sandrena, androfeme, testogel or testim, please hold off applying your dose until after your blood tests appointment.
Yes. After a full discussion, if you decide to proceed with a prescription, we can provide a private prescription as part of your consultation cost. We can send the prescription to an online pharmacy who will then contact you for payment of the actual product directly. They then post the medication to you and most are delivered within 2 days. The benefit of using an online pharmacy is that it is rare to have any HRT supply issues compared to your local pharmacy.
We would usually charge £30 for completing a private prescription. This covers the cost of a review of your records to ensure suitability and organising/writing the prescription. If we are prescribing as part of a consultation, we include this as part of the consultation cost. Any prescriptions provided out with a consultation will be charged at £30.
Private prescriptions also then incur the cost of the medication supplied by the pharmacy. As a guide, 3 months supply of combined HRT plus postage costs approximately £55.
If you have been started on HRT by Willow Health, you will need to have a review at 3 months if you want to continue to receive prescriptions from us. You can book in for a follow up appointment here.
Following this 3 month review, we can continue to provide your prescriptions for a year assuming all is well. You will need to have at least an annual review to allow us to continue safe prescribing.
At present, we do not have the facilities for fitting mirena coils at Willow Health. Most can have a coil fitted at their GP or local sexual health clinic.
Yes. Like oestrogen, testosterone declines around the time of the menopause. This can lead to reduced libido, brain fog and fatigue. Currently testosterone replacement is not licensed to women in the UK, but is prescribed by menopause specialists and some GPs. Often low libido is multifactorial and many find it improves when they start replacing oestrogen with HRT. It is also essential that we treat any vaginal symptoms which can contribute to lack of libido. For those who have persistent low libido despite this, we may offer a trial of testosterone. An informed discussion is required at your consultation.
No. Let’s say you are destined to experience menopause symptoms for 5 years and you take HRT for 4 years, you will probably only experience another 1 year of symptoms. So you will have avoided those years of symptoms by treating them, not delaying them.
Unfortunately some people have been misinformed with regards to HRT. We can explore your history and basis for this decision. If you have a complicated medical history or have had treatment for cancer in the past, it is sometimes necessary to see clinic letters detailing your medical history. It may be that we need to write to your GP or consultant asking for information to help us make the best informed decision.
Absolutely. We would avoid oral HRT due to the increased risk of strokes, but HRT delivered through the skin would be suitable.
Possibly. During our consultations, we explore your family history and calculate your individual risk of breast cancer. This will aid our discussion to help you make an informed decision.
There may be some situations where it is just too risky to take HRT. For example, active cancers (but not all), active liver disease, medical conditions where the risk of blood clot is very high, or abnormal vaginal bleeding that has not been investigated.
We know that 5% of people continue to experience symptoms for 15 years or longer, meaning well into their 60s. HRT is also beneficial in preventing osteoporosis. The main risks to consider are the increased risk of breast cancer and the increased risk of blood clots and stroke. We will discuss all these risks and there may be safer options such as oestrogen through the skin, plus body-identical progesterones.
If HRT is started after the age of 60, or after 10 years since the menopause, the evidence suggests that there should not be any increased risk in heart disease with use of newer forms of HRT.
© 2023 Willow Health