A guide to menopause and HRT options

Understanding menopause

Menopause is a natural biological transition, not a disease. But for many women, the symptoms it brings — hot flushes, night sweats, anxiety, brain fog, joint pain, low mood, and disrupted sleep — can be profoundly disruptive to daily life, work, and relationships. Our dedicated menopause clinic offers dedicated support throughout every stage of this transition.

Perimenopause (the transitional phase before periods stop completely) can begin as early as the mid-30s and typically starts in the mid-40s. Symptoms can last for years, and no two women experience it the same way. Despite affecting 13 million women in the UK, menopause remains widely misunderstood and undertreated.

Common menopause symptoms

The symptoms of perimenopause and menopause are far more varied than most people realise. Beyond the well-known hot flushes, women may experience:

• Temperature and circulation changes: hot flushes, night sweats, palpitations
• Psychological symptoms: anxiety, low mood, irritability, brain fog, poor concentration
• Musculoskeletal symptoms: joint stiffness, muscle pain, reduced grip strength
• Bladder and vaginal changes: vaginal dryness, recurrent UTIs, urinary urgency
• Sleep disruption: difficulty falling asleep, frequent waking, unrefreshing sleep
• Other: weight gain, thinning hair, dry skin, reduced libido, fatigue

Menopause symptoms can overlap with other conditions, and it sometimes takes time for the underlying cause to be identified. Because symptoms are varied and often subtle, having a longer consultation specifically focused on menopause can help ensure nothing is missed.

What is HRT and how does it work?

Hormone Replacement Therapy (HRT) replaces the hormones -- primarily oestrogen and, where needed, progesterone -- that decline during menopause. It is the most effective treatment for menopausal symptoms and has additional benefits for bone health, cardiovascular protection, and cognitive function.

Modern HRT comes in many forms, and the right choice depends on your symptoms, medical history, and personal preference:

• Transdermal oestrogen (patches, gels, sprays) -- delivered through the skin, bypassing the liver. Generally the safest route.
• Oral oestrogen -- tablets taken daily. Effective but carries a slightly higher risk profile.
• Micronised progesterone (Utrogestan) -- body-identical progesterone, often preferred for its natural profile and sleep benefits.
• Testosterone -- increasingly used for libido, energy, and cognitive symptoms. Applied as a cream or gel.
• Vaginal oestrogen -- a local treatment for vaginal and bladder symptoms that can be used alongside systemic HRT.

Is HRT safe?

The safety profile of HRT has been extensively studied and is now well-established. The NICE guidelines (updated 2024) are clear: for most women under 60, or within 10 years of their last period, the benefits of HRT significantly outweigh the risks.

Transdermal oestrogen combined with micronised progesterone carries no increased risk of blood clots and a minimal impact on breast cancer risk. The outdated fear around HRT, driven largely by a single misinterpreted study in 2002, has been thoroughly debunked by subsequent research.

Why see a private GP for menopause?

A standard 10-minute NHS appointment is rarely enough time to explore the complexity of menopause. Symptoms are varied, treatment is personalised, and the conversation requires nuance. Our menopause consultations last a minimum of 30 minutes, giving you the time to discuss your symptoms properly and make an informed decision together with your GP.

We take a thorough approach:

1. A detailed symptom review and medical history
2. Blood tests where appropriate (including hormone levels, thyroid function, and baseline health markers)
3. A personalised HRT plan tailored to your symptoms, risk factors, and preferences
4. Regular follow-ups to monitor response and adjust treatment
5. Ongoing access to your named GP -- no repeating your story to a new face

How much does a menopause consultation cost?

A menopause consultation at our clinic starts from £120. This includes a thorough clinical review, a personalised treatment plan, and any necessary prescriptions. Follow-up appointments are available from £95 (a reduced follow-up rate — standard consultations are from £110). Blood tests, if required, are additional and priced transparently.

You deserve to feel like yourself again

Menopause is not something you should just endure. With the right support, the right information, and the right treatment, most women experience significant improvement in their symptoms — often within weeks. If you have been struggling or simply want more time to discuss your options, we are here to listen.

AtWell's menopause clinic is based in Balsall Common, serving patients from Solihull, Coventry, Kenilworth, and surrounding areas.

"I was struggling with perimenopause symptoms and wanted more time to discuss my options. At AtWell, the doctor listened, ran the right tests, and started me on HRT within a fortnight. I feel like myself again."

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