Perimenopause

Finding out if someone is in perimenopause can be challenging.  As we specialise in female hormonal and mental health from a GP perspective we are always on the look out for perimenopause.  However, at the same time we do not assume symptoms are hormone related.  This is why we have longer appointments, with longer time behind the scenes for our clinicians to thoroughly review your previous health journey.

Our preference is to prescribe pharmaceutical grade, licensed, body-identical hormones.  For most women on HRT this consists of an estradiol topical patch, with utrogestan (micronized progesterone).  However, we provide personalised care, and synthetic hormones can be the best options for some cases.  We do not offer compounded hormones, due to variabilities in consistently and uncertainty with safety profiles. 

We do prescribe testosterone.  However, a consultation for a ‘testosterone prescription’ from our point of view is not as simple as that.  We will review your history, current medications, your symptoms and your goals as well as considerations of affordability, risks vs benefit and applicability.  Testosterone isn’t licensed, but like all medications we want to make sure we are doing the best for our patients.  And in cases where it is appropriate, we are happy to support medications that are off licence.  

HRT is only part of our management plans and your wishes are our priority.   There are lots of ways to support hormones and wellbeing without medications – both hormonal and non-hormonal.  Through sharing your story we will be able to figure out the best ways forward for your health.

Absolutely we can try!  We can’t promise, but many of the individuals we work with have improvement in wellbeing through our clinic without hormonal medications, or we may use hormonal medications in slightly different ways, or approaches. 

This is a really personal question and requires an individual assessment, but fundamentally, at FemaleGP we will not judge your symptoms and tell you whether your symptoms are bad enough for intervention.  We will explore your current symptoms, your experience now, and the options available to improve your quality of life.  We also review your past medical history and experience of different stages of hormonal changes throughout life.  This is because we believe it gives clues as to how to make an individualised plan to maximise wellbeing in midlife.  HRT are one option that can improve menopause symptoms.  It is also really important to ensure that other causes of decreased well being are excluded.   

There are many reasons for irregular periods, but irregular periods can be a sign of your hormones not performing as they should.  The causes are also different at different stages of life.  It is important to understand the cause of irregular periods.  To do this we need to know your previous history, and current symptoms.  We often do bloods tests as well. 

Absolutely! If you are over 45 years of age, then we don’t need to confirm a diagnosis of menopause.  If you are under 45 years of age I like to ensure I’m not missing premature ovarian insufficiency (as we manage that slightly differently).  There are lots of support options available, and the Mirena can be part of that!

Yes.  Life after breast cancer can be a challenge.  Some women find that they lose their sense of sense of self, and become defined their new diagnosis.  Breast cancer management can also involve medication which triggers ‘menopause’ to help prevent cancer recurrence, or women may have had their HRT stopped. 

Management of menopause after breast cancer is really personal.  We are happy to talk through the changes one can experience, lifestyle, non-hormonal and hormonal options to improve physical and psychological symptoms of menopause.  

Heavy periods is a common experience in women, particularly at puberty and in perimenopause.  At FemaleGP we look into WHY your periods may be heavy, as well as ensuring we improve the flow too.  There are many different medications (hormonal, non-hormonal, and intrauterine devices) available, and we also talk about sanitary products.  We also talk about tampons and menstrual cups as ways to help improve your quality of life.  Iron deficiency can make someone feel tired, have low mood, appetite changes, and ringing in your ears.  We take iron deficiency seriously!  We also find it really important to explore other possible causes of low iron, and not just assume it is due to menstrual loss.