Perimenopause and menopause

Reasons to come in

• irregular cycles, heavy or prolonged bleeding around the menopause
• hot flushes, night sweats, sleep problems
• low mood, irritability, difficulty concentrating
• changes in weight and body composition
• vaginal dryness, discomfort and pain during intercourse, bladder symptoms (see also CO₂ laser vaginal rejuvenation)
• questions about hormone therapy — who it is for, when, and with what limitations

Not every symptom is hormonal. That is why the consultation includes a medical history, a gynaecological examination and ultrasound and, if needed, a tailored selection of laboratory tests.

Metabolic context

Health for the years ahead

The menopause is a good time to look at risk factors — glucose and lipid metabolism, blood pressure and bone health. We discuss which tests are worth doing and when to see another specialist.

Decisions about treatment, including hormone therapy, are made together — after weighing benefits and risks, in line with current guidelines.

I have a particular interest in how hormonal changes affect women in demanding professions — including pilots, cabin crew and shift workers, where sleep, concentration and wellbeing directly affect performance at work.

How to prepare

• note the dates of your recent periods and your most troublesome symptoms
• bring recent test results and a list of medicines and supplements you take
• write down your questions — the visit is a time for conversation