Managing Menopause

Updated on 14th November 2023 at 12:18 pm


Menopause information leaflet

There is a lot of information around regarding the menopause and HRT. This can feel overwhelming and difficult to navigate. If you are unsure if the symptoms you are experiencing may relate to the menopause please do make an appt with a GP or our practice nurse to discuss.

What is the menopause?

Menopause is when your periods stop due to lower hormone levels. It usually affects women between the ages of 45 and 55, but it can happen earlier/later.

It affects anyone who has periods.

Menopause can happen naturally, or for reasons such as surgery to remove the ovaries (oophorectomy) or the uterus (hysterectomy), cancer treatments like chemotherapy, or a genetic reason. Sometimes the reason is unknown.

Perimenopause is when you have symptoms of menopause but your periods have not stopped. Perimenopause ends and you reach menopause when you have not had a period for 12 months.

Symptoms can start years before your periods stop and carry on afterwards.

Menopause and perimenopause symptoms can have a big impact on your life, including relationships and work.

What kind of symptoms will I get?

Some people get none other than their periods stopping.

Period changes

Bleeding patterns can change – they can become irregular, heavy, more painful. If this is problematic please see a GP.

Physical symptoms

These are wide ranging and very varied. Common symptoms include hot flushes, migraines, sleep issues, palpitations, vaginal dryness, skin changes, urinary tract infections.

Mental health changes

Some people notice marked changes in their moods – they can become anxious (having never had this) low in mood – people often describe a brain fog when concentration, memory and tasks can become challenging. People often notice a change in their sex drive.


What can I do to help myself?

Having a healthy diet, exercises regularly, keeping alcohol in safe limits, having a good sleep regime can all improve the symptoms of menopause. Speaking to your friends/family about their experiences can also help. Stopping smoking can also have an impact on symptoms – please ask about our stop smoking service.

What will happen if a come to the surgery about this?

If you are under 45 years of age and still getting periods, with symptoms, we will probably suggest a blood test called FSH – this is one of the sex hormones your body produces – it goes up considerably after the menopause.

If you are over 45 years of age and still getting periods, and getting symptoms, you are probably going through the ‘perimenopause’ – this is the time before your periods stop entirely but you maybe experiencing a lot of the symptoms of the menopause. We do not need to preform the blood test so we will discuss whether you would like to consider HRT to manage your symptoms. You may also have a continued need for contraception which can alter what we offer/discuss with you.

If you are over 45 years and it is more than a year since your last period, and you are symptomatic, it is likely you have gone through the menopause and we would discuss whether you would like HRT to control your symptoms.

If you are under 45 years of age and your periods have stopped we would strongly recommend you make a GP appt to discuss – we are very likely to recommend HRT to protect your bones.

What is HRT?

HRT stands for hormone replacement therapy. Generally you will need two hormones (unless you have had you womb removed e.g via hysterectomy) these are progesterone and oestrogen.

The lowest risk way to give oestrogen it topically i.e. through the skin – this is either a patch or gel/spray. There is also an option for a vaginal ring that release oestrogen. There is also an option for tablets if topically preparations don’t suit you.

Progesterone can be given a number of different ways. Topically is ONLY via a patch. You can also have progesterone via a tablet either on its own or in combination with oestrogen. The final route you can have progesterone is having a mirena coil inserted. The latter is often useful if you also have an only need for contraception. We can refer you to the women’s health HUB at Corbridge for this.

For women who’s only symptom is vaginal dryness there is an option for a very low dose/low risk vaginal oestrogen and this is usually a tablet pessary or cream.


What are the risks of HRT?

It is important to consider the risk/benefit of any medication you maybe considering taking.

The main risks we worry about are slight increased risk of breast cancer – if you have had breast cancer it is very unlikely we would suggest taking HRT. The risk is low – there are 5 extra cases of breast cancer in every 1000 women who take HRT for 5 years.

There is a slight increase risk of blood clots – this particularly relates to oral HRT and gels/sprays/patches do NOT have this increased risk associated with them.

There is a very small increased risk of a stroke – this is very low if you are under 60.

Benefits of HRT

Control of symptoms is the main benefit – as mentioned before the perimenopause/menopause can have a big impact on your life.

Bone protection – there is benefit for your bones from taking HRT – unfortunately this is NOT sustained when you stop the treatment.

Maintaining muscle mass – HRT can help improve muscle strength.

What about testosterone?

There is a lot of media information about testosterone and it’s use in HRT. It can be of benefit for women who are struggling with poor sex drive/low libido.  This is an off licence product so you would need a GP appt to discuss this. You will also need a blood test prior to starting this and every 6 months whilst you take it. This is used in ADDITION to normal HRT.

Alternatives to HRT

There are a number of additional medications we can try instead of HRT which can sometimes help control symptoms. These can be tried in women who can’t take HRT or don’t want to. Low dose topical vaginal oestrogen can be used in the majority of women – EVEN those who may not be able to take normal HRT.  Please make an appt if you would like to discuss these further.

Is there an age limit for HRT?

There is no age limit for starting or stopping HRT but the benefits of taking it reduce the longer the time from your last period. The risks of HRT increase with age and we would discuss this with you before prescribing.

If you would like to discuss your symptoms/concerns further please do make a GP or practice nurse appt to discuss.



Here are some further sources of information: