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The average age for the menopause in the UK is 51 with a range from 45-55 and it heralds a number of changes to physiological mechanisms due to associated hormonal changes – principally reduction in estrogen.

The average life expectancy for women is now 86 which means nearly 40 years in a postmenopausal state. This is a modern phenomenon given that it is only in the last 100 years (a blink of the eye in evolutionary terms) that life expectancy has changed so much. There is no other major hormone that isn’t replaced routinely when deficiency occurs. This is partly a cultural attitude and partly due to fears about the risk of hormone replacement therapy (HRT). Some reporting on HRT in the general media has given the impression that it is dangerous to take HRT when the reality is very different.

Whilst some women may get very little in the way of symptoms and for others symptoms that they do notice are manageable most women will notice some change and there is a significant impact on long-term health. On average symptoms last for 4 years from the last period but for some the duration is much longer. Symptoms typically start before periods stop and this is called the perimenopause.

Effects of the peri-menopause/menopause include:

  • Irregular bleeding
  • Hot flushes
  • Night sweats
  • Disrupted sleep
  • Poor concentration
  • Impact on short term memory
  • Vaginal dryness
  • Reduced sex drive (libido)
  • Mood change
  • Changes in skin and hair quality
  • Changes in collagen (affecting pelvic floor tone, urinary incontinence)
  • Impact on bladder function (the bladder lining is estrogen sensitive)
  • Osteoporosis (thinning of the bones) and increased risk of fracture
  • Increase in cardiovascular disease
  • Loss of muscle strength

Deciding whether to use HRT is a complex decision but many of the effects of the menopause can be prevented with the potential to improve day to day quality of life and long-term health.

There are a number of different ways of taking HRT including tablets, patches or topical gels. The combination of hormones and which route will work best is a very individual decision with each having different pros and cons. There are also a number of individual risk factors (eg your weight, whether you smoke and your personal or family medical history).

Apart from HRT there are other medical and complementary therapies that can help with symptoms.

Risks of HRT* include:

Breast Cancer:

Estrogen only HRT causes little or no difference in the risk of breast cancer.

HRT that contains estrogen and progestogen may increase breast cancer risk. This risk may be higher if you take HRT for longer but falls again when you stop taking HRT.

Heart disease and stroke:

If you start HRT before you’re 60 it does not increase your risk of cardiovascular disease.

HRT does not affect your risk of dying from cardiovascular disease.

HRT tablets (but not patches or gels) slightly raise the risk of stroke. However, it is important to remember that the risk of stroke in women under 60 is very low.

VTE (venous thromboembolism – blood clots in leg or lung)
HRT tablets (but not patches or gels) are linked with a higher risk of developing a blood clot.

*Taken from NICE guideline on HRT (https://www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt)

During a consultation a comprehensive assessment is made, what options are available and which treatment is likely to give the most benefit are discussed and if appropriate a prescription for treatment provided.

You can get additional information from the NHS Choices website (https://www.nhs.uk/conditions/menopause/symptoms/)

Request an appointment

Clinics are three times a week and Gail will help you arrange a time to see Mr Miskry and if necessary a scan on the same day.

If you are pregnant, you can expect to have a number of routine tests and appointments and you can find out more about the schedule of care here.

Appointments can be arranged by phone or email.

Book an Appointment


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    These are some of our most commonly asked questions, but you can see all of them here

    Do I need a GP referral for private treatment?

    No. However if you have private medical insurance please check with your insurer as they may require a GP referral in order to provide cover.

    Where does Mr Miskry see patients?

    All clinics are held at 148 Harley Street.

    Where does Mr Miskry perform operations?

    The Lindo Wing, St Mary’s Hospital and King Edward VII’s Hospital.

    If I have a private consultation will this alter my care in the NHS?

    No. Your treatment or position on an NHS waiting list will not be affected by having had a private consultation/surgery.

    Are tests included in my consultation fee?

    Any tests Mr Miskry recommends as part of your care are payable directly to the clinic/lab/hospital where they are carried out and are not part of our fees.