Frequently Asked Questions
FAQs about consultations
To book a consultation, please read the FAQs on this page and then call the clinic on 01277 201001. If the clinic is closed, please leave a message on the answer phone with your name and number and your call will be returned the next working day.
An initial consultation is £250 and subsequent consultations are £165.
For new patients, payment for the appointment is taken at the time of booking the appointment. If you cancel the appointment with more than 24 hours’ notice, you will receive a full refund for your appointment. If you cancel your appointment with less than this, then you will be refunded half your appointment fee. No shows on the day will be charged the full consultation fee.
For existing patients, you will pay for your consultation on the day of your appointment, after you have been seen. The same cancellation rules will apply as above.
There will be enough time during your consultation to discuss all your concerns about menopause and to be given options of treatment and a prescription.
Menopause clinic appointments are available on Mondays, Wednesdays and some Saturdays.
We prefer to see patients in person but occasionally follow up consultations, for existing patients only, can be conducted over the telephone. This will be at the discretion of the doctor. No telephone consultations will be conducted for new patients. The fee for a telephone consultation is the same as a follow up face to face consultation, i.e. £165.
No, you can self-refer. Please bring information about your medical problems and your current medication list with you.
Please bring information about any ongoing medical problems you have and an up to date medication list with you e.g. a copy of your repeat prescription. It would be helpful if you would complete our menopause questionnaire and print it out to bring it to your appointment
Usually patients are seen at the initial appointment and then 2-3 months later. Once established on a treatment which is working well for you, you would usually be seen 6 monthly.
Medical insurance companies generally do not cover treatment for menopause.
You will have a complimentary telephone call to tell you the results of your tests once they have been received by the doctor.
Please look at the rest of the FAQs and see if your query is already answered here. If it is not, it is preferable to email the clinic on firstname.lastname@example.org Emails will be replied to within 3 working days and are therefore not suitable for urgent issues. For any urgent issues please call the clinic on 01277 201001. If the clinic is closed, we do not provide a routine ‘out of hours’ service. If you feel that your problem is urgent and cannot wait until the clinic is next open, we advise that you contact your NHS GP, or call 111, or where appropriate, call 999.
FAQs about the clinic
The clinic is part of Essex Private Doctors and appointment bookings are taken by the surgery on 01277 201001.
Essex Private Doctors, 1st Floor, 40 Hutton Road, Shenfield, Essex, CM15 8LB
There is a small car park directly outside the surgery. If this is full there is street parking in bays along Hutton Road but you do need to buy a parking ticket from the parking meter and display it in your windscreen.
Please note that the clinic is on the 1st floor and accessed by stairs. When required it is possible to see patients on the ground floor. Please advise the receptionists on booking the appointment so arrangements can be made.
FAQs about treatments and prescriptions
All treatment options for menopause will be discussed including HRT and other non-hormonal treatments and the most appropriate option, based on your medical history and your personal preferences, will be prescribed.
Compounded bioidentical HRT is not licensed or regulated. It is not prescribed at this clinic. Body identical HRT is however prescribed at this clinic.
Read more about Body identical vs bioidentical HRT.
Often standard oestrogen HRT is enough to treat symptoms, however there are some women who also benefit from the addition of testosterone. If it is appropriate, then testosterone can be prescribed from this clinic.
You can take your prescription to any chemist to obtain your oestrogen or progestogen. As it is a private prescription, the pharmacy will charge you for the cost of the medication plus a private prescription fee. If you have been prescribed Androfeme® (testosterone cream) a local pharmacy which stocks it is Pharmchoice Pharmacy, 9 Ingrave Road, Brentwood, Essex, CM15 8AP. 01277 215809 https://pharmchoicepharmacy.co.uk/
The clinic also has arrangements with The Independent Pharmacy which is an online pharmacy who you can post your prescription to and they will send it to you in the post.
You will be prescribed enough medication during your appointment to last until your next review and repeat prescriptions are discouraged without an appointment. If you have not attended a review appointment and you then run out of your medication, provided it is appropriate to issue, a prescription for a limited supply of medication for 1 month will be given until you can attend a face to face appointment. Please call the surgery to request this and tell the receptionist the names and doses of medication you are taking. Prescriptions which are issued outside of an appointment will incur a £30 fee.
Currently this is not a service that is offered at our clinic, but we hope to be able to offer this in the future. We have good links with the local private gynaecology consultants and are happy to do a referral to them to have a Mirena® fitted, if required.
We have good links with local private hospitals and can refer on for private investigations e.g. DEXA or pelvic ultrasound scans; or to other private specialists e.g. breast, cardiology, gynaecology. The fees for these investigations are set by the hospitals or the consultants themselves. We are unable to access NHS services from this clinic.
FAQs about menopause
Yes! Menopausal symptoms often start in the perimenopause which is when you are becoming menopausal but still having periods.
FAQs about HRT
HRT works by replacing your declining levels of hormones so that menopausal symptoms disappear. The most significant hormone is oestrogen. Transdermal (through the skin) oestrogen, by way of a gel or a patch, is the safest way of using it and there are very few women for whom HRT in this way would not be suitable. It can also be administered orally, vaginally using a vaginal tablet (pessary), vaginal ring or a cream.
Because oestrogen can cause the lining of the womb to thicken, it is important to prevent this with the hormone progestogen – so called combined HRT. Progestogen is formulated as a patch, oral tablet, vaginal tablet or in the form of a Mirena® coil. If you do not have a uterus (womb), progestogen is not required.
On occasions, women can benefit from testosterone in addition to oestrogen and progestogen.
The length of time is variable, sometimes women feel better after a few weeks of treatment, but for most women it can take up to 3-6 months to feel the full effect. Each woman is unique and therefore the amount of hormone required for each individual woman to feel well differs.
This is the use of hormones which are identical to those made naturally by the body. In most instances we can tailor your HRT using these formulations.
In low risk women and if started within 10 years of the menopause or below the age of 60, the benefits of HRT usually outweigh the small risks. HRT is not usually a suitable treatment for women with breast cancer or women who have had breast cancer in the past.
The risks of HRT depend on the type and dose of HRT you are given and other individual factors such as your age, general health and lifestyle.
Oral HRT increases the risk of blood clots, strokes and gallbladder problems. However, transdermal HRT does not come with these increased risks.
Synthetic progestogens (not body identical) used in combined HRT have been shown to cause a small increased risk of breast cancer in women over and above women not using HRT; however, the risk is small and is less than the risk of breast cancer associated with drinking 2 or more units of alcohol each night. There is no increased risk of breast cancer in women who take HRT under the age of 50 years.
There is good evidence that body identical progesterone does not come with the same increased risk of breast cancer that synthetic progestogens do.
There is no increased risk of breast cancer if you have had a hysterectomy in the past and are only taking oestrogen without a progestogen.
In low risk women and if started within 10 years of the menopause or below the age of 60, in addition to relieving menopausal symptoms, HRT also leads to a reduced cardiovascular risk (heart disease) and reduced risk of osteoporosis (bone thinning).
No! Provided the benefits of the HRT outweigh the risks there is no age limit or time limit for taking HRT.
It is very common for women to have irregular and even sometimes heavy bleeding when they start HRT or when they increase the dose of oestrogen in the HRT. This can take 3 to 6 months to settle.
If you are still having periods or it has been less than a year since your last period, then HRT is given in a “cyclical” or “sequential” way which means you have oestrogen every day and progestogen for 10-14 days a month. This will cause a regular bleed. Initially the bleeding can be heavy, but this usually improves after a couple of months and you should then have an acceptable monthly bleed.
If it has been more than a year since your last period, then you will usually be given “continuous combined HRT” and you have oestrogen and progestogen every day. This should eventually lead to no bleeding, although it is quite common to have some vaginal bleeding in the first 3-6 months of starting continuous combined HRT and when the dose of oestrogen has been increased. However, after 6 months the bleeding should stop – if it has not stopped then further investigations may be required.
Inform the clinic or your GP if:
- You are still having vaginal bleeding after 6 months on continuous combined HRT
- Your bleeding is changing on cyclical HRT
- You have been on continuous HRT for longer than 6 months and you then develop vaginal bleeding
It is common to experience breast tenderness within the first few months of starting HRT, this usually settles but can take several months. If it is persisting, please tell the doctor at your review appointment as the dose or type of your HRT may need to be altered.
Sometimes HRT can cause bloating or abdominal discomfort which usually settles within a couple of months. If it is persisting, please tell the doctor at your review appointment as the dose or type of your HRT may need to be altered. Contact the clinic or your GP sooner if you have severe symptoms or symptoms which worsen.
Female metabolism changes during the menopause making it easier to gain weight and more difficult to lose it. HRT itself doesn’t appear to cause much weight gain. In fact, some women find that once they are on HRT and their menopausal symptoms have improved so that they feel better, sleep better and have more energy and motivation, they find it easier to lose weight.
If you are prescribed testosterone it will be a tiny amount, just enough to make you feel better but to keep your testosterone at the normal female level. At this level there are usually no side effects but occasionally women notice some increased hair growth in the area they rub the cream. To avoid this, you should change the area of skin where you rub the cream each day.
Nausea (sickness), indigestion and leg cramps sometimes occur in the first few weeks, but these usually go within a few months if you continue to use the HRT. Some women get headaches on HRT but it is less common when using transdermal HRT. Sometimes testosterone can cause your skin or hair to become greasier initially and you may get a few spots, but this often settles after a couple of months. If you are experiencing side effects, please tell the doctor at the review appointment as the dose or type of your HRT may need to be altered.
No HRT does not give you protection against pregnancy. If you are still having periods, and are therefore perimenopausal, you will also require an additional contraceptive method.