Menopause explained | Diagnostics | Treatments | Delivered with TLC
Menopause & Perimenopause Care
Your health, your power, your journey. Menopause is natural, but struggling in silence is not something you have to accept.
Hot flushes, night sweats, poor sleep, anxiety, low mood, brain fog, joint aches, vaginal dryness, painful intimacy, recurrent urinary symptoms and reduced libido can all affect day-to-day life, relationships and confidence.
At The Women’s Health Clinic, we begin with a free 20-minute telephone consultation. If you decide to move forward, we can arrange an in-depth menopause consultation to explore your symptoms, medical history, goals and treatment options in a calm, respectful and evidence-informed way.
Common reasons women enquire
Women often get in touch because they feel different, dismissed, exhausted, anxious, uncomfortable, or unsure whether symptoms are hormonal.
What may be discussed
Your consultation is built around informed choice rather than one-size-fits-all treatment.
Educational only. Not a diagnosis, prescription, or medical advice. Suitability for any treatment, including hormone treatment, is confirmed only after consultation and assessment. Results vary.
At a glance
Menopause care at TWHC is designed to help you understand what is happening, what may genuinely help, and what feels right for you before you make any commitment.
Your first step
Free 20-minute telephone consultation
Free call
understand the service first
Initial consultation
£175 guide price
Assessment first
no one-size-fits-all plan
Choice
you decide what feels right
Treatment planning may include
Important clinical balance
This page explains the service, not a prescription product. Any treatment is discussed individually, with benefits, risks, alternatives and monitoring explained before a plan is agreed.

Your first step
You do not need to know whether you are “in menopause” before getting in touch
Many women contact us during the uncertain stage: periods may still be coming, symptoms may come and go, and previous appointments may not have joined the dots.
The consultation is designed to help clarify whether your symptoms may fit perimenopause, menopause, postmenopause, early menopause, surgical menopause, or another cause that needs assessment first.
Watch patient stories, case studies and media features
Hear from women who have sought support from The Women’s Health Clinic and learn more about our wider women’s health approach. Individual experiences vary.
What are perimenopause, menopause and postmenopause?
Menopause is diagnosed after 12 months without a period, but symptoms can begin years earlier during perimenopause when hormone levels fluctuate.
Perimenopause
Perimenopause is the transition towards the end of the reproductive years. Periods may become irregular, but they may also continue while symptoms are already affecting daily life.
Menopause
Menopause is the point at which periods have stopped for 12 consecutive months and no other cause explains the change. The average age is around 51 in the UK, but there is wide variation.
Postmenopause, early menopause and POI
Postmenopause is the time after menopause. Early menopause usually refers to menopause before 45, while premature ovarian insufficiency refers to loss of ovarian function before 40.
The balanced way to think about menopause care
Menopause is a normal life stage, but symptoms can still be disruptive, distressing and medically important. Good care should not dismiss symptoms as “just menopause”, and it should not treat every woman as needing the same solution.
Who may benefit from a menopause consultation?
You do not need to have all the answers first. A consultation can help when symptoms are affecting daily life, confidence, intimacy, work, sleep or relationships.
Women in perimenopause
If your periods are changing, or your symptoms are happening before your periods have stopped, perimenopause may be part of the picture.
Postmenopausal women
Symptoms do not always stop once periods stop. Vaginal, bladder, sleep, mood, sexual and long-term health concerns may continue into postmenopause.
Women with intimate or bladder symptoms
Genitourinary syndrome of menopause can affect the vulva, vagina, bladder and urethra. These symptoms are common, but many women never mention them unless asked directly.
Early, premature or surgical menopause
Early menopause, premature ovarian insufficiency and surgical menopause can feel sudden, confusing and emotionally difficult. These situations often need tailored support and long-term planning.
Menopause symptoms we commonly assess
Menopause symptoms are not only hot flushes. Hormonal change can affect sleep, mood, cognition, skin, joints, bladder, vaginal comfort, sexual wellbeing and long-term health.
Symptoms can overlap with thyroid problems, anaemia, mood conditions, medication side effects, pelvic floor issues, infection, skin conditions and other medical causes. That is why assessment matters.
Who needs assessment first?
Some symptoms should not simply be assumed to be menopause. A proper review is especially important if there is:
Why assessment matters
The same symptom can have different causes. A careful history helps identify whether menopause is likely, whether blood tests or other checks may be useful, and whether another pathway is more appropriate.
Blood tests are not always needed
In many women over 45, menopause is assessed clinically from symptoms and cycle changes. Blood tests may still help in younger women, complex cases, to rule out other causes, or before considering testosterone.
Realistic expectations
Treatment can help many women, but no option is suitable for everyone. Good care includes discussing benefits, risks, alternatives, monitoring and what to do if symptoms do not respond as expected.
Why women seek menopause care
Many women have spent months or years trying to cope. Some have been told their symptoms are “normal”. Others have had very short appointments and still do not understand what is happening or what their choices are.
Functional, medical and emotional reasons
Symptoms may affect sleep, work, memory, mood, intimacy, bladder comfort, energy, exercise or daily confidence. Women may also want to discuss HRT suitability, vaginal oestrogen, blood tests, contraception, bone health, cardiovascular risk, early menopause or surgical menopause.
Symptom clarity
A consultation can help connect symptoms that feel unrelated and identify whether menopause, perimenopause or another cause may be contributing.
Treatment choice
Options may include hormonal, local vaginal, non-hormonal, lifestyle, psychological or intimate health pathways depending on your symptoms and suitability.
Intimate wellbeing
Vaginal dryness, painful intimacy, urinary symptoms and reduced sexual comfort are often part of menopause care, not separate embarrassments to hide.
Long-term health planning
Bone health, heart health, metabolic health, contraception, medication review and screening questions may all form part of the discussion where relevant.
How this compares with other routes
Standard GP route
Helpful for many women, but appointment time can be limited and menopause may be only one concern among many.
Online-only route
Convenient for some women, but may not suit those needing examination, intimate health support or complex review.
TWHC route
A menopause conversation connected with wider women’s health, intimate wellbeing, contraception and follow-up support.
The aim is not to replace NHS care. It is to provide time, choice, explanation and a joined-up private pathway where women want a more detailed conversation.
How our menopause service works
The process is designed to help you understand the service first, then move into a detailed consultation only if it feels right for you.
1. Free telephone consultation
A no-obligation 20-minute call with a nurse advisor to explain the service, answer initial questions and help you decide whether to book.
2. Book your initial consultation
If you wish to proceed, an initial menopause consultation is arranged. The current guide price highlighted for this appointment is £175.
3. History, symptoms and suitability
Your clinician reviews your symptoms, cycle history, medical history, medication, risk factors and goals. Blood tests are discussed only where useful.
4. Personalised plan and review
You receive a tailored plan. If medication is prescribed, it is arranged through the appropriate pharmacy route and reviewed over time.
What may be included in a menopause care plan?
Treatment is not automatic and is never one-size-fits-all. The aim is to help you make informed choices after a careful discussion of benefits, risks, preferences, medical history and alternatives.
Additional care topics often discussed
We avoid promising that one treatment will solve every symptom. The consultation is there to decide what is clinically appropriate and what feels acceptable to you.
Menopause, vaginal health and intimate wellbeing
Low oestrogen can affect the vaginal and vulval tissues, bladder and urethra. This can lead to dryness, irritation, painful sex, recurrent UTI-type symptoms, urgency, reduced comfort and loss of confidence.
This is often called genitourinary syndrome of menopause. It is common, under-discussed and treatable in many women after proper assessment.
For some women, local vaginal oestrogen, moisturisers, lubricants or pelvic floor support may be enough. Others may also wish to discuss wider intimate wellness options at WHC.
You can learn more about our wider intimate health pathway on our vaginal rejuvenation page.
Treatment overview
Care options under the menopause umbrella
Depending on suitability, menopause care may include medical, hormonal, non-hormonal, lifestyle, psychological, intimate health and follow-up support.
Licensed HRT discussion
Hormone therapy may be discussed where appropriate, including the difference between licensed body-identical options and compounded “bio-identical” preparations.
Vaginal oestrogen and local care
For dryness, painful intimacy and urinary symptoms, local vaginal treatment may be discussed as part of a broader genitourinary and intimate health plan.
Testosterone assessment
Testosterone is not a general treatment for tiredness or mood. It may be considered only in selected women with persistent low sexual desire after proper assessment and blood monitoring.
CBT, lifestyle and non-hormonal options
Some women cannot or prefer not to use hormonal treatment. Non-hormonal options, menopause-specific CBT, sleep support and lifestyle strategies may form part of care.
Intimate health pathway
Menopause can affect vaginal comfort, sensation, bladder symptoms and sexual confidence. WHC can connect menopause care with wider intimate wellbeing services where appropriate.
Contraception and Mirena questions
Perimenopause does not automatically mean pregnancy is impossible. Contraception, Mirena coil use and HRT endometrial protection can be discussed where relevant.
Important treatment nuances we discuss carefully
Menopause care is not just choosing “HRT or no HRT”. Current guidance and specialist practice include careful discussion of route, dose, risk factors, local vaginal symptoms, non-hormonal options, contraception overlap, and red-flag symptoms that should not be assumed to be menopause.
Licensed body-identical, not compounded
We explain the difference between licensed body-identical HRT and compounded “bio-identical” hormones. Treatment is discussed only where clinically appropriate after assessment.
Route matters
Patches, gels, sprays, tablets and local vaginal preparations have different uses and risk profiles. Transdermal routes may be discussed where clot risk or other factors make route selection important.
GSM is often under-discussed
Vaginal dryness, painful intimacy, urgency and recurrent UTI-type symptoms may relate to genitourinary syndrome of menopause. Local vaginal oestrogen, DHEA, moisturisers or other routes may be discussed.
Non-hormonal choices
Menopause-specific CBT, lifestyle support and selected non-hormonal medicines, including options such as fezolinetant where suitable, may be discussed for women who cannot or prefer not to use HRT.
Testosterone is narrow-use
Testosterone is not a general treatment for tiredness, mood, weight, brain fog or “energy”. It may be considered only for selected persistent low sexual desire concerns with blood testing and monitoring.
Bleeding must not be ignored
Postmenopausal bleeding, unexplained bleeding, new pelvic pain or sudden severe symptoms need proper assessment. These should not be treated as “just menopause”.
Educational only. This section is designed to show the type of clinical discussion that may happen at consultation. It is not prescribing advice.

Menopause care delivered with TLC
The Women’s Health Clinic was built around the belief that women deserve time, listening, clarity and choice — especially when symptoms affect so many areas of life.
Women-centred, respectful care
We understand how difficult it can feel to talk about mood, sexual symptoms, bladder symptoms, weight, sleep, anxiety and confidence in a short appointment.
A clear and compassionate approach
Our role is to explain options honestly, including what may help, what may not be suitable, what needs monitoring and when another service may be more appropriate.
Why women choose TWHC
Women often value time to talk, TLC support, transparent pricing, intimate health expertise, evidence-informed care and proper assessment.
A joined-up women’s health clinic
Menopause often overlaps with contraception, vaginal health, sexual wellbeing, bladder symptoms and long-term health. WHC is built to have those conversations together rather than in isolation.
Access and appointment choice
Private menopause consultations in London and across the UK
The research showed that local and online access are major decision factors. This page now makes the access route clearer while avoiding unconfirmed location claims.
In-clinic assessment
A face-to-face consultation may be more appropriate where examination, intimate symptoms, coil questions, bleeding concerns or complex medical history need fuller review.
Video consultation route
Where suitable and available, secure video consultations can help women access menopause support without travelling. Suitability depends on your symptoms and clinical needs.
The right route first
The free telephone call helps explain whether the initial menopause consultation, video route, in-clinic assessment or another service may be the right next step.
Menopause service pricing
We believe pricing should be clear before you decide. The initial menopause consultation guide price is highlighted below. For follow-ups, blood tests, prescription/admin fees, packages and the latest charges, please check the pricing page.
Free telephone consultation
A no-obligation 20-minute call with a nurse advisor to understand the service before booking.
20-minute telephone call
Menopause consultation
An in-depth appointment to review symptoms, medical history, goals, suitability and treatment options.
Guide price — confirm on pricing page
Follow-up and prescriptions
Follow-up appointments, private prescription arrangements, blood tests and mini-services may vary.
Latest fees and packages
Why pricing is shown this way
Your menopause plan may involve consultation only, follow-up reviews, medication, blood tests, prescription administration, local vaginal treatment, contraception discussion or onward referral. That is why we highlight the initial consultation and direct you to the pricing page for the latest full fee list.
A consultation-first service
Treatment is not sold as a package before assessment. We begin by understanding your symptoms and medical context, then discuss appropriate next steps.
Planning your next step
If you are unsure whether the menopause service is right for you, start with the free telephone consultation. If you are ready for a detailed assessment, the initial menopause consultation is highlighted at £175.
Reviews and patient stories
How other women often describe the experience
Women looking for menopause care often want to know one thing: “Will someone finally listen and help me understand my choices?”
Common themes in patient feedback include feeling listened to, understanding symptoms for the first time, feeling less embarrassed, having clearer choices, and feeling supported through follow-up. Individual results and treatment experiences vary.
Feeling listened to
A good menopause journey is not only about medication. It is also about being heard, believed and given time to make informed choices.
Clear explanations
Women often value knowing what may help, what may not help, what risks exist, and what the next review step looks like.
Supported throughout
Menopause care often needs adjustment over time. Follow-up gives space to review symptoms, side effects, preferences and next steps.
Success stories
A typical menopause patient journey
Every woman’s story is different, but many follow a similar path from confusion to clarity.
1. She notices a change
It may begin as poor sleep, anxiety, hot flushes, brain fog, vaginal discomfort, low libido or a feeling that she is no longer herself.
2. She wonders whether it is menopause
She may still be having periods, or she may already be postmenopausal, but the symptoms are affecting life more than expected.
3. She books a free call
She asks questions, understands the service and decides whether an initial menopause consultation is the right next step.
4. She has an in-depth consultation
Her symptoms, medical history, cycle history, risk factors, contraception needs, intimate health and priorities are reviewed.
5. She receives a plan
The plan may include education, monitoring, prescription if appropriate, non-hormonal care, intimate health support, follow-up or referral.
Frequently Asked Questions
Clear answers to the questions women most often ask before booking a menopause consultation.
Perimenopause is the transition phase before menopause, when hormone levels fluctuate and symptoms may begin even if periods are still happening. Menopause is diagnosed after 12 consecutive months without a period, when no other cause explains the change.
The free call is designed to explain the service, answer initial questions and help you decide whether an initial menopause consultation is right for you. It is not a diagnostic appointment and does not replace a full clinical assessment.
The initial menopause consultation guide price is £175. For follow-up appointments, blood tests, repeat prescriptions, packages and the latest fee information, please check our pricing page.
Your practitioner will review your symptoms, cycle history, medical history, medication, risk factors and goals. You can discuss treatment options, whether blood tests are useful, and whether follow-up, prescriptions or another pathway may be appropriate.
Not always. In many women over 45, menopause can be assessed from symptoms and period changes. Blood tests may be useful in younger women, if symptoms are unusual, to rule out other causes, or before considering certain treatments such as testosterone.
Hormone treatment may be discussed and prescribed only where clinically appropriate after consultation and assessment. The consultation focuses on your symptoms, medical history, benefits, risks, alternatives and monitoring needs.
Body-identical HRT usually refers to licensed medicines containing hormones that are chemically identical to hormones naturally produced by the body, such as oestradiol and micronised progesterone. This is different from compounded “bio-identical” hormones, which are not regulated in the same way as licensed medicines.
For many women, the benefits of HRT can outweigh the risks, but suitability is individual. Risks and benefits depend on age, medical history, type of HRT, route, dose, duration and personal risk factors. This is discussed during consultation.
Yes. Low oestrogen can affect the vulva, vagina, bladder and urethra. This is often called genitourinary syndrome of menopause. It may cause dryness, discomfort, painful sex, urgency, recurrent UTI-type symptoms or irritation. These symptoms are common and can be discussed discreetly.
Testosterone may be considered in selected women with persistent low sexual desire after assessment. It is not a general treatment for tiredness, weight, mood or brain fog. A blood test and careful monitoring are required if it is considered appropriate.
Some women may discuss non-hormonal medication options, menopause-specific CBT, lifestyle changes, sleep support, vaginal moisturisers, lubricants, pelvic floor support or other strategies depending on symptoms and suitability.
These situations can be more complex and often need tailored assessment. Early menopause, premature ovarian insufficiency and surgical menopause can affect symptoms, fertility, bone health, heart health and long-term planning, so they should be discussed properly.
Possibly. Periods becoming irregular does not automatically mean pregnancy is impossible. Contraception, Mirena coil use, and the role of Mirena as part of some HRT regimens can be discussed during consultation where relevant.
Hormonal change can contribute to anxiety, low mood, irritability and sleep disturbance, but these symptoms can also have other causes. A consultation can help explore whether menopause may be contributing and what treatment or support options may be appropriate.
You can still start with a discussion. Some women may need additional checks, shared care, specialist advice or referral before treatment decisions are made. We will be clear about what can be safely managed and what may need another pathway.
Often, yes. Menopause care may require review, dose adjustment, symptom tracking, side-effect discussion and ongoing risk-benefit review. The number and timing of follow-ups depends on your plan.
Postmenopausal or unexplained bleeding, new pelvic pain, severe low mood or crisis symptoms, persistent urinary symptoms, possible infection or sudden new symptoms should be assessed properly and not assumed to be menopause.
You can start by booking the free 20-minute telephone consultation. If you wish to continue, you can then arrange an initial menopause consultation. Pricing and the latest fees are available on our pricing page.
Fezolinetant is a non-hormonal option that may be discussed for selected women with troublesome hot flushes or night sweats where it is appropriate. Suitability, risks, availability and alternatives must be reviewed at consultation.
Different routes have different uses. Systemic HRT may be delivered by patch, gel, spray or tablet, while vaginal oestrogen is used locally for vulval, vaginal and urinary symptoms. The right route depends on symptoms, medical history, risk factors and preference.
Yes, where relevant. Vaginal DHEA, local vaginal oestrogen, moisturisers, lubricants and wider intimate health options may be discussed for genitourinary symptoms of menopause. The right option depends on your history and symptoms.
Video consultations may be suitable for some women, depending on their symptoms and clinical needs. Some concerns, such as bleeding, pelvic pain, intimate symptoms needing examination or coil-related questions, may be better assessed in clinic.
Your next steps
1. Book your free telephone consultation
2. Talk through what has changed
3. Decide whether to book the initial consultation
4. Have a detailed assessment if appropriate
5. Receive a personalised plan and review pathway
If something has changed, you do not need to have all the answers before getting in touch. You simply need a place to ask questions openly and understand your options clearly.
What does evidence-informed menopause care mean?
Menopause care sits in a regulated medical space. Good information should be balanced: it should explain effective options, but also recognise risks, contraindications, monitoring and the difference between a consultation service and advertising prescription medicines.
NICE-informed approach
Menopause diagnosis and treatment should be individualised, with clinical diagnosis often appropriate in women over 45.
Prescription medicines are assessed
HRT, vaginal oestrogen and testosterone are discussed as clinical options only where appropriate after assessment.
Risk-benefit conversation
Benefits and risks vary by age, medical history, route, dose, duration and personal risk factors.
Important clinical points covered on this page
This page is educational and does not provide diagnosis or prescribing advice. Please book a consultation if you would like your own symptoms and options reviewed.
Read expert women’s health articles
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