Menopause Assessment and Treatment

Menopause is the natural stage in a woman’s life when her menstrual periods cease permanently, marking the end of her ability to become pregnant. It is a normal part of aging. Some women experience few or no menopausal symptoms and may even feel relieved to be free of concerns about periods or pregnancy. For others, the transition can bring a range of symptoms, such as hot flushes, night sweats, sleep disturbances, joint and muscle aches, pain during sex, mood swings, forgetfulness, difficulty concentrating, or a combination of these. Many symptoms can be reduced with lifestyle changes or medication. 

Management and treatment of menopausal symptoms depend on each individual woman’s experience. Some women with symptoms that are affecting their quality of life will need to seek treatment from their GP to help them manage their symptoms.  

The British Menopause Society have devised a series of short videos covering key menopause topics which can be viewed by clicking this link: https://thebms.org.uk/education/principles-practice-of-menopause-care/bms-ppmc-resources-toolkit/what-is-the-menopause 

For advice on how to self-manage your symptoms, and lifestyle changes that will help the menopause and perimenopause click this link: 

https://www.nhs.uk/conditions/menopause/things-you-can-do/ NHS 

Hormone Replacement therapy (HRT)

Hormone Replacement Therapy (HRT) is used to provide relief for many of the menopausal symptoms – such as hot flushes, night sweats, mood swings and vaginal dryness. HRT can be taken as pills or applied as gels, patches, vaginal creams, tablets or pessaries. There are different types of hormone replacement therapy (HRT) available. They can contain different hormones – oestrogen, progestogen or both. In some cases, testosterone may also be prescribed. Current guidelines recommend that women who take HRT can stay on the lowest effective dose to alleviate symptoms for as long as is needed – with regular check-ups and supervision by their doctor.   

Some women may look for alternatives to HRT. For more information : https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/alternatives-to-hormone-replacement-therapy-hrt/ 

Non-hormone treatments

There are non-hormone treatments if symptoms are having a big impact on your life and you cannot, or choose not to, have HRT. 

For Hot flushes and night sweats: 

• A blood pressure medicine called clonidine may be prescribed. 

• An epilepsy medicine called gabapentin may be prescribed.  

• CBT may be beneficial 

For Mood symptoms:  

• Antidepressants can help with mood symptoms for those who have been diagnosed with depression or anxiety. 

• CBT may be beneficial 

What is CBT?

Cognitive behavioural therapy (CBT) is a talking therapy which can help with: 

• low mood and anxiety caused by menopause and perimenopause 

• some physical symptoms like hot flushes and joint pain 

Women can refer themselves directly to an NHS talking therapies service without a referral from a GP by following this link: https://www.nhs.uk/service-search/mental-health/find-an-nhs-talking-therapies-service 

There are various schemes which offer reduced or free prescriptions

A prescription is required for all medical HRT treatment options. These can be obtained through your registered GP practice. 

Some women are eligible for free prescriptions which will include prescribed HRT medications. This is based on various factors such as low income, age and whether being in receipt of certain benefits.  

Click here for more information: https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/free-nhs-prescriptions 

A hormone therapy prepayment certificate (HRT PPC) saves money for those needing more than 2 prescribed qualifying HRT items in a year. It  covers an unlimited number of some HRT medicines for 12 months, including if they’re prescribed for something other than menopause symptoms.  

Apply here: https://health-charge-exemptions.nhsbsa.nhs.uk/buy-hrt-ppc/start 

For those that have to pay for a lot of NHS prescriptions, it may be cheaper to buy a prescription prepayment certificate (PPC). This covers all NHS prescriptions (including dental) and is a fixed charge (no matter how many items that you need). Payment can be spread over 12 months. 

Apply here: https://www.gov.uk/get-a-ppc