Their clinic is approved and regulated by the Care Quality Commission, and they can independently prescribe HRT.

Nutritional therapy complements hormone therapy perfectly, and I was really interested in what they had to say.

SD – As menopause nurses, what are the most common symptoms women talk to you about?

P&M – Anxiety, weight gain, brain fog, vaginal changes, and low libido are common topics, and there might be one or more of those symptoms making a stronger impact on them day to day than others. If a symptom has changed how their life ticks along normally – like how anxiety is affecting them at home with their partner/children or at work, that’s usually when someone opens up to us and discloses what’s been going on.

SD – What drew you to specialise in menopause care?

P – We’ve both worked with women for all of our nursing careers. Mell was an experienced practice nurse who worked mainly in women’s health for many years. She carried out smears, fitted coils, and all forms of contraception and supported women through all stages of reproductive care. She was also a cervical screening assessor, making sure new nurses were trained to the highest standards when learning to take smears. Having gone through a particularly difficult menopause herself, she brings professional expertise and personal understanding to the support she offers.

In the last two decades of my own career I’ve been drawn to work with women as a nurse counsellor, a family planning and sexual health specialist nurse and – after experiencing a treatment induced menopause in my early 30’s and then a natural menopause after my periods came back, I was very aware of how severe menopause symptoms could change your life, so personal experience was definitely a huge personal driver for me to learn more about it and to give women the care they deserved at that time.

SD – I’ve heard women say they are hesitant about going on HRT because they don’t know how long they’ll need to be on it. They’re also fearful that symptoms will return once they do come off it. What do you advise?

P&M – As long as you feel the benefits from your HRT and have no contraindicating conditions which would discourage use, you can, in effect, stay on it as long as you choose to.

Our risk of developing certain conditions increases naturally with age, so although we do become more susceptible to age-related illnesses, there are certain conditions for which HRT has been shown to have a protective effect. These include cardiovascular disease ( the leading cause of death in women ), and it protects our bone health as we age. There’s now growing evidence to support its effect on our brain too.

The perimenopausal phase is when our symptoms are at their worst, as our hormone levels are fluctuating almost daily. Once you’re postmenopausal, and your ovaries have effectively gone to sleep, there’s no more erratic hormone levels to deal with. While many symptoms do gradually settle or reduce in severity once you’re postmenopausal, they can still make an appearance and impact on your life, which is why some people might choose to either stay on HRT at lower doses or trial a gradual tapering off before finally stopping its use. If you do stop HRT, and certain symptoms return that bother you, if you are generally fit and well, you could restart it following a discussion with your GP or menopause nurse.

SD – What’s the one thing you wish all women could know about peri/menopause?

 P&M – How the changes can affect almost every aspect of your life. The aches and pains that stop you doing what you enjoy, the low libido that affects your relationship and sensuality, the unpredictable mood changes that stop you enjoying time with friends or your partner. There are so many symptoms that arise in menopause because of a change in our hormones. It’s so important to know what to look out for and what help is there for you in terms of support, education and treatment.

SD –  If a woman is thinking of coming to see you, is there anything she needs to do beforehand? How does your consultation process work?

P&M – We’re registered with the Care Quality Commission to ensure the care we deliver is effective, safe, and compassionate. All our consultations are booked through our website. Once someone books a time and date to suit their needs, they’ll automatically be sent a pre-consultation health questionnaire via email to complete in advance of their appointment. This helps us support them more effectively by giving us a clearer understanding of their health history and menopause experience to date before we meet in a video call.

We give every new client a full 40-minute private video consultation to ensure we can tackle their main concerns and cover the appropriate treatment options for them. If necessary, we can also prescribe treatment privately and signpost to any additional support.

We provide a thorough report via email following their consultation with us, which they can choose to keep for themselves or share with their GP. Alternatively, we can send their report directly to their GP.

SD –  It can feel a bit doom and gloom when we talk about menopause symptoms, but a lot of women find menopause to be a positive and transformative process. What’s been the upside of peri/menopause for you personally?

Learning to accept, and perhaps even quite like, the person you’ve become after all the trials and tribulations we have experienced!
The menopause can feel like that final uphill slog after so many big life events before it. But, with the right advice, help, care, treatment, and good friends, we can get through the menopause and maybe even come through it with new goals, a different outlook on life, and newfound strength and determination.

Just because we’re in the middle of the perimenopause or have become postmenopausal doesn’t mean time’s run out to be the best version of ourselves that we want to be. The time is now – go for it.

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