The Leeds Teaching Hospitals NHS Trust

Menopause Care

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Menopause is when your periods stop due to lower levels of female hormones. This usually happens naturally between the ages of 45 and 55. If it happens naturally before the age of 40 it is called premature ovarian insufficiency (POI). Menopause can also happen early as a result of surgery to remove the ovaries (oophorectomy) or the uterus (hysterectomy) and following cancer treatments like chemotherapy, or a genetic reason. Sometimes the reason is unknown.

Up to 85% of women experience symptoms related to the menopause. Some women require advice or treatment to help with their symptoms. This page is for women undergoing symptoms of the menopause and the healthcare professionals caring for them.

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Menopause care in Leeds

For most women, menopause care can be provided by your GP.

Symptoms of the menopause can vary between individuals and no two women will have the same experience. Common symptoms include hot flushes, night sweats, skin changes, mood changes and sleep disturbance. It is also very common to experience vaginal dryness, difficulties with sex and bladder symptoms. It is important to note that symptoms of the menopause can start before your periods stop.

Hormone replacement therapy (HRT) is used for lots of women to manage symptoms of the menopause, or perimenopause (the time around the menopause itself). There are benefits and risks with HRT, and several different ways of providing HRT to the body. The majority of women can have HRT safely, but it needs to be supervised by a doctor to ensure it is tailored to you. There are links to information about HRT and other ways of managing menopause symptoms below.

In some cases, perhaps relating to your medical or family history, your GP may need advice from a Menopause Specialist. This may mean having an extra appointment with your GP after they have spoken to a Menopause Specialist, or it could mean having an appointment in the specialist Menopause clinic. The team in the Menopause clinic will ask questions to understand your symptoms and history, as well as your current health and any risks to your health. They will discuss this with you and offer options for managing symptoms of the menopause - this might include HRT or other alternatives. After an appointment, the specialist writes to your GP to explain what happened in the appointment and their advice.

Most of the women referred to the Menopause clinic only need to be seen once. After this, your GP will be able to supervise your care with the guidance of the specialist. If you need to be seen in the Menopause clinic again you will be told about this at your appointment.

For Women and their families

Symptoms of the peri-menopause and menopause

The peri-menopause and menopause are stages of life that each woman will experience differently. The peri-menopause (time surrounding the menopause) can last for eight to ten years, although some women will notice symptoms for a shorter or longer period, and to a varying degree.

Common symptoms of menopause include hot flushes, night sweats, problems sleeping and mood changes. As well as these it is common to notice a change in your menstrual cycle if you are still having periods - perhaps longer or shorter cycles, or very heavy or light periods.

Lots of other symptoms can happen during the menopause transition - symptoms like new or worse anxiety, lower energy levels or fatigue, difficulty with memory or concentration, joint pain, loss of sex drive or difficulties with sex. If you have experienced other symptoms that you're not sure about, speak to your GP - these might also be related to menopause or they could be a sign of something else that your GP will also need to know about.

Lifestyle advice

Sticking to a healthy lifestyle can make a significant difference to how a woman experiences the menopause and how severe her symptoms are. Did you know that smoking is associated with more frequent and more severe hot flushes?

Women are living longer now than ever. This means that around 40% of our lifespan is now after the menopause, so reflecting on your health and paying close attention to your lifestyle is important for your whole body. Some basic steps to take include:

  • stopping smoking
  • getting a minimum of 30 minutes of moderate intensity exercise 5 days a week
  • quitting or reducing your alcohol intake
  • ensuring you have a varied and balanced diet
  • attending your over-40s health check and any other screening you are offered such as a cervical smear test or mammogram

Paying attention to all of these can make a difference to your symptoms as well as being an investment in your future health.

When to seek help and who from

You should see your pharmacist or GP if you have menopause symptoms that you feel you would like help to manage. To find out more about topics related to menopause and HRT there are lots of resources below, but your pharmacist or GP can also help you here if needed.

If you have previously been told you shouldn't be given HRT and you have symptoms of the menopause that you would like help with, please see your GP. Even if you cannot have HRT your GP will discuss what alternatives are suitable for you. If your medical history or family history mean that HRT needs to be discussed with a menopause specialist, your case will be referred on to the team for advice. As above, sometimes this means having an appointment in the specialist menopause clinic.

You can see what happens when GPs refer patients to the Menopause clinic in the flowchart below.


For Healthcare Professionals

Please note some links in this section are internal to Leeds Teaching Hospitals NHS Trust only, which means patients may not be able to access some information.

Menopause transition, diagnosis, and prescribing overview - Leeds Health Pathways

LTHT Management of Menopause Transition and Hormone Replacement Therapy (HRT) guideline

Testosterone protocol

POI - Standard operating procedure

Menopause and the workplace

Postmenopausal bleeding / bleeding on HRT

Primary Care Women's Health Forum