Frequently asked questions

Please click here to contact us and schedule an appointment. 

Introductory appointments are face to face at our clinic in Henley-on-Thames. We offer the option of face to face or video consultation for follow up review.

Once you have booked an appointment, you will receive a confirmation email, along with a link how to fill a medical and symptom questionnaire.

If you have opted for a video appointment, you will be sent a link for the video call.

You do not need a referral from your GP, you can self refer. 

If you hold any existing information such as list of medications, medical history, investigations or bloods from other appointments, it would be helpful to have these ready for your appointment. 

Treatment for the menopause is not covered by private medical insurance. However, we recommend you always check with your insurance company. 

Appointments are with our specialist, Dr Shilpa McQuillan, who is an accredited British Menopause Society (BMS) specialist, GP and Community Gynaecologist. Read more in her personal bio here.  You can also learn more about our clinic here. 

We are open for face-to-face appointments!  

However, we are proud to maintain the highest standards for infection prevention & control in our healthcare setting. For that reason, we kindly ask that you to wait in your car until your appointment time. Your clinician will greet you at the door.  Once in the clinic, please wear a mask inside the clinic at all times and follow our strict hygiene rules.  Please do not attend our clinic if you have any symptoms of Covid-19 and/or have tested positive for Covid-19.   

 After your introductory appointment most women will be reviewed at 3 months. Once your treatment is optimised we will typically review you annually.

The appointments can get booked up quickly, so it is advisable to book this as soon as you can.

We understand that it can get expensive. With your consent, we can send a summary of our advice and treatments to your GP, who may be happy to manage your treatment on the NHS.

If you have any questions following your appointment, we include one follow up email in your consultation fee (6 weeks from initial, 4 weeks from follow-up consultations). 

For any further email communication requests, there will be an extra admin charge. We do encourage if you have any complex questions or concerns about your ongoing treatment, it may be more appropriate to book a further follow up consultation. 

We aim to respond within 5 working days.   

You can do this at home. Some pharmacies and GP surgeries may offer these services in their waiting area. If you are unable to do this prior to your appointment, we can do this at the clinic.

You do not usually need blood tests to diagnosis menopause (especially over the age of 45). If you are experiencing typical symptoms we can usually offer to start a personalised treatment plan without blood tests. In some case, blood test may be useful for monitoring treatment response to certain HRT medications. We can discuss this at your appointment. 

We offer 2 choices for issuing prescriptions:

We can directly send you a prescription by post, which you may take to any pharmacy of your choice 

OR

We can use our partnered online pharmacy service, Pharmacierge, who will contact you directly to arrange a delivery to your door (Within 1-2 days, with no delivery charge). 

For both of these, you will directly pay the pharmacy for your medication.
For ongoing prescriptions, we can either issue these (at an extra admin charge outside of consultations) or it may be continued at the discretion of your GP. 

Majority of women benefit from HRT. For some women, HRT may not be recommended. We believe in offering a holistic approach, and we can discuss all the different options and talking through the evidence with you.

There are many alternative treatments to HRT, some prescribed and some over the counter remedies. Take a look at our 'Non Hormonal Medications' page for more information.

HRT is not a 'one size fits all'. We will ask you to fill our medical questionnaire, and check your blood pressure, weight, and height. These will help guide which treatment options are safe for you. We base all of our recommendations on evidence, which we can talk through with you. These are supported by NICE and the BMS. 

We also only prescribe treatments that are rigorously safety tested and are Medicines and Healthcare  Products Regulatory Agency (MHRA) approved. 

Having family history of breast cancer does not necessarily mean you are at higher risk than the general population. We will take a thorough history and may suggest a referral to a geneticist or the hospital breast team if we need further information.    

Testosterone is an important female hormone that improves low sex drive, energy, brain concentration, muscle & bone health. If you are already on HRT but continue to experience these symptoms, we may suggest starting you on testosterone. We will need to periodically monitor your levels to ensure they remain within female physiological range.  Your GP may consider monitoring you on the NHS once we have stabilised you on treatment. 

There is no maximum time limit for a woman to continue on HRT. We advise you have annual follow up. This enables us to check any changes to your individual circumstance, and also keep you informed of any up-to-date changes to evidence-based guidelines and recommendations.

We offer an initial follow up review at 3 months. By this time, most women do see some improvement in symptoms. However, try not to be deflated if you still have symptoms at this point as every woman's needs are different. Our treatment plans are personalised, and we may need to adjust treatments for your individual case. 

Common side effects include breast tenderness, nausea, and bloating. Most of these settle and improve within 3 months. 

Breast tenderness can be improved with star flower oil. We suggest starting with 1000mg daily for 3 months (available from over-the-counter pharmacies). 

Women using transdermal HRT (through the skin) may find changing application from the upper arm, to inner thigh, away from the breasts, reduces the intensity of side effects.   

Unscheduled and irregular bleeding is common when starting HRT, or when increasing the dose- these tend to settle by 3-6 months. If the bleeding does not improve, or worsens after this time, you should contact the clinic or your GP , as further investigation may be necessary. 

In the event of any emergency, such as having an allergic reaction to any medication, you must contact you usual NHS urgent or emergency care provider.  Please do not use our clinic services for any medical emergencies.

Menopause, or other terms such as ‘the change’, ‘the climacteric’ means to permanently stop having periods. The average age of menopause in the UK is 51. 

Post menopause is the term used once a woman's periods have stopped for 12 consecutive months.   

Early menopause is diagnosed if menopause occurs between the ages of 40 and 45.

Some women (approximately one percent) can go through menopause as early as their 30's. The term for menopause under the age of 40 is called Premature Ovarian Insufficiency (POI).  It is really important these women are offered HRT to protect them from long-term effects of heart disease, brain function, and osteoporosis. 

As a woman gets older, their store of eggs in the ovaries naturally declines. The menopause occurs when there are no more eggs, resulting in a dramatic decline in important female hormones (oestrogen, progesterone and testosterone).  These hormones control the menstrual cycle. They also have receptors in most parts of the body- resulting in huge effects on cardiovascular, brain, musculoskeletal, skin, urinary tract and genital systems.  As a result, women experience a wide range of symptoms such as flushes, mood disorder, brain fog, joint and muscle aches, sleep issues, vaginal and urinary tract problems, low sex drive and energy.  

Yes. Perimenopause is the term used for the time leading up to the menopause. This can start years before a woman has her final period.  During this build up, the female hormones (mainly oestrogen, progestogens, testosterone) start to fluctuate and often decline gradually.  This initial subtle change can be quite distressing as the diagnosis may not be obvious. Often periods continue, but may become more erratic, and early symptoms may evolve such as mood changes, and brain fog, which are no the typical obvious diagnostic physical symptoms (such as hot flushes or night sweats).  

To complicate matters, some other conditions such as low thyroid hormone can also present similarly.  

If you think this may be you, why not book an appointment with us today to speak to our specialist. 

During peri-menopause , you may still be able to get pregnant. 

This is because it is still possible to ovulate (produce an egg) when you are having periods, and even shortly after stopping periods.  

You may be already on contraception, which has stopped your periods. This can give a false impression you are in menopause, and that you do not need contraception going forward. 

It is also important to know that HRT itself is not a form of contraception as it only contains low levels of hormones.   

As a general rule, it is safe to stop using contraception if:  

You are not on any hormones, have not had any periods for more than one year, and are over the age of 50  OR

You are not on any hormones, have not had any periods for more than two years, and are under the age of 50  OR

You are over the age of 55