Hormone Balancing
Menopause Support
Symptom relief through perimenopause and beyond
Perimenopause can run for a decade and is routinely mistaken for stress, depression or burnout. We name what is happening, treat what is treatable, and are candid about what therapy will and will not fix.
Who this is for
Often right for
- Perimenopausal symptoms dismissed because bloodwork looked normal
- Hot flushes and night sweats disrupting sleep and work
- Mood changes, anxiety and brain fog appearing alongside cycle change
- Vaginal dryness, painful sex, urinary urgency and recurrent UTIs
- Early or surgical menopause, where treatment matters most
- Patients who cannot or prefer not to take systemic hormones
Booking commits you to nothing
What to expect
Your Menopause Support visit
A full symptom history
An hour covering cycle change, sleep, mood, cognition, joints, urinary and sexual health, plus family history. Nothing on that list is treated as too minor or too awkward to raise.
Excluding the mimics
Thyroid disease, anaemia, sleep apnoea and depression all overlap with menopause. Bloodwork here is largely about ruling those out rather than confirming menopause itself.
Setting priorities
We ask which two or three symptoms are costing you the most, and treat those first. Chasing everything simultaneously makes it impossible to tell what helped.
Choosing an approach
Systemic therapy, local vaginal oestrogen, non-hormonal medication or a combination — with the trade-offs of each explained in numbers you can take away.
Review and titration
At eight to twelve weeks we assess what has changed and adjust. Most patients need at least one adjustment; that is expected rather than a setback.
The longer view
Bone density, cardiovascular and metabolic risk all shift after menopause. We build screening and strength work into the plan rather than treating symptoms in isolation.
The science
Why it works
Perimenopause is the transition, not the destination, and it is where most patients suffer without a diagnosis. Cycles remain and hormone levels swing unpredictably rather than simply falling, which is exactly why a single blood test on a single day so often reads as normal. Diagnosis in this phase is primarily clinical — your symptom pattern and age matter more than one oestradiol result — and being told your bloods are fine is not evidence that nothing is wrong.
The symptom list is wider than the one most people know. Hot flushes and night sweats are the recognised pair, but sleep fragmentation, anxiety that feels unfamiliar, low mood, loss of verbal recall, joint and muscle pain, migraine change, palpitations, dry skin, urinary urgency, recurrent UTIs and vaginal dryness are all part of the same physiology. Several of these get treated in isolation for years — the sleep, the mood, the joints — without anyone connecting them.
Hormone therapy is the most effective treatment for vasomotor symptoms and it is not the only option. Non-hormonal medication has a genuine evidence base for hot flushes. Vaginal oestrogen treats genitourinary symptoms with negligible systemic absorption and is appropriate for many patients who cannot take systemic therapy, including most breast cancer survivors after discussion with their oncologist. CBT has real data for sleep and mood. Strength training and protein intake do more for bone and body composition than any prescription.
We will also be honest about the limits. Therapy reliably reduces flushes and improves sleep and genitourinary symptoms. Its effect on mood is real but partial, and it is not a treatment for depression. Cognitive complaints often improve with sleep rather than directly with hormones. Weight change during menopause is driven substantially by age and muscle loss, and replacement alone will not reverse it.
At a glance
- Initial consult
- 60 minutes with a physician
- Diagnosis
- Clinical in perimenopause; bloodwork to exclude other causes
- Options
- Systemic HRT, vaginal oestrogen, non-hormonal medication
- Onset
- Flushes and sleep often improve within 2–6 weeks
- Review
- At 8–12 weeks, then at least twice yearly
- Also covered
- Bone, cardiovascular and metabolic risk
Questions
Menopause Support questions
- Very possibly. Perimenopause commonly begins in the early forties and sometimes in the late thirties, while cycles are still regular. Age alone is a poor rule-out. If your symptom pattern fits, we will investigate it properly rather than deferring until your periods stop.
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