The menopause occurs when the production of oestrogen and progesterone – the hormones needed for reproduction and the regulation of menstrual cycles – decreases in a woman’s body. This usually happens naturally between the ages of 45 and 55, but can also result from the removal of the uterus and ovaries in a hysterectomy, or due to chemotherapy or radiation therapy.
Much of our work is concerned with the diagnosis of perimenopause and menopause, and how both can be managed through either non-hormonal treatment or hormone replacement therapy (HRT). These can help alleviate vasomotor symptoms of menopause (caused by the dilation of blood vessels) such as sweating and flushing, insomnia, cognition problems, fatigue, lethargy, and the loss of libido, and improve vaginal, bone and general health.
Premature menopause or primary ovarian insufficiency can also occur when the ovaries fail to produce normal levels of reproductive hormones. In the context of hypothalamic-pituitary disease in particular, careful exploration into the causes and consequences of the disease is required, and a consideration of the role of HRT in treating it.
We often discuss the use of testosterone to treat female androgen deficiency (FAD) and/or hypoactive sexual desire disorder (HSDD), and monitor your health while on testosterone.
Menorrhagia – heavy and/or prolonged periods – can cause distress, be uncomfortable, indicate a problem with the womb or hormones, and can lead to iron deficiency. By working together – sometimes with a gynaecologist or expert in female ultrasound – we can often work out what the problem is. Sometimes we will help you or your other doctors to understand whether there is a hormonal component to it; at other times we guide your treatment to lessen the heavy bleeding. If you have iron deficiency, we can also help treat this to prevent you from becoming anaemic.