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Thankfully, everyone is talking about menopause! If you know you are suffering with symptoms such as hot flushes, sweats, brain fog, tiredness or anxiety, you may be wondering where to start when trying to get some help?? Many women suffer for years with perimenopause and believe they just have to put up with the 40 odd symptoms of menopause. NO NO NO!

Please don’t wait until you are desperate and at breaking point as it usually makes the process more frustrating. I work as a NHS and Private GP so I very much understand the challenges GP surgeries are facing and the struggles patients are having. So, I’m going to share some advice and tips that will allow you to get the most from your consultation with your health professional.

Who to speak to?

It’s not essential that you always speak to a GP about perimenopause or menopause. GP surgeries are changing so practice teams are made up of multiple health professionals including: nurses, paramedic practitioner, nurse practitioners and junior doctors.

Non-GPs are dealing with all sorts of problems, so it’s important to try and speak to the right person… I hear you sigh in exasperation… please wait! There are lots of ways to find this right person:

• have a look at the practice website – does anyone have a special interest in women’s health?
• look at the practice social media and pop a query there if you feel comfortable
• most practices are offering e-consults (usually called Footfall), where you can fill out an online query form in detail and this is passed onto the appropriate health professional – this will save you and the reception A LOT of time!
• speak to the receptionist – it’s a good idea to avoid the busy times such as morning and early afternoon
• Consider seeing a doctor who is training; most training practices will have GP trainees. These are a qualified doctor who is on a 3 year training programme to become a GP. Menopause education is a HOT TOPIC so quite often they will be interested in learning more through patients and will have longer appointments.

Making an appointment?

So now that you know you who to see, it is about trying to make an appointment:

• Try to get a ROUTINE appointment rather than urgent, either on-line or by phone.
• Try to book a double appointment as this will give the health professional more time to spend with you.
• Be prepared to try a few times as most surgeries release staggered appointments every few weeks to cope with demand.
• Do your research if you consider making a private appointment with a menopause specialist. Taking a look at testimonials, motivations and credentials for work will be reassuring for you and often works out better in the long run.

Homework before an appointment?

If you have not done so already, download the FREE Balance App or similar. It will provide you with symptom tracker , information and group chats that provide immense support. You can download the Health Report from the App which will be a summary of your symptoms and also your periods (if relevant). Many women find this alone is hugely empowering and gives them control back.

Preparing in the run up to your appointment is ESSENTIAL. No one will know your history or health like you.

• Periods:

What are your periods doing? Have you missed any? Are they getting longer or shorter? Do you regularly feel unwell at certain days of the month?

• Contraception:

What contraception are you currently using? Is it making you feel worse? For example, many women on the progesterone only pill find that vaginal dryness or mood maybe worse.

• Past medical history:

Have you had any fertility care? What hormones have you had in the past either as treatment or contraception?

• Family history:

What is your family history? If you don’t know ask! It is important as it clears up the unknown.  Pay particular attention to any history of heart disease, clots, breast cancer, ovarian cancer, osteoporosis and dementia.

If you have anyone with a family history of breast cancer find out three things:

the age they were diagnosed, type of breast cancer and their Oestrogen receptor status (they can find all of this on the top of a hospital letter usually in bold)

Look at your lifestyle?

Your lifestyle will impact your entire health – mind, head to toe! Take this opportunity to have a CLEAN UP!

• Do you smoke?
• Do you drink above the recommended amount of 14 units/week (1.5 bottle of wine)?
• Do you exercise regularly? 30 mins a day or 250 mins a week?
• How much caffeine per day? Decaffeinated and green tea still contain caffeine!

Going to the appointment?

Go calmly and if you have done all the above, you should be brilliantly prepared and the time should be used to focus on YOUR NEEDS. It is not supposed to be a battle but a shared conversation of risk and benefits for your health. For example, if you don’t exercise, drink 3+ coffees and 7 units of alcohol a day, then expect lifestyle changes to be a crucial part of your consultation. However, if you’ve learnt all of this from the above information and made changes long before, then the conversation should be much more comfortably focused on treatment options including hormone replacement therapy.

If you start HRT, don’t forget/be forgotten – Follow up?

Knowing your health and lifestyle is CRUCIAL and if you make healthy changes they will benefit you entirely in all disease areas. Once you make or start HRT it is important to:

• Not miss doses – ensure you have plenty prescribed and ask for a 3 month repeat supply
• Keep a bleeding or side-effect log
• Stick with it! It usually takes around 3 months to get a good idea of how it suiting you.
• Have a REVIEW at 3-6 months.

Menopause and perimenopause are consequences of hormonal fluctuations and gradual decline. We have plenty of evidence that rebalancing the hormones using body identical HRT (available on the NHS) is SAFE and BENEFITS most women. I hope this information helps you to find and consult the best health professional for you.

Written by Dr Radhika Vohra

May 2025

NHS & Private General Practitioner in Surrey,

Educator & Medical Trustee to The Menopause Charity