Menopause

What is the menopause?

Menopause is a natural stage of life when periods stop and hormone levels change, most commonly between the ages of 45 and 55. Many women will already recognise when they are approaching or experiencing menopause, often noticing symptoms such as hot flushes, sleep disruption, low mood, or changes in periods. The transition phase before periods stop is known as perimenopause, and symptoms can vary widely from person to person.

Although menopause is a normal part of ageing, symptoms can have a significant impact on daily life. A range of treatments and support options are available to help manage symptoms effectively, including hormone replacement therapy (HRT), non-hormonal treatments, and lifestyle guidance. Specialist care can help tailor the right approach to your symptoms, health history, and preferences, ensuring you feel supported at every stage.

At Guy’s and St Thomas’ Specialist Care, we provide personalised menopause management with access to experienced clinicians who can guide your treatment and ongoing care at Guy’s Hospital and St Thomas’ Hospital. Our private gynaecology services offer a comprehensive range of support, helping you manage symptoms effectively and make informed decisions about your health.

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Our world-leading consultants offer:

collaborative, multidisciplinary expertise across all areas of women’s health
fast, accurate diagnostics and treatments at state-of-the-art facilities
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Early menopause and premature ovarian insufficiency

Early menopause occurs when periods stop between the ages of 40 and 45, while premature ovarian insufficiency (POI) refers to menopause before the age of 40. Both conditions are linked to a reduction in ovarian function, which leads to lower levels of oestrogen and can affect ovulation, fertility, and overall health.

There are a number of reasons why menopause may happen earlier than expected, including family history, smoking, certain medications, surgery to remove the ovaries, or treatments such as chemotherapy or radiotherapy. In some cases, no clear cause is identified. Women experiencing early menopause or POI may also notice symptoms similar to menopause, alongside concerns about fertility. Options such as fertility preservation, including egg freezing, or the use of donor eggs can help support future family planning where appropriate.

Lower oestrogen levels over a longer period of time can also increase the risk of conditions affecting long-term health, including reduced bone density (osteoporosis) and cardiovascular disease. Early menopause and POI have also been linked to heart rhythm conditions such as atrial fibrillation. Specialist assessment and ongoing management can help reduce these risks, with personalised treatment options such as hormone replacement therapy (HRT), lifestyle support, and regular monitoring.

If you think you may be experiencing early menopause or POI, get in touch with our specialists at Guy’s and St Thomas’ Specialist Care who can provide expert assessment, investigate underlying causes, and support you with a tailored treatment and management plan

Symptoms of the menopause

The severity of menopause symptoms can vary for each person, these sometimes can be mistaken for other conditions, especially those associated with ageing. It’s important to fully understand the cause of your symptoms so you receive the right support and treatment.

Symptoms of menopause can include:

aches, muscles and joint pain: although this is associated with ageing, it can worsen during the menopause
changes to your periods: during the menopause, it’s likely your periods will become less regular and lighter before gradually stopping. How long this takes, will differ for each woman. If you are experiencing other symptoms but still have periods, this is known as the perimenopause
difficulty sleeping: menopause can disrupt your sleep due to night sweats, which may lead to irritably during the day
headaches and migraines: if you are prone to headaches and migraines, these can worsen during the menopause
heart palpitations: you may experience changes to your heart rhythm or an increased heart rate
hot flushes: you may struggle to regulate your temperature with sudden bursts of feeling hot or cold
impact on sexual wellbeing: you may find you have a reduced sex drive or may experience vaginal dryness, itching or pain during sex
urinary tract infections: you may experience recurring urinary tract infections, that cause burning or discomfort when urinating, and a frequent need to urinate, as well as fevers
weight gain: you may find you gain weight or store weight differently

If you need help with managing your menopause symptoms, contact our team to book an appointment with a specialist.

Diagnosing menopause

To get an accurate diagnosis of menopause, our women’s health specialists will look at your symptoms and medical history. They may also recommend blood tests to check your hormone levels.

Menopause is usually a clinical diagnosis (in women aged 45-55) based on your history and confirmed once your periods have stopped for 12 months, but other tests can be beneficial to rule out any other causes of your symptoms, especially if you might be experiencing early menopause or POI.

If you’re experiencing menopause symptoms and would like expert support to manage them effectively, our consultants are here to help. Whether you need advice on treatment options, symptom control, or longer-term care, our team can guide you through the next steps with confidence.

Get in touch with our customer service team to arrange an appointment.

Menopause management

The treatment and support available for menopause will depend on your symptoms, their severity , and whether they need to be managed over a longer period.

Our specialists can offer several treatments to manage the symptoms of menopause.

Hormone replacement therapy

There are several hormone replacement treatments (HRT) that can be used to supplement declining hormones. Replenishing these hormones can help with conditions such as hot flushes, night sweats, vaginal dryness and in the longer term prevent osteoporosis and cardiovascular disease.

HRT can be prescribed in many different forms including:

patches
gels
tablets
topically in the form of pessaries, gels or creams

The hormones you need will differ depending on your medical and surgical history – but they will contain either oestrogen and progestogen (combined HRT) or just oestrogen (oestrogen-only HRT).

Localised vaginal oestrogen preparations such as creams, tablets, pessaries or rings may be recommended if you have mild or common symptoms. Testosterone can be prescribed if this is contributing to your symptoms, especially for women who have had both of their ovaries removed.

Beta blockers

If you’re experiencing severe heart palpitations, you may be prescribed beta blockers to help regulate your heartbeat. Heart palpitations are not usually caused by a serious heart condition, but HRT can be used to replenish oestrogen, a deficiency of which can cause other heart conditions.

Fertility preservation and IVF

Early menopause can reduce your natural fertility, so you may want to investigate preserving your eggs. Find out more about fertility preservation here.

IVF is also an option to help with fertility, as well as donated eggs, surrogacy, and adoption if you plan to have a family.

Diet and nutrition support

Diet has a large impact on how you feel and how your body functions. Dietary changes during the menopause can support bone health, lower bad cholesterol, and maintain a healthy weight. These include:

reducing alcohol consumption
avoiding spicy food
introducing fibre, vegetables, fruit, calcium, and protein

Guidance from one of our expert dietitians can help support you with this.

Lifestyle changes

Lifestyle changes such as quitting smoking can help reduce menopause symptoms. It’s not uncommon for people who smoke to experience more intense hot flushes, mood swings, and difficulties sleeping. Smoking can also reduce the production of oestrogen, resulting in premature menopause.

Regular exercise can help manage menopause symptoms such as weight gain and low mood. It can also help maintain healthy bones and muscle density, which can be affected by the reduction of oestrogen.

Cognitive behavioural therapy for insomnia (CBT-i)

If HRT isn’t effective or doesn’t help with sleep disruption caused by menopause, cognitive behavioural therapy for insomnia may be recommended.

CBT-i can help you address and manage unhelpful habits, such as excessive thoughts or anxiety, that are impacting your sleep. You’ll have the support of one of our sleep specialists who will help you manage symptoms and address these habits.

Manage your menopause with specialist support

Get personalised, expert-led care to help you manage symptoms, understand your treatment options, and feel confident in your next steps with support from Guy’s and St Thomas’ Specialist Care.

Contact our team to arrange an appointment or discuss your options.

Reviewed regularly to reflect clinical best practice
Last reviewed: 02 February 2026