Menopause

Taking Your Unique Experience of the Menopause to Provide the Best Approach.

All women should have access to individualised and up to date advice for the Perimenopause and the Menopause, but this is not always the case.

Dr Trish Davis - Private Menopause Treatment

Dr. Trish Davis provides patient centred care with menopause at the heart of the discussion.

At the Rebalance Your Life clinic we aim to support and guide women individually, with particular reference to the role of hormone replacement therapy (HRT) in line with guidance from the British Menopause Society as well as discussion of diet modification and lifestyle advice.

In addition, men can have testosterone management in accordance with guidance from the British Society for Sexual Medicine.

Dr. Davis is a member of and holds the Certificate in Menopause Care from the British Menopause Society.

Hormone Replacement Therapy

As recommended by the British Menopause Society we use regulated Body Identical hormone therapy which is the safest kind of HRT.

Non-regulated Bioidentical HRT otherwise called Compounded Bio-HRT, uses synthetic manufactured hormones that are precise duplicates of hormones.

There is absence of medical evidence to support the way that these are used. For example, the dose of bioidentical progesterone used has not been proven to be sufficient to protect the endometrium in the presence of estrogen against cancer.

The same regulatory pathway of evaluation of the MHRA are not followed by manufacturers of bioidentical hormones. And so, the safety of these medications is simply unknown. Further data from large studies is required and this will be available we hope in the near future. However Dr Davis has completed training in bioidentical hormone therapy also and is able to advise if this might be the right type of HRT for you.

Expert Advice

The decision whether to take HRT together with the dose and duration is made on an individualised basis after discussing the benefits and risks with each patient.

perimenopause treatment - hormone therapy

We can advise women who are experiencing

  • Premature menopause (40-45y)
  • Premature Ovarian Insufficiency (Under age 40y)
  • Surgical menopause
  • Peri-menopause
  • Symptoms that persist
  • Ongoing symptom management whilst taking HRT
  • Testosterone service for women already on HRT

We provide HRT guidance to those who may have

  • Migraine
  • A family history or personal history of breast cancer
  • A history of blood clots
  • Cardiovascular medical problems
  • Osteoporosis
Hormones

What are Hormones?

HRT Newcastle

Hormones control cell growth, development, protein synthesis & metabolic rate. Optimum levels are essential for quality of life, good health and disease prevention.

HRT (Hormone replacement therapy) follows individualised diagnosis of sex hormone imbalance from a detailed discussion.

The objective of HRT treatment is to optimize hormone levels in the blood, help reduce symptoms associated with low levels of hormone and improve general wellbeing. The hormones are prescribed and tailored for each patient to ensure optimum effectiveness.

Interpretation of hormone deficiency is based on symptom evaluation, medical history, lifestyle, blood analysis and widespread understanding of the data and research available on HRT and extensive clinical experience.

Sex hormones include

  • Oestrogen
  • Progesterone
  • Testosterone

Sex hormones control our

  • Nervous System
  • Cardiovascular System
  • Immune System
  • Gastrointestinal System
  • Skeletal & Muscular Systems
  • Endocrine System

Perimenopause and Menopause can be the cause of mood disorders and memory symptoms in the menopause transition whether a woman has pre-existing depression / anxiety or not.

Menopause Practice StandardsBritish Menopause Society
Symptoms

What symptoms might I notice?

Perimenopause / Menopause

Oestrogen deficiency causes many symptoms which include

  • hot flushes and/or sweats

  • period problems / heavy periods

  • irritability, depression, mood swings, anxiety

  • insomnia

  • aches and pains including joint ache

  • vulval changes, urinary symptoms and urinary tract infections

  • memory problems

  • worsening of premenstrual stress disorders

  • osteoporosis

  • skin and hair changes, itchy skin

  • palpitations

  • gastrointestinal symptoms such as indigestion

  • headaches, new or increased frequency of migraine

Treatment Outcomes

How can treatment help me?

By correcting hormonal imbalance caused by menopause you can have

  • reduced blood pressure and reduced incidence of heart disease

  • ‘good cholesterol’ balance correction, (reducing the ‘bad’ LDL type)

  • prevention of fat in the organs reducing cardiovascular risk

  • improved sensitivity to insulin and reduced incidence of diabetes

  • immune system response improvement

  • improved skin, hair and muscles

  • improved mood, brain function and health

  • improved pain management

  • reduced loss of bone in spine and hip, increased BMD

  • improved sexual function, reduction in urine infections

  • reduction in risk of dementia

Patients Journey

Consultation Duration

45mins

Management Planning

Decision on whether testing initial hormone levels is appropriate and what steps are needed.

Review Appointment

3 months after the initial consultation.

Ongoing Review

Review at 3 months post initial HRT prescription and then annually.

1

Get in Touch

Book an initial consultation either by telephone 0770 704 8488 or through the Booking Request Form.
This consultation can take place in person or virtually over a secure online platform.
2

Consultation

You will have received a pre consultation questionnaire in your confirmation booking email and this needs to be completed before you attend.

We will take a full medical history and explore any concerns and experiences to date so that we can start to think about what your management options are.

45 minute appointment after completion of medical questionnaire.

3

Management Planning

We will decide on whether testing initial hormone levels is appropriate and what steps need to be taken to improve symptoms that may include lifestyle adaptations or support.

If a prescription is appropriate then this can be organised for you to take to your GP or local pharmacy or this can be delivered to you through an online pharmacy.

A summary leaflet with some general tips and advice will given to you in clinic. Please be aware that currently in the UK, shortages of some HRT medicines mean that there can be a delay in delivery occasionally. Alternative options are prescribed when this happens that will have the same therapeutic outcome.

After your appointment you will receive a summary of the consultation and a management plan. This can also be sent to your GP with your permission.

4

Review Appointment

A review appointment will be organised 3 months after the initial consultation.

If you required blood tests at the initial consultation that may affect our decision making or prescription, it may be necessary to have a review sooner than 3 months. If this is necessary it will be explained during the planning stage.

At the follow up appointment we can assess how you are getting on with any treatment that has been started. If further tests are necessary then this will be explained and planned with you. A summary of the discussion will be sent to you.

5

Ongoing Review

This is something that you can engage with as long as you wish.

We recommend a review at 3 months post initial HRT prescription and then annually. Ideally if you are taking testosterone then blood levels should be monitored before this is started, at 3 and 6 months and then annually.

6

After your appointment

HRT.

If you have been prescribed HRT, please be aware that unscheduled bleeding can occur in the first 3-6 months of use but that it should settle. After that time this may require investigation. Please advise us at your 12 week review if you are having unexpected bleeding and this can be evaluated with you.
There can occasionally be initial side effects of HRT. These include

  • breast tenderness,
  • bloating,
  • low mood.

These symptoms should settle but can be discussed if present, at your 3 month review appointment.

Testosterone.

The need for testosterone will be assessed only once HRT is established and symptoms indicate possible low levels. In this case a blood test will be taken to check testosterone levels. If testosterone is prescribed you will need a 3 and 6 month blood test to check that the dose is correct.
All patients need to have an annual review of an ongoing HRT prescription to make sure that they are on the correct treatment.

FAQ's

Frequently Asked Questions

How much will the HRT medication cost?

If deemed appropriate, a prescription for HRT will be issued privately at a cost of £35 and this can either be issued by our remote pharmacy (who will contact you to take payment for the medication and organise delivery) or it can be taken to any local pharmacy.

We don’t stock any items. It is your choice how you do this. Some women decide to ask their GP to issue the prescription, and the decision to do so is up to the individual GP.

£35 will be charged for each private prescription, regardless of the number of items on the prescription.

Do you prescribe Bioidentical HRT?

We do not prescribe Bioidentical HRT. This is a ‘non NHS’ kind of HRT that uses a synthetic ‘chemically identical formula’ to human hormones, made in private laboratories.

We believe in the British Menopause Society stance on HRT, that ‘Body Identical HRT’ is safer than ‘Bio identical HRT’.

Can I have a Mirena coil inserted in the clinic / implant?

If this is needed then the practicalities of this will be discussed -including the option of fitting in the clinic if available. Alternatively we may refer you to another service for this to be done or your GP.

Do you prescribe female testosterone?

Yes, if it’s appropriate, we prescribe testosterone on a private prescription.

What is the review process?

Please ensure that you have made your follow-up appointment approximately three months after the initial appointment and we will advise when to have any further follow-ups. To obtain a prescription from us you will need to be seen at least annually.

If you have not been seen by us for over 2 years a new INITIAL consultation will be needed.

What correspondence will I receive from the clinic after my appointment?

The clinician will email you a summary, outlining what was said during the consultation, usually within 7-10 days.

Your GP can also be sent a copy of this letter if you would like this, or you may have said you prefer for your GP not to be contacted.

Usually, we ask you to give a copy of your summary letter to your GP.

How do I receive the results of any blood tests I have?

Blood tests are taken in clinic, close to your home or by a nurse at your home for an additional charge.

We use an alternative lab if you choose to go to a centre close to where you live. Once you have been invoiced by us for your tests then you will be able to proceed with a centre visit or a kit will be sent to your home. As soon as your results are available, they will be reviewed and commented on by us.

You will then receive an email with your results / comments / treatment plan / prescription.

What is checked in the blood tests and other investigations?

We may recommend a blood test to assess hormone levels or to simply check for good health. This will depend on what happens in your consultation. Blood tests are also sometimes recommended as part of a well woman check or to assess other systems, for example thyroid function tests.

It is not usually necessary to do a blood test to diagnose the menopause. It is always necessary to have a blood test for men who are attending for testosterone advice.

We cannot access your NHS doctor’s lab system. Recommended investigations for some women, such as a bone mineral density scan, mammogram or pelvic ultrasound scans can be arranged if needed.

At what age might I need HRT?

Patients most commonly experience menopause symptoms from the age of about 45. Some women experience an early menopause (40-45y) or Premature Ovarian Insufficiency (under 40y).

Was are the possible side effects of oestrogen?

Adverse reaction may include bloating, breakthrough bleeding, breast swelling and tenderness, fluid retention, nausea, headaches, leg cramps, dyspepsia.

Was are the possible side effects of progestogens?

May cause sedation, in view of this it is recommended to coordinate dosing with sleep cycle. Adverse reactions may include bloating, migraine, breakthrough bleeding, missed menstruation, breast swelling and tenderness, fluid retention, sedation and depression.

Was are the possible side effects of testosterone therapy?

Side effects can include acne, hair growth on face and body but reduced on the scalp, change in libido, clitoris enlargement, voice changes and water retention. If using gels or creams then irritation to the skin where it is applied can occur.

What happens during the consultation?

The 45 minute consultation process includes assessment regarding the risks and benefits of hormone replacement for you as an individual in relation to your medical history as a whole. The decision to use HRT has to be made on a person to person basis, taking into account any baseline risk factors that may include non-modifiable genetic predispositions and modifiable lifestyle factors.Further onward referral can be made if the decision to use HRT is more complex, for example in those who have a history of breast cancer and who have decided that they would like to go ahead with HRT will also be seen by a Consultant Gynaecologist Dr Davis is able to provide counselling and support regarding the options available for your unique experience of the menopause transition, including HRT.

Can you recommend any resources?

Website Links

Menopause Matters

www.menopausematters.co.uk

Manage my Menopause

www.managemymenopause.co.uk

The British Menopause Society

www.thebms.org.uk

Womens Health Concern

www.womens-heath-concern.org

Bladder Matters

www.bladdermatters.co.uk

Sexual Advice Association

www.sexualadviceassociation.co.uk/factsheets

FPA Sexual Health

www.fpa.org.uk/download/people-over-50-relationships-and-sexual-health-pdf

Polycystic Ovarian Syndrome

www.verity-pcos.org.uk

Endometriosis

www.endometriosis-uk.org

Pelvic Pain

www.pelvicpain.org.uk

Premature Ovarian Insufficiency

www.daisynetwork.org

Calcium Intake calculator

www.iofbonehealth.org

Recommended Books

Mating in Captivity

Esther Perel

Intimacy & Desire

David Schnarch

Enhancing Couple Sexuality

B McCarthy

Mind the Gap

Karen Gurney

Moisturisers

May be helpful for genito-urinary symptoms.

These hold moisture on the vaginal wall, use 2-3 times per week.

  • Replens
  • Regelle
  • Hyalofemme

Lubricants

Check the label as some contain petroleum and this can damage condoms and cause infections.

  • Sylk
  • Yes
  • Astroglide
  • Durex Play
  • Pjur

Treatment Pricing

Consultations

Female hormone consultations can be in person or online.

Pricing
Hormone Initial Consultation

£295

Hormone Follow-up Consultation

£225

Telephone Call for Existing Registered Patients

£115

Prescription Request

£35

Book Now

Investigations

Blood Tests

Blood test prices vary depending on what is required plus the option to have it taken by a nurse at your home, near your home or in the clinic. Additional charges if applicable are listed below. Finger prick samples are unreliable and are therefore not ever used by this clinic.

Pricing

Advanced Well Woman

Blood count, Liver, Kidneys, Urate, Cholesterol, Iron, Diabetes, Thyroid, FSH, LH, Estradiol, SHBG, Vitamin B12, Folate, Vitamin D, Magnesium.

In Clinic

£285

Nurse to Your Home

£345

Female Hormone

SHBG, Thyroid, Testosterone, FHS, LH, Estradiol, FAI, PRL

In Clinic

£145

Nurse to Your Home

£205

SHBG, Testosterone Estradiol

In Clinic

£120

Nurse to Your Home

£180

Estradiol

In Clinic

£80

Nurse to Your Home

£140

Book Now

Dr Davis is knowledgeable and listens. I was impressed. If you are thinking you need more than 10 minutes with a GP to discuss your situation, then I would recommend her.

Gemma SalehGoogle Review

I contacted Dr Trish after having a total hysterectomy and my ovaries out. My hormones had flat lined and I was in a terrible state. She has helped me build myself back up and been an amazing sounding board every step of the way. There is no one size fits all with Dr Trish, she tries different hormones and different delivery methods until you are feeling your old self again. Would totally recommend, don’t hesitate!

Mary LonsdaleGoogle Review

My consultation with Dr Trish Davis was completely reassuring and reaffirming. It is clear she is incredibly passionate and knowledgeable about her field, and incredibly thorough in her review of me as an individual. Dr Davis was exceptionally patient and understanding, and took the time to really understand my circumstances and tailor an HRT treatment plan to suit me. I left the appointment feeling heard, validated and positive about my next steps with HRT. I believe every women should be afforded that right and 100% recommend Dr Trish Davis.

Lorraine BurkeGoogle Review

Trish has been so helpful to me, I have found with other doctors they will just try to mask any symptoms but with Trish she is looking into my care further, looking into other underlying causes of my current symptoms. I really appreciate all Trish has done for me and I wouldn’t go to anyone else!

Lauren GarforthGoogle Review

Trish has basically saved my life! I was in a terrible state with severe symptoms of the menopause. My mental health was suffering as well as having no energy, horrific mood swings and just about everything else the menopause has to offer. She did extensive blood tests to see exactly where my hormones were and md general health, she then suggested a treatment plan and talked through everything with me. It has been life changing for me. Trish is fantastic and I highly recommend her.

Gemma SalehGoogle Review

I had been struggling for months with severe menopause symptoms and found that my GP just didn't have the time or expertise to offer the help and support I needed. Trish really took the time to understand and talk through my medical history and explain how this impacted on treatment options. Without the benefit of her expertise and guidance I would still be struggling just to function instead of feeling that I can get through this and get back to being the real me.

Fiona CuthbertsonGoogle Review

In my experience menopause has been really tough to deal with on top of running a business and keeping up with family dynamics. Dr Trish has given me my life back and I strongly advise seeking her out if you suffer symptoms of menopause. Her expertise and calm approach is second to none.

Orchid AestheticsGoogle Review
Appointments

To book an appointment please use the online Booking Form

Booking Form

Or call us on

0800 464 7220

If you are unsure whether this service is right for you then a free discovery call can be arranged. Please request this using the Booking Form.

To book a consultation, please use the Booking Form and select which service you would like.

If you live outside the North East we can organise a prescription to be sent to you or it can be requested from your GP. If you require blood tests, they can be taken at or close to home.