I start menopause care by understanding your symptoms, menstrual history, health background and priorities. The right plan is individual and may involve lifestyle measures, symptom treatment, monitoring or specialist input.
Hormone blood tests are not routinely needed to diagnose menopause in otherwise healthy women aged 45 or over (NICE guidance); testing may be appropriate in younger women, atypical presentations, or where another diagnosis is being considered.
Perimenopause and menopause can affect sleep, mood, hot flushes, bleeding patterns, sexual wellbeing and quality of life. Similar symptoms can also have other explanations, which is why a careful assessment matters.
Unexpected postmenopausal bleeding, heavy bleeding, new severe pelvic pain, chest pain or acute neurological symptoms need prompt assessment rather than routine menopause treatment.
Written & reviewed by
Dr George XynopoulosConsultant Physician & Cardiologist · GMC 3502763 · Reviewed by Dr George Xynopoulos, GMC 3502763
Clinical review date: 21 August 2026
View full profileWhat your consultation can cover
I discuss symptom pattern, period changes, contraception, cardiovascular and bone-health considerations, previous conditions and treatment preferences. Tests are requested only when clinically useful; they are not automatically needed to diagnose every menopause transition.
| Area | Topics to discuss | Possible next step |
|---|---|---|
| Vasomotor symptoms | Flushes, sweats, sleep and daily impact | Lifestyle, non-hormonal or hormone-treatment discussion where suitable |
| Bleeding change | Pattern, timing and any postmenopausal bleeding | Gynaecology assessment and investigation where appropriate |
| Long-term health | Blood pressure, lipids, bone and cardiovascular context | Proportionate health-check or specialist pathway |
Treatment decisions are individual
Treatment suitability depends on your symptoms, medical history, current medicines and personal preferences. Any discussion of hormone treatment is clinically individual and should include benefits, limitations, contraindications and review arrangements.
When to seek urgent help
Call 999 or attend A&E for severe chest pain, stroke-like symptoms, collapse, severe breathlessness or another life-threatening emergency. Seek prompt medical advice for postmenopausal bleeding, heavy bleeding with faintness, new severe pelvic pain or rapidly worsening symptoms.
Related care and follow-up
Menopause symptoms may overlap with thyroid, mood, sleep or cardiovascular concerns. The clinic confirms the appointment, reporting and follow-up arrangements for your selected pathway at booking.
Testing and results
Health-check reporting depends on the tests and clinician-review route selected; the clinic confirms the applicable process at booking.
What to Expect at Your Appointment
Discuss symptoms
Share changes, impact and treatment priorities.
Review health context
Consider history, medicines and relevant risks.
Agree options
Discuss proportionate symptom and health pathways.
Plan review
Clarify follow-up and when to seek earlier help.
Frequently Asked Questions
References
- [1]Becker CM et al. ESHRE guideline: endometriosis. Human Reproduction Open. 2022.
- [2]Teede HJ et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Human Reproduction. 2023.
- [3]Munro MG et al. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes. International Journal of Gynecology & Obstetrics. 2018.
- [4]The North American Menopause Society. The 2022 hormone therapy position statement. Menopause. 2022.
- [5]Zondervan KT, Becker CM, Missmer SA. Endometriosis. New England Journal of Medicine. 2020.
- [6]NICE. Menopause: diagnosis and management (NG23). Updated guidance accessed August 2026.
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