Welcome to Wells Menopause Clinic

Please note this clinic does not offer an emergency service – emails will be answered within 5 working days unless the clinic is closed. Any temporary closures will be mentioned here:

THE CLINIC WILL BE CLOSED FROM FRIDAY 5TH AUGUST UNTIL MONDAY 15TH AUGUST 2022.

News July 2022

I closed my waiting list to NEW patients in March 2022 to concentrate on setting up a new NHS menopause service for Somerset. If you live in Somerset, you can check if you meet the criteria for the Somerset NHS Menopause Service via the Glastonbury Surgery website.

For those already on my waiting list, I will be contacting you as appointments become available but you can also look at alternative clinic options via the ‘Find a Specialist Service’ on the British Menopause Society website.

CURRENT patients can continue to email me as usual and I can either advise you or find a review appointment if needed. Please give at least 2 to 3 weeks notice if you are needing a new prescription, especially in view of the current shortages.

Some patients are finding their menopausal symptoms have returned when changed to the new pump-packs of Oestrogel (same pack but slightly different labels). Please see my Instagram posts and video for more details. If you are a current patient and feel this is relevant to you, please email the clinic to arrange a follow up appointment or ask your GP to change you to a different form of transdermal oestrogen.

Unfortunately there are lots of shortages of HRT at present.There is an HRT conversion chart on page 3 of the HRT factsheet on the Women’s Health Concern website – see link below. You can show this to your GP or pharmacist to help them work out equivalent doses if you have to change your HRT.

Click here for a factsheet on HRT: Types, doses and regimens

Updated BMS guidelines (May 2022) suggest blood tests are done before initiating testosterone. You can ask if your GP surgery is able to do these, if not you can contact the clinic about private options. The tests required are oestradiol, testosterone and sex hormone binding globulin levels. If using oestrogen gel in the mornings, please book your blood test for the early morning and don’t apply any gel until after the blood has been taken.

If on oral oestrogen, please ask your GP to change you to transdermal oestrogen before these blood tests.

Welcome

The average age of the menopause for women in the UK is 51 but hormonal changes often start in your 40s or even earlier, long before periods stop. This leads to many different physical and psychological symptoms that can affect women to varying degrees. You (and your doctors) may worry that you are developing conditions such as dementia, a brain tumour, depression, heart disease, lymphoma, bladder disease, arthritis or fibromyalgia. You may be referred to lots of different specialists for investigations when in fact you may just need to replace your reducing oestrogen levels.

This symptom checker  (click to download or open)  may be useful to print off and fill in if you are having a GP consultation. If attending my clinic, we will go through these symptoms during the consultation.

Why go private?

Ideally all menopause care would be available on the NHS but sadly this is not the case for many women at present. GPs are under immense pressure with rising workloads and reduced staffing levels. Some GPs are not aware of the current evidence on the safety and benefits of HRT. Others are aware and trying to advise women during 10 minute appointment slots, very difficult for both patient and GP. A private consultation can give you plenty of  time in a relaxed setting to discuss your symptoms and look at all your options for improving both how you are feeling now and improving your future health.

  • My aim is to spend time working out the right HRT options for you and to then get you back to your GP for ongoing NHS prescriptions and follow up if possible. Everything I prescribe is available on the NHS apart from testosterone which is currently not an option in some areas. Hopefully this will change soon. I have recently managed to get testosterone for women on the Somerset GP Prescribing Formulary and menopause doctors are working on this in other areas of the UK.
  • I can also look at your lifestyle and how this can be improved. However it can be so much easier to make lifestyle changes once HRT has improved your debilitating symptoms.
  • Some women may request HRT from their GP but are told it is not safe for them to start or to continue it long-term due to underlying health conditions or their family history. In many cases certain types of HRT can be prescribed safely. Other women may have been told to stop HRT after 5 years or once they have reached 60 but would now like to restart it. If indicated I can write to your GP to advise them about the current evidence on the safety of HRT in your particular case. For most women under the age of 60,  the benefits outweigh any risks and long-term HRT can significantly reduce the risks of cardiovascular disease and osteoporosis.
Dr Juliet Balfour
BSc MBBS MRCGP DRCOG DFSRH
Advanced Certificate in Menopause Care
BMS Menopause Specialist