< Back Ovarian Cancer Awareness Month: Understanding Symptoms, Diagnosis & Management Wellbeing March marks Ovarian Cancer Awareness Month, a crucial time to raise awareness about a disease that is often diagnosed late due to its subtle symptoms. As a menopause specialist, I want to highlight the importance of recognizing the signs early, seeking timely diagnosis, and exploring available management options, including what ovarian cancer means for fertility. What is Ovarian Cancer? Ovarian cancer occurs when abnormal cells in the ovaries grow uncontrollably, forming tumours. There are different types, with epithelial ovarian cancer being the most common. Because symptoms are often vague and mistaken for other conditions, ovarian cancer is sometimes referred to as the "silent killer." Symptoms to Watch For Ovarian cancer symptoms can be non-specific, making early detection challenging. However, key symptoms include: Persistent bloating —not just occasional bloating, but a frequent feeling of fullness. Pelvic or abdominal pain —ongoing discomfort that doesn’t go away. Changes in appetite —feeling full quickly or experiencing loss of appetite. Frequent urination —needing to urinate more often than usual. Changes in bowel habits —constipation or diarrhoea without a clear cause. Unexplained fatigue —persistent tiredness that doesn’t improve with rest. Unintentional weight loss —losing weight without trying. Getting a Diagnosis Since ovarian cancer symptoms often mimic other conditions, it’s important to seek medical advice if symptoms persist for more than a few weeks. The diagnostic process may include: Pelvic examination —checking for abnormalities in the ovaries and surrounding area. Ultrasound or CT scan —imaging to detect masses or irregularities. CA-125 blood test —measuring levels of a protein that may be elevated in ovarian cancer. Biopsy or surgery —confirming the diagnosis through tissue sampling. Management & Treatment Options Treatment depends on the type and stage of ovarian cancer. Options include: 1. Surgery Oophorectomy —removal of one or both ovaries. Hysterectomy —removal of the uterus, often necessary for advanced cases. Debulking surgery —removing as much cancerous tissue as possible. 2. Chemotherapy & Targeted Therapy Chemotherapy —used after surgery or as primary treatment for advanced cases. Targeted therapy —drugs designed to attack specific cancer cell weaknesses. 3. Hormonal & Immunotherapy Hormone therapy —used in some ovarian cancer types to slow tumour growth. Immunotherapy —boosting the body’s immune system to fight cancer cells. Ovarian Cancer and Fertility For women diagnosed at a younger age, ovarian cancer can have significant implications for fertility. If only one ovary is affected and removed, the other ovary may still function, allowing for natural conception. In some cases, fertility preservation options , such as egg or embryo freezing, may be available before treatment. It’s essential to discuss fertility concerns with an oncologist and fertility specialist early on. Ovarian cancer awareness is vital for early detection and better outcomes. Knowing the symptoms and seeking medical advice promptly can make a life-saving difference. If you or someone you know is experiencing persistent symptoms, don’t hesitate to ask for further testing. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Hot Flushes in Your 40s? You're Not Imagining It and You Deserve Support Managing Symptoms, Menopause Advice, Perimenopause, Wellbeing A ground breaking study from Monash University, Australia featured in The Guardian this week is finally challenging outdated assumptions about perimenopause and we couldn’t be more relieved. For years, women experiencing hot flushes before their periods stop have been told it’s too early for menopause or that their symptoms are caused by stress, anxiety, or even caffeine. But this new research has found that 46% of perimenopausal women experience hot flushes , and that these symptoms correlate with measurable hormonal shifts particularly falling oestrogen levels. Even more strikingly, researchers found that women with hot flushes had reduced brain connectivity in areas related to memory and cognition. This could explain why so many perimenopausal women also report brain fog, forgetfulness, or difficulty concentrating . At Bristol Menopause & Wellwoman Clinic , we hear this every day: women in their 40s saying they “don’t feel like themselves anymore” struggling with heat surges, fatigue, and mental load, but being told by professionals that they’re “not menopausal yet.” This study confirms what many women have long suspected: perimenopause is real, and hot flushes are a valid symptom of hormonal change. It’s time for a shift in how we recognise and respond to perimenopause. If you’re feeling dismissed, confused, or simply overwhelmed by symptoms – you are not alone. We offer personalised care, thorough hormone assessments, and a space to be heard. Book a Perimenopause Consultation In-person or video appointments available scheduled here Let’s get you back to feeling like you again. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back March Endometriosis Awareness Month: Understanding Symptoms, Diagnosis & Management Wellbeing March marks Endometriosis Awareness Month, an important time to shed light on a condition that affects millions of women worldwide. As a menopause specialist, I see first hand how endometriosis impacts not only reproductive health but also overall well-being. Despite its prevalence, many women go undiagnosed for years, often suffering in silence. In this blog, we’ll discuss the symptoms, how to get a diagnosis, and the management options available including what this means for fertility. What is Endometriosis? Endometriosis is a chronic condition where tissue similar to the lining of the uterus (the endometrium) grows outside the womb, commonly on the ovaries, fallopian tubes, and even the bladder or bowel. This misplaced tissue responds to hormonal changes just like the uterine lining, meaning it thickens, breaks down, and bleeds each cycle. However, because this tissue has no way to exit the body, it can lead to pain, inflammation, and scar tissue formation. Symptoms to Watch For Endometriosis symptoms can vary from mild to severe, and they often overlap with other conditions, making diagnosis challenging. Some key symptoms include: Pelvic pain —typically worse during menstruation but can occur at any time. Heavy or irregular periods —long, heavy, or painful periods are common. Pain during or after sex —deep pelvic pain can occur due to endometrial implants. Painful bowel movements or urination —especially during menstruation. Bloating (‘endo belly’) —some women experience severe bloating. Fatigue —chronic pain can be exhausting. Fertility issues —some women only discover they have endometriosis when struggling to conceive. Getting a Diagnosis Unfortunately, many women wait years for a diagnosis, often being told their pain is ‘normal’ or misdiagnosed with other conditions like IBS or pelvic inflammatory disease. The gold standard for diagnosing endometriosis is laparoscopy , a keyhole surgery where a camera is inserted into the abdomen to look for endometrial implants. However, doctors may use ultrasound and MRI to rule out other conditions before recommending surgery. Management & Treatment Options There is no cure for endometriosis, but treatments aim to manage symptoms and improve quality of life. Options include: 1. Pain Management Over-the-counter pain relief —NSAIDs like ibuprofen can help with inflammation. Hormonal treatments —the contraceptive pill, Mirena coil, or progesterone-only therapy can help suppress the menstrual cycle and reduce symptoms. 2. Surgical Interventions Laparoscopic excision surgery —removes endometriosis tissue and can provide long-term relief. Hysterectomy —considered only in severe cases when other treatments have failed and a woman is not planning to have children. 3. Lifestyle & Alternative Approaches Anti-inflammatory diet —reducing processed foods and increasing omega-3s may help. Pelvic physiotherapy —can improve mobility and ease pain. Acupuncture and mindfulness —some women find these complementary therapies beneficial. Endometriosis and Fertility Endometriosis can impact fertility by causing inflammation, scarring, and adhesions around the reproductive organs. However, many women with endometriosis can still conceive naturally or with assistance. Fertility treatments like IVF, hormonal therapies, or surgery to remove endometrial implants can improve chances of conception. If you’re trying to conceive and have endometriosis, consulting a fertility specialist can help tailor a plan suited to your needs. Endometriosis is a complex condition that requires a personalised approach to management. Whether you’re dealing with debilitating pain, fertility concerns, or just want answers about your symptoms, speaking to a specialist is the first step. If you suspect you have endometriosis, advocate for yourself—early intervention can make all the difference. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Menopause and Diet: How Food Can Be Your Strongest Ally Written By Dr Rebecca Hiscutt Diet is one of the most powerful tools you can use to support your body through menopause. What and when you eat can amplify symptoms or help steady your energy, mood and metabolism. Below are some of the most common menopause symptoms, why diet matters, and simple, evidence-informed strategies to help you feel more like yourself again. Aches and Pains More than half of women report joint or muscular discomfort during menopause, with about 20% saying it’s their worst symptom. This isn’t just ageing, it’s often driven by inflammation. Why diet matters • Hormonal shifts increase inflammation. • Fatigue, poor sleep and mood changes can lead to quick-fix eating (sugar, processed carbs) which drives inflammation further. • Stress depletes key nutrients like magnesium and B vitamins, important for joint and muscle function. Dietary strategy • Focus on whole, anti-inflammatory foods: lean protein, non-starchy vegetables, and natural fats. This will help you feel fuller and reduce cravings for sweet or salty carbohydrate foods. • For the next two weeks spend 15 minutes each week planning meals and writing a shopping list. Take photos of these. Now you have a two week meal plan you can cycle through saving you headspace and time. Just repeat, tweaking one or two meals if you like for variation. Top tip: omega 3 fats are highly anti-inflammatory. Build oily fish into your weekly meals. e.g. Salmon, broccoli and asparagus tray bake with lemon and garlic. If yon’t eat oily fish consider an omega 3 supplement. Cognition and Brain Fog Around 60% of women report memory problems, difficulty concentrating, or that vague ‘cotton wool brain.’ Falling oestrogen affects brain regions linked to focus and recall. Why diet matters • Key nutrients (B12, folate, choline, iron, zinc, magnesium) are essential for brain health. • Blood sugar instability can worsen fatigue and fog. • Nutrient gaps can occur in midlife due to busier lives, stress, restrictive diets or increased need (stress, heavy periods). Dietary strategy • Prioritise nutrient-dense foods such as: eggs, oily fish, leafy greens, meat, pumpkin seeds • Check and optimise B12, iron and folate levels if low or borderline. • Stabilise blood sugar: build meals around protein, healthy fats and fibre to help minimise grazing on sugary snacks. Hot Flushes and Night Sweats Around 80% of post-menopausal women experience vasomotor symptoms like hot flushes and night sweats. While hormone changes are the main driver, blood sugar fluctuations can also trigger symptoms. Why diet matters • Spikes and crashes in blood glucose can trigger or intensify hot flushes. • Evening hyperglycaemia worsens night-time sweating and poor sleep. Dietary strategy • Make protein the anchor of every meal to reduce glucose spikes. • Finish eating at least 3 hours before bed to support stable blood sugar overnight. • Hydrate well as dehydration can increase blood glucose levels. Sleep Disturbance Sleep disruption is one of the earliest and most common menopausal symptoms. Just one poor night of sleep increases insulin resistance, making other symptoms worse the next day. Why diet matters • High sugar or alcohol at night destabilises blood sugar and cortisol rhythms. • Magnesium supports relaxation and the production of GABA and melatonin. Dietary strategy • Eat a balanced evening meal: protein + natural fats + a small portion of fibre-rich carbs. • Consider trialling magnesium glycinate supplementation if needed (gentle and well tolerated). • Be mindful of how alcohol and caffeine impact your sleep Exhaustion Falling oestrogen makes the body less sensitive to insulin, so it struggles to move sugar into cells for energy. This creates an energy ‘block’, driving fatigue, inflammation, and fat gain. Why diet matters • Elevated insulin traps energy in fat stores, rather than releasing it for energy • Sugary snacks make energy highs and lows worse. Dietary strategy • Reduce refined carbohydrates and close your ‘eating-window’ earlier in the evening. • To help with this start your day with a high-protein breakfast to curb cravings and stabilise energy. Irritability and Anxiety Mood swings, irritability and anxiety are often some of the first symptoms to appear in perimenopause impacting quality of life and relationships hugely. Why diet matters • Fluctuating hormones affect the production of neurotransmitters that help us feel calm and motivated, such as serotonin and GABA • Low levels of magnesium, zinc, B vitamins and omega-3s can increase anxiety • Blood sugar crashes can heighten irritability. Dietary strategy • Look for every opportunity to provide your body and brain with the ingredients it needs to produce calming neurotransmitters. • Support gut health by choosing whole foods over processed, sugar-rich foods, including fermented foods and natural probiotics • Start by stocking up on unprocessed foods you love to replace processed snacks. E.g apples cooked with cinnamon and creme fraiche or Greek yoghurt, watermelon and feta cubes, your favourite olives. Weight Gain and Visceral Fat The combination of falling oestrogen, rising insulin and higher cortisol shifts fat storage to the abdomen, increasing Visceral fat, a more metabolically active and inflammatory type of fat. Why diet matters • High refined carb intake keeps insulin levels high, promoting fat storage. • Adequate protein helps preserve lean muscle mass, increasing metabolic rate. Dietary strategy • Adjust macronutrient balance for what you need now. Tweak carbohydrate, protein and fat so you feel full and satisfied but enable insulin levels to come down and burn fat. • Pair diet with resistance training, steady-state movement, small bursts of HIT and sleep optimisation. • Put in place a stress management plan as cortisol impacts fat distribution. Your Personalised Menopause Nutrition Toolkit Menopause calls for a different nutritional approach. Small, targeted shifts can ease symptoms and build long-term health: • Eat protein first at each meal. • Cut back on refined carbohydrates. • Support key nutrients like omega-3, magnesium and B vitamins. • Pair food strategies with movement, stress support and sleep. Note: Nourishing yourself through diet alongside movement, stress management and sleep is key for symptoms management, wellbeing and long-term health whether as an independent strategy or alongside HRT. Dr Rebecca Hiscutt . PhD is a registered dietitian with a specialist interest in women’s health and works alongside Bristol Menopause Clinic to provide holistic and comprehensive care for their patients. Nutrition support and guidance can be provided in person at Bristol Menopause Clinic on virtually. Find out more here References: Donga, E. et al. (2010). A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects. Journal of Clinical Endocrinology & Metabolism, 95(6), 2963–2968 Dormire S, Howharn C. The effect of dietary intake on hot flashes in menopausal women. J Obstet Gynecol Neonatal Nurs. 2007;36(3):255-262 Greendale, G. A. et al. (2021). Changes in regional fat distribution and anthropometric measures during the menopause transition. Journal of Clinical Endocrinology & Metabolism, 106(9), 2523–2533 Lovejoy J.C. The menopause and obesity. Medical Clinics of North America, 2018; 102(2): 305-318 Mauvais-Jarvis, F., Clegg, D. J., & Hevener, A. L. (2013). The role of estrogens in control of energy balance and glucose homeostasis. Endocrine Reviews, 34(3), 309–338 Kim Y., Je Y. Dietary patterns and hot flashes: A systematic review and meta-analysis. Maturitas, 2017; 100: 83-90 Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Can HRT Enhance Weight Loss with Tirzepatide (Mounjaro) in Postmenopausal Women? Alternative Therapies, Diet, HRT, Managing Weight At ENDO 2025 in San Francisco, an important study was presented exploring the effect of hormone replacement therapy (HRT) on weight loss in postmenopausal women taking tirzepatide (Mounjaro), a medication licensed for the management of type 2 diabetes and obesity. What Was the Study About? The real-world, retrospective cohort study looked at 120 postmenopausal women who were prescribed tirzepatide for overweight or obesity. 40 women were also taking HRT (either transdermal or oral oestrogen, with or without progestogen). 80 were on tirzepatide alone. Participants were followed over a median of 18 months. What Were the Results? Women who were taking both HRT and tirzepatide had: ✔️ A greater median percentage weight loss (17% vs 14%) ✔️ A higher rate of achieving 20%+ weight loss (45% vs 18%) These findings suggest that concomitant HRT may positively influence weight loss response when using incretin-based therapies like tirzepatide. However, as with all retrospective studies, we must interpret the findings cautiously. These are associations—not proven cause and effect—and more robust research is needed to understand the biological mechanisms involved. Prescribing Considerations The British Menopause Society (BMS) has issued guidance on using oral HRT alongside medications like tirzepatide or semaglutide (Wegovy). These treatments can slow gastric emptying, which may interfere with the absorption of oral progestogens . This can potentially lead to insufficient endometrial protection in women with a uterus, increasing the risk of unscheduled bleeding or endometrial hyperplasia. To mitigate this, clinicians may consider prescribing: Transdermal oestrogen Alongside a non-oral progestogen (e.g., micronised progesterone or an intrauterine system), especially in patients on GLP-1 receptor agonists or GIP/GLP-1 dual agonists like tirzepatide. Supporting Womens Health with Personalised Care At Bristol Menopause & Wellwoman Clinic , we support women navigating the complex relationship between weight, hormones, and menopause . Whether you're struggling with weight changes, perimenopausal symptoms, or looking for medically supervised weight management, we're here to help. Want to explore your options? Our team includes menopause specialists, weight loss clinicians, and prescribing experts who can create a plan tailored to you. Book a consultation today Contact us here Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back HRT Explained: Myths, Benefits, and the Latest Research HRT, Managing Symptoms, Menopause Advice, Perimenopause The Confusion Around HRT For years, hormone replacement therapy (HRT) has been surrounded by confusion, fear, and misinformation. Women experiencing hot flushes, brain fog, joint pain, and mood swings often wonder: Is HRT safe? Does it cause cancer? Will it help with weight gain and brain fog? What are the risks versus the benefits? With conflicting headlines and outdated medical advice, many women are left struggling through menopause symptoms without proper guidance. As a menopause specialist, I want to clear up the myths, explain the science, and give you the latest research so you can make an informed decision about HRT. What is HRT? A Simple Breakdown HRT (Hormone Replacement Therapy) replaces the hormones that naturally decline during menopause—primarily oestrogen and, in some cases, progesterone and testosterone. Oestrogen – The key hormone that helps r elieve hot flushes, brain fog, joint pain, mood swings, and vaginal dryness. Progesterone – Given to women who still have a uterus to protect against endometrial (womb) cancer. Testosterone – Sometimes prescribed to boost libido, brain function, and energy in menopausal women. Fact: The body still needs oestrogen after menopause to protect the brain, bones, and heart. Myth vs. Fact: Debunking Common HRT Misconceptions Myth 1: HRT Causes Breast Cancer Fact: The link between HRT and breast cancer has been exaggerated and misunderstood. The Science: The 2002 Women’s Health Initiative (WHI) study caused fear around HRT, but later analysis showed: Oestrogen-only HRT (for women without a uterus) does NOT increase breast cancer risk. The small risk linked to combined HRT (oestrogen + progesterone) is the same as drinking 1 glass of wine per day . The absolute risk increase is minimal (4 additional case per 1,000 women per year) . Takeaway: HRT is not the primary cause of breast cancer, and the benefits often outweigh the risks for most women. Myth 2: HRT Increases the Risk of Heart Disease Fact: Oestrogen actually protects the heart —when taken early in menopause. The Science: Women who start HRT before the age of 60 or within 10 years of menopause have a lower risk of heart disease. HRT helps maintain healthy cholesterol levels and reduces inflammation in the arteries. The British Heart Foundation recognises oestrogen’s protective effects on cardiovascular health. Takeaway: HRT can r educe heart disease risk if started at the right time. Myth 3: HRT Causes Weight Gain Fact: HRT does NOT cause weight gain —in fact, it may help prevent midlife weight gain. The Science: Oestrogen supports metabolism and prevents fat accumulation around the abdomen. Muscle mass declines without oestrogen, making weight gain more likely in women who don’t take HRT. Women often gain weight due to aging and lifestyle changes, not HRT itself. Takeaway : Staying active and eating a balanced diet will support weight management—HRT can help by maintaining muscle and metabolic health. Myth 4: HRT Only Helps with Hot Flushes Fact: HRT benefits almost every system in the body, not just thermoregulation. HRT’s Benefits Beyond Hot Flushes: Brain Health: Reduces brain fog and lowers dementia risk in early menopause. Bone Health: Prevents osteoporosis by reducing bone loss. Heart Protection: Helps maintain arterial flexibility and circulation. Mental Health: Supports mood stability and anxiety reduction. Skin & Hair: Improves collagen production, reducing wrinkles and hair thinning. Takeaway : HRT is a full-body support system, not just a fix for hot flushes. The Latest Research: What We Know in 2024 HRT research has come a long way, and today’s approach is personalised and safer than ever. 1. The "Window of Opportunity" for Maximum Benefit Starting HRT early (within 10 years of menopause) has the best protective effects on the brain, heart, and bones. Delaying HRT past 60 doesn’t mean it’s unsafe, but benefits may be lower. What This Means: If you're struggling with menopause symptoms, don’t wait—early treatment provides the best long-term health benefits. Body-Identical vs. Synthetic HRT: What’s the Difference? Body-Identical HRT (Recommended in the UK) – Derived from plant-based sources and chemically identical to natural hormones. Examples: Oestrogen gel (e.g., Oestrogel ) Oestrogen patches (e.g., Evorel ) Micronised progesterone ( Utrogestan ) Synthetic HRT (Older Formulations) – Used in the past but linked to higher risks of side effects. The NHS and the British Menopause Society now recommend body-identical HRT as the safest option. Can HRT Reduce Dementia Risk? Recent research suggests that oestrogen plays a major role in brain health, reducing Alzheimer’s risk in women who start HRT early. The Science: A Lancet Neurology study found that women who take HRT have better cognitive function. Oestrogen supports brain plasticity, reducing the risk of memory loss. Takeaway: More research is ongoing, but HRT could be a powerful tool for brain health in midlife women. Who Should NOT Take HRT? While HRT is safe for most women, it may not be suitable if you have : A history of breast cancer or oestrogen-sensitive cancers or a very strong family history or any BRACA genes. Uncontrolled high blood pressure (needs to be managed first) Severe liver disease or rare blood clotting disorders If you’re unsure, consult a menopause specialist to discuss personalised options. Final Thoughts: Is HRT Right for You? HRT is one of the most effective treatments for menopause symptoms and offers long-term health benefits, but the choice is personal. If you’re struggling with hot flushes, brain fog, low energy, or mood swings, HRT could be life changing. The latest research confirms its safety when started early. If you can’t take HRT, lifestyle strategies (strength training, diet, stress management) remain crucial for menopause health. Next Step: Speak to a BMS (British Menopause Society) Specialist for personalised menopause care . Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Women's History Month & International Women’s Day: Accelerating Action Wellbeing March is Women’s History Month, a time to celebrate the incredible achievements of women throughout history while recognising the work that still needs to be done. It also includes International Women’s Day (March 8th), a global day dedicated to acknowledging the social, economic, cultural, and political contributions of women. This year’s theme, Accelerate Action, urges us to push forward for gender equality, amplifying voices and making tangible change worldwide. Women’s History in the UK & Beyond Women in the UK have played a vital role in shaping society. From the suffragettes who fought for voting rights to today’s leaders in science, politics, and activism, British women continue to break barriers. Dame Sarah Gilbert , one of the scientists behind the Oxford-AstraZeneca COVID-19 vaccine, and Baroness Doreen Lawrence , a tireless advocate for racial justice, are just two examples of inspiring women driving change. Internationally, women have been at the forefront of transformation. Malala Yousafzai , a Nobel laureate from Pakistan, continues to champion girls’ education, while Dr. Kizzmekia Corbett , an American immunologist, played a crucial role in developing the Moderna COVID-19 vaccine. Across the world, women are leading movements for equality, access to healthcare, and justice. Why Accelerate Action? Despite progress, women still face gender inequality in many areas: The gender pay gap remains an issue across industries. Women’s healthcare needs more research and funding. Women in leadership are still underrepresented. Violence against women is a global crisis that requires urgent action. By accelerating action, we can push for policy changes, support women-led businesses, advocate for better healthcare, and educate the next generation on gender equality. Ways to Get Involved Support women-led initiatives —whether it’s a business, charity, or community project. Educate yourself and others —read about women’s history, attend talks, or share stories that inspire you. Advocate for policy changes —write to your local representatives about issues affecting women. Celebrate women in your life —recognition starts with small, meaningful gestures. Women’s History Month and International Women’s Day remind us of the resilience, brilliance, and contributions of women across the world. We will be playing our part by being at the International Women’s Day event at City Hall on Saturday 8th March. Please come and see us to say hello. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Menopause Package: Initial & Follow up Consultation Included - New Patient Only £350 Book Now About Comprehensive Menopause Support Package for New Patients – Just £350 Take control of your menopause journey with our comprehensive support package, designed for new patients. For just £350, you’ll receive both an initial consultation and a follow-up review appointment to ensure you have the expert care and guidance you need throughout this important life stage. Our experienced menopause doctor will provide personalised advice, treatment options, and continuous support to help you manage your symptoms and feel confident every step of the way. What's Included in the Comprehensive Menopause Support Package: Initial 45-Minute Consultation In-depth Consultation with an Experienced Menopause Doctor : Discuss your symptoms, concerns, and health history to receive tailored advice. Personalised Health Plan : Get a customised approach to managing your menopause, covering lifestyle adjustments, nutrition, and possible treatments. Private Prescribing (if needed) : If appropriate, our doctor will prescribe hormone replacement therapy (HRT) or other treatments. Letter to Your GP : A comprehensive letter to your GP, ensuring they are fully informed about your treatment and care plan. Review Appointment Progress Review : Check in with your doctor to review how you're feeling and assess the effectiveness of your treatment plan. Treatment Adjustments (if needed) : Based on your progress, we'll adjust your plan to ensure the best care moving forward. Ongoing Support and Advice : Receive expert guidance on any new symptoms or concerns, helping you continue managing your menopause with confidence. Private Prescribing (if required) : If further prescriptions are necessary, they will be provided during the review consultation. Letter to Your GP : A follow-up letter summarising your progress and any treatment changes will be sent to your GP for continued care. Benefits of Booking the Comprehensive Menopause Support Package: Expert Care Every Step of the Way : Receive specialised care from an experienced menopause doctor throughout your entire journey, from your initial consultation to your follow-up review. Tailored, Ongoing Support : We’ll ensure your treatment plan evolves with you, addressing any changes in symptoms or health, so you’re always receiving the best possible care. Cost-Effective Comprehensive Package : For just £350, you receive both your initial consultation and a follow-up review appointment—giving you complete support without the need for additional bookings or costs. Personalised Approach : Your treatment plan is designed around your specific needs, addressing your symptoms, health history, and goals for menopause management. Confidence in Managing Menopause : With ongoing guidance, adjustments, and support, you’ll feel empowered to manage your menopause symptoms effectively. Book Your Comprehensive Menopause Support Package Today For just £350, you’ll receive a complete menopause consultation and follow-up plan tailored to your needs. Follow link below to book now. Please note: In line with our policy, you are unable to book with a doctor who is your registered GP or a GP at the practice where you are currently registered. This includes Dr Jo Burgin (Bridgeview Medical Practice) and Dr Danielle Calandrini (Newbridge Surgery). Thank you for your understanding. Book Now Discover our range of menopause supplements, available to order today! Shop Now

< Back World Health Day: Prioritising Women’s Health Across Every Stage of Life For women, health is dynamic. It evolves across the life course, influenced by hormonal changes, reproductive health, lifestyle factors, and increasing demands on physical and emotional wellbeing. Why World Health Day Matters for Women World Health Day is a timely reminder that health is not simply the absence of disease, but the foundation of how we live, function, and feel every day. For women, health is dynamic. It evolves across the life course, influenced by hormonal changes, reproductive health, lifestyle factors, and increasing demands on physical and emotional wellbeing. Yet despite this, women’s health concerns are still too often under-recognised, under-treated, or attributed to “normal ageing.” At Bristol Menopause & Wellwoman Clinic , we believe that women deserve informed, evidence-based, and personalised care at every stage of life. Understanding Women’s Health Beyond Symptoms Women’s health is frequently approached reactively, with care sought only once symptoms become disruptive. A more effective and clinically sound approach is proactive and preventative . This includes: Early identification of hormonal changes Regular health screening and risk assessment Lifestyle optimisation to support long-term health outcomes Timely intervention where needed From a clinical perspective, this allows for better management of both symptoms and future disease risk. The Hormonal Journey: A Lifelong Perspective Hormones play a central role in women’s health, influencing far more than reproductive function. Oestrogen, progesterone, and testosterone contribute to: Cognitive function and mental clarity Mood regulation and emotional resilience Bone density and musculoskeletal health Cardiovascular protection Metabolic function and weight regulation From the late 30s onwards, hormonal fluctuations become more pronounced, leading into perimenopause and eventually menopause . Common symptoms may include: Brain fog and reduced concentration Sleep disturbance Low mood or anxiety Reduced energy and motivation Joint aches and stiffness Changes in weight and body composition These symptoms are real, clinically recognised, and importantly, treatable. Moving Away from “Normal”, Towards Optimal Health One of the most common and limiting messages women receive is: “Your blood tests are normal.” While results may fall within laboratory reference ranges, they do not always reflect optimal health or explain symptoms. A more nuanced approach considers: Symptom presentation Hormonal patterns rather than isolated values Individual baseline and life stage Functional health markers At Bristol Menopause & Wellwoman Clinic, consultations are designed to provide time, expertise, and clarity , ensuring women feel heard and supported. The Importance of Preventative Health Screening Midlife is a critical window for preventative health. During this time, the risk of cardiovascular disease, osteoporosis, metabolic dysfunction, and cognitive decline begins to rise. A structured health assessment can help to: Identify early risk factors Assess cholesterol, glucose, and inflammatory markers Evaluate nutritional status (including vitamin D, B12, iron) Provide personalised lifestyle and treatment recommendations Preventative care is not about over-medicalisation. It is about early insight, informed choices, and long-term health protection . A Whole-Person Approach to Women’s Health Effective care goes beyond prescriptions. It requires a holistic, evidence-based approach that includes: Lifestyle Foundations Nutrition that supports metabolic and hormonal health Strength-based exercise to preserve muscle and bone Sleep optimisation, including CBT-i strategies where appropriate Stress management and nervous system regulation Medical Support Where Needed Individualised Hormone Replacement Therapy (HRT) Testosterone assessment and treatment when appropriate Non-hormonal options for those unable to take HRT Ongoing Support and Review Women’s health is not static. Treatment plans should evolve with time, symptoms, and life circumstances. Empowering Women Through Education and Access A key barrier in women’s health is not a lack of solutions, but a lack of access to clear, evidence-based information. Education allows women to: Understand what is happening in their bodies Recognise when symptoms are hormone-related Make informed decisions about treatment options Advocate for their own health This is central to our mission at Bristol Menopause & Wellwoman Clinic. World Health Day: A Call to Action This World Health Day, we encourage women to shift the narrative from: “I’ll put up with it” → “I want to understand and improve my health.” If you are experiencing symptoms, feeling unlike yourself, or simply want a clearer picture of your health, seeking specialist support can be a valuable first step. How We Can Support You At Bristol Menopause & Wellwoman Clinic , we offer: 45-minute specialist menopause and wellbeing consultations Comprehensive, personalised health assessments Evidence-based hormone evaluation and treatment Ongoing support tailored to your individual needs Our approach is grounded in clinical expertise, personalisation, and compassion . Book an Appointment If you would like to better understand your health and explore your options, you can book an initial consultation with one of our experienced clinicians. Your health is not something to navigate alone. Book Here Women’s health deserves attention, investment, and expertise. Not just on World Health Day, but every day. Because when women feel well, they function better, live more fully, and thrive. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Perimenopause Anxiety: Why It Happens, What It Feels Like, and How to Find Relief Perimenopause is commonly associated with hot flushes, night sweats, and changes in menstrual periods. However, for many women, psychological symptoms such as anxiety, panic attacks, irritability, and low mood are among the earliest and most distressing features of the menopausal transition. What Is Perimenopausal Anxiety? Perimenopause refers to the years leading up to menopause, during which ovarian hormone production becomes increasingly unpredictable. While physical symptoms are well recognised, fluctuations in hormone levels can also have a significant impact on brain function, emotional regulation, sleep quality, and stress resilience. Many women report: New-onset anxiety despite no previous history Worsening of pre-existing anxiety Panic attacks Increased irritability or anger Reduced confidence and self-esteem Feeling overwhelmed by situations that were previously manageable A sense of "not feeling like themselves" These symptoms can occur with or without the more commonly recognised symptoms of menopause. Why Does Anxiety Increase During Perimenopause? The causes of anxiety during perimenopause are often multifactorial. At this stage of life, many women are balancing competing responsibilities, including demanding careers, caring for children or teenagers, supporting ageing parents, managing relationships, and navigating major life transitions. These pressures can contribute to emotional strain and may make it difficult to distinguish psychological stress from hormonal symptoms. However, there is also a clear biological basis for mood and anxiety symptoms during perimenopause. Psychological symptoms are not simply a reaction to stress. They are frequently driven by significant hormonal fluctuations affecting brain function and the body's stress-response systems. The Effect of Hormones on the Brain The brain contains receptors for oestrogen, progesterone, and testosterone. These hormones act as important regulators of neurological function and influence: Mood regulation Emotional processing Stress responsiveness Sleep quality Cognitive function Memory and concentration Unlike the gradual hormonal decline that many women expect, perimenopause is characterised by marked fluctuations in hormone levels. Oestrogen and progesterone may rise and fall rapidly and unpredictably, creating instability within the brain's neurochemical systems. These hormonal changes influence several important neurotransmitters, including: Serotonin Serotonin plays a central role in regulating mood, emotional wellbeing, and anxiety levels. Fluctuating oestrogen levels can affect serotonin production and activity. Dopamine Dopamine is involved in motivation, reward, focus, and pleasure. Hormonal changes may contribute to reduced motivation, low mood, and emotional dysregulation. GABA Gamma-aminobutyric acid (GABA) is the brain's primary calming neurotransmitter. Progesterone has a positive effect on GABA activity, helping promote calmness and relaxation. As progesterone levels become more erratic, women may notice increased anxiety, restlessness, and sleep disturbance. These neurochemical changes help explain why many women experience sudden emotional symptoms that feel out of character or disproportionate to their circumstances. Why Symptoms Are Often Worse During Perimenopause Research and clinical experience suggest that fluctuating hormone levels may be more disruptive than consistently low hormone levels. For this reason, psychological symptoms often peak during the perimenopause rather than after menopause has occurred. Many women experience: Anxiety Irritability Emotional sensitivity Mood instability Panic symptoms at a time when hormone levels are changing rapidly from month to month and, in some cases, from day to day. Who Is at Greater Risk? Some women appear to have an increased sensitivity to hormonal fluctuations. Risk factors include: A history of severe premenstrual syndrome (PMS) Premenstrual dysphoric disorder (PMDD) Postnatal depression Previous hormone-related mood disturbances Personal history of anxiety or depression These women may be more vulnerable to psychological symptoms during the menopausal transition because of the way their brains respond to changing hormone levels. How Perimenopausal Anxiety Can Present Anxiety related to perimenopause often presents differently from traditional anxiety disorders. Common presentations include: New-Onset Anxiety Women who have never previously experienced anxiety may suddenly develop persistent worry, nervousness, or feelings of overwhelm. Worsening Existing Anxiety Those with a prior history of anxiety frequently report an increase in both symptom intensity and frequency. Panic Attacks Panic attacks are common and may occur without warning or an identifiable trigger. Symptoms can include: Racing heart Palpitations Sweating Shaking Breathlessness Dizziness Chest discomfort Feelings of impending doom New Specific Fears or Phobias Some women develop new anxieties that appear unusual or unexpected, such as: Fear of driving, particularly on motorways Fear of crowded places Fear of travelling alone Increased social anxiety Irritability and Anger Many women report episodes of disproportionate irritability, anger, rage, or heightened emotional reactivity. Mood Swings Mood fluctuations often resemble PMS symptoms but may occur unpredictably or become more severe and prolonged than previously experienced. Morning Anxiety A characteristic pattern is waking with significant anxiety or low mood that gradually improves as the day progresses. Many women describe this as distinct from clinical depression, often saying they feel emotionally different but not necessarily depressed. Low Mood and Depression During Perimenopause The risk of depressive symptoms increases during the menopausal transition. Some women may develop features of clinical depression, including: Persistent low mood Loss of interest or pleasure Fatigue Feelings of hopelessness Reduced self-worth Social withdrawal However, for many women, emotional symptoms fluctuate significantly and appear closely linked to hormonal variability rather than representing a primary depressive illness. A thorough assessment is important to distinguish between these presentations and ensure treatment is appropriately targeted. Brain Fog and Cognitive Symptoms Cognitive symptoms are another common and often distressing feature of perimenopause. Women frequently report: Brain fog Poor concentration Reduced mental clarity Forgetfulness Difficulty finding words Short-term memory lapses Oestrogen plays an important role in cognitive processing, memory, and attention. As hormone levels fluctuate, temporary changes in cognitive function may become noticeable. Although these symptoms can be alarming, they are commonly associated with perimenopause and do not usually indicate dementia or neurodegenerative disease. The Relationship Between Sleep and Anxiety Sleep disturbance is both a symptom and a driver of anxiety during perimenopause. Several factors contribute: Hormonal Effects on Sleep Changing hormone levels affect the brain's sleep-regulation systems, increasing the likelihood of fragmented and non-restorative sleep. Night Sweats and Hot Flushes Vasomotor symptoms can repeatedly interrupt sleep, leading to fatigue and reduced resilience during the day. Declining Progesterone Progesterone has naturally calming and sleep-promoting properties. As levels become lower and more erratic, sleep quality may deteriorate. Activation of the Stress Response System Insufficient sleep increases activation of the sympathetic nervous system, sometimes referred to as the "fight-or-flight" response. This can result in: Palpitations Sweating Dry mouth Breathlessness Muscle tension Headaches Feelings of panic These physical symptoms can further intensify anxiety and create a self-perpetuating cycle. The Impact on Daily Life The effects of perimenopausal anxiety can be substantial and far-reaching. Women may experience: Reduced self-confidence Impaired work performance Difficulty concentrating Problems with decision-making Reduced productivity Relationship difficulties Withdrawal from social activities Loss of enjoyment in previously valued activities Many women report feeling isolated because their symptoms are misunderstood by others or dismissed as normal stress. Evidence-Based Strategies That Can Help Effective management often requires a combination of lifestyle measures, psychological support, and medical treatment where appropriate. Lifestyle Measures A healthy lifestyle forms the foundation of symptom management. Evidence-based recommendations include: Regular physical activity Strength training and aerobic exercise Maintaining a consistent sleep routine Limiting alcohol consumption Reducing caffeine intake if symptoms are exacerbated Consuming a balanced diet rich in protein, fibre, and healthy fats Maintaining stable blood sugar levels through regular meals Practising stress-management techniques such as mindfulness, yoga, or relaxation exercises Psychological Therapies Talking therapies can provide valuable support and practical coping strategies. Options include: Cognitive Behavioural Therapy (CBT) Counselling Mindfulness-based interventions Anxiety management programmes These approaches may help women understand and respond more effectively to both emotional and physical symptoms. Hormone Replacement Therapy (HRT) For women whose symptoms are linked to perimenopausal hormonal changes, Hormone Replacement Therapy (HRT) may be an effective treatment option. Potential benefits include: Stabilisation of hormone fluctuations Improvement in anxiety symptoms Better sleep quality Reduced mood instability Improvement in overall quality of life Treatment decisions should be individualised following discussion with a healthcare professional experienced in menopause care. Some women may be prescribed antidepressant medication during perimenopause. While antidepressants can be highly effective for certain individuals, it is important to assess whether hormonal fluctuations are contributing to symptoms. A comprehensive review can help ensure treatment plans address all potential underlying factors. It Is Not Your Fault One of the most important messages for women experiencing perimenopausal anxiety is that these symptoms are real, common, and biologically driven. Experiencing anxiety, panic attacks, irritability, or emotional instability during perimenopause does not mean you are weak, failing to cope, or "going mad." For many women, these symptoms reflect the complex interaction between fluctuating hormones, brain chemistry, sleep disruption, life circumstances, and individual biological sensitivity. Recognising the hormonal contribution to psychological symptoms is often the first step towards effective treatment and recovery. When to Seek Professional Advice You should seek medical advice if symptoms are: Affecting daily functioning Impacting work performance Causing relationship difficulties Leading to avoidance of normal activities Associated with persistent low mood Accompanied by recurrent panic attacks Significantly affecting sleep or quality of life Early assessment and appropriate management can lead to significant improvement in both emotional wellbeing and overall quality of life. Perimenopausal anxiety is a common and clinically recognised consequence of hormonal fluctuation during the menopause transition. It may present as anxiety, panic attacks, irritability, emotional instability, low mood, poor sleep, or cognitive difficulties. Understanding the biological basis of these symptoms can help women access appropriate support and evidence-based treatment, allowing them to navigate this stage of life with greater confidence and wellbeing. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Alex Gear Nutritionist Alex is a registered Nutritional Therapist, Naturopath and Health Coach. She trained in Nutrition and Naturopathy at the renowned The College of Naturopathic Medicine and is a member of The British Association for Applied Nutrition and Nutritional Therapy (BANT) and The Complementary and Natural Healthcare Council (CNHC). Alex is very passionate about helping people to feel their best through food and lifestyle. Alex knows what it’s like to juggle many balls and is very much in touch with the challenges people face in their everyday lives. Alex inspires and motivates people, yet her approach is a balanced and realistic one. Alex has been involved in the food industry for over 20 years, but her underlying passion has always been about health and nutrition. It gives her great pleasure to help people to overcome their health issues so that they look and feel better. Having overcome her own health issues, Alex really understands how her clients feel when they first come to see her. Alex works very closely with her clients to ensure that they take positive steps to a healthier life. Clients often lack confidence and may often feel very daunted at the prospect of making changes, so she supports and guides them and gives them the tools to be able to maintain long-term health with renewed confidence and enthusiasm. Alex combines her understanding, enthusiasm and passion with her love of food to help people to become the best versions of themselves. Alex follows the principles of Functional Medicine and so her aim is to get to the root cause of her clients’ issues. She treats everyone as an individual as we are all different and have different sets of circumstances. Alex is passionate about helping women look & feel amazing every day through midlife and beyond.

< Back Hazel Hayden Founder Hazel Hayden is a Consultant Nurse and a highly respected British Menopause Society Registered Specialist, with a passion for empowering women through every stage of menopause. She’s also trained in sleep and insomnia therapy, Cognitive Behaviour Therapy (CBT) for menopause, and has a diploma in nutrition. Hazel’s expertise extends to weight management through her training in the National Medical Weight Loss Programme. As a member of both the International Menopause Society and the International Association for Premenstrual Disorders, Hazel stays at the forefront of advancements in women's health. She’s a sought-after speaker at local and international conferences, where she shares her insights on menopausal health as well as its impact on mental health. In addition to her speaking engagements, Hazel remains committed to her clinical work, supporting women through their unique menopausal health journeys. Her areas of expertise also include cardiovascular disease, type 2 diabetes, and respiratory disorders, ensuring a holistic approach to patient care. Hazel goes beyond individual care, training other healthcare professionals to become British Menopause Society Specialists, helping to raise the standard of menopause care for women everywhere. With a deep dedication to improving women’s health, Hazel has also combined her clinical knowledge to create specialist supplements tailored to support women navigating menopause, offering them practical solutions to thrive during this transformative but sometimes challenging time. I have dedicated my career to supporting the health and wellbeing of my patients. I have combined my knowledge to also provide specialist supplements for menopausal women.