< Back PCOS to PMOS: What the New Name Means for Women Polycystic Ovaries Learn why PCOS is being renamed PMOS, what it means for your diagnosis, symptoms, fertility, hormones and long-term metabolic health. PCOS Has a New Name: Understanding PMOS For many years, Polycystic Ovary Syndrome (PCOS) has been one of the most commonly diagnosed hormonal conditions affecting women. However, international experts have recently proposed a new name: Polyendocrine Metabolic Ovarian Syndrome (PMOS). While the name may sound different, your diagnosis, symptoms, and treatment options remain the same. The change is designed to better reflect the true nature of the condition, which extends far beyond the ovaries. Why Has PCOS Been Renamed PMOS? The term Polycystic Ovary Syndrome has long been considered misleading. Many women diagnosed with PCOS do not actually have ovarian cysts, while others with polycystic-appearing ovaries may not have the condition at all. The new name, PMOS , highlights the wider hormonal and metabolic factors involved. What Does PMOS Mean? Polyendocrine Multiple hormone systems are involved, not just the reproductive hormones. Metabolic Recognises the important role of insulin resistance, blood sugar regulation, cholesterol levels, and weight management. Ovarian Maintains the connection with ovulation, menstrual cycles, and fertility. Syndrome Reflects that PMOS is a collection of symptoms and health changes rather than a single condition. What Causes PMOS? PMOS is a complex hormonal and metabolic condition that can affect women throughout their reproductive years and beyond. It is commonly associated with: Insulin resistance Elevated androgen (male-type hormone) levels Irregular ovulation Menstrual cycle disturbances Weight gain or difficulty losing weight Fertility challenges Increased long-term cardiovascular and metabolic health risks What Does This Mean If You Already Have PCOS? If you have previously been diagnosed with PCOS, your diagnosis remains valid. You do not need further testing or a new diagnosis simply because the name has changed. However, PMOS encourages a broader approach to care, recognising that the condition affects many aspects of health beyond fertility and menstrual cycles. Your Care Should Include: Regular monitoring of blood pressure Blood sugar and diabetes screening Cholesterol and cardiovascular risk assessment Weight and metabolic health support Mental health and emotional wellbeing discussions Lifestyle advice including nutrition, exercise and sleep Why the New Name Matters The move from PCOS to PMOS is about more than terminology. The new name helps women, healthcare professionals and researchers better understand that this is a whole-body hormonal and metabolic condition , rather than simply an ovarian problem. It also reduces the focus on "cysts," which can create confusion and unnecessary anxiety for many women. Instead, conversations can focus on: Hormonal health Metabolic wellbeing Symptom management Fertility planning Long-term health outcomes Personalised treatment approaches How Could PMOS Improve Women's Healthcare? As awareness of PMOS grows, women may benefit from: More Joined-Up Care Greater collaboration between: GPs Endocrinologists Gynaecologists Dermatologists Dietitians Mental health professionals Better Education and Support Women may receive clearer information about: Insulin resistance Weight management Fertility treatment options Long-term health risks Lifestyle strategies that improve symptoms A Lifelong Health Approach PMOS is increasingly recognised as a lifelong condition. While symptoms can change over time, proactive management can significantly improve health outcomes and quality of life. When Should You Speak to a Healthcare Professional? If you have PCOS or PMOS, it may be worth reviewing your current care plan. Consider discussing the following with your clinician: Are your blood sugar and cholesterol levels being monitored? Have your cardiovascular risk factors been assessed? Are your symptoms affecting your mental wellbeing? Do you have a personalised lifestyle plan? Are your treatment options being reviewed regularly The transition from PCOS to PMOS represents an important shift in how we understand and manage this common condition. Although the name has changed, the message is clear: women deserve care that looks beyond the ovaries and considers the whole person. By recognising the hormonal, metabolic and reproductive aspects of PMOS, healthcare professionals can provide more comprehensive support, helping women improve both their immediate symptoms and their long-term health. Need Support with PCOS or PMOS? At Bristol Menopause Clinic, our experienced clinicians provide personalised assessments, hormone reviews, lifestyle guidance and evidence-based treatment plans to help women manage PCOS/PMOS and optimise their long-term health. 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 10 Nutrition Tips for a Healthy New Year Alternative Therapies, Diet, Exercise, Managing Symptoms, Managing Weight, Perimenopause, Post Menopause, Self-Care The start of the new year can leave many people thinking about all the ways they can improve their lives therefore, it does give us the chance to start a new chapter in our lives. It can be challenging to distinguish between nutrition fads, myths, and the facts often leaving us feeling confused and even stressed about making the right food choices. Here, our expect nutritionist Alex shares her top tips... Set realistic goals - focus on small, achievable changes such as adding more veggies or drinking more water Plan balanced meals - including protein, healthy fats, and fibre Prepare in advance - meal prep is key to avoiding last-minute unhealthy choices. Stock up on healthy foods Eat whole nutrient dense foods including fruits, vegetables, whole grains, and lean proteins Start your day with a healthy breakfast - rich in protein, fibre and healthy fats can energise you for the day ahead Look after your gut - eat a variety of fermented foods such as yogurt and kefir to support a healthy digestive system and balanced gut microbiome Stay hydrated - aim for at least 2 litres of water daily Watch your portions - use smaller plates and listen to your hunger cues Limit sugar and alcohol - enjoy treats in moderation without guilt Stay consistent - build habits you can sustain all year, not just in January! Here, at the Bristol menopause clinic, our experts provide coaching and holistic wellness support based on scientific research to help you put strategies into place that work for you and empower you to take charge of your health Do you want to start the new year feeling fresh, focused and balanced? Getting the right help is key. So, why not in a free complimentary call with our Nutritionist and see how she can help support you and your health for now and your future Find out more here Happy New Year everyone! 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 Lifestyle Medicine and Menopause: Building Resilience from the Inside Out Alternative Therapies, Diet, Exercise, Managing Symptoms, Managing Weight, Menopause Advice, Perimenopause, Post Menopause, Self-Care, Wellbeing Every year, World Menopause Day highlights an important theme to raise awareness and improve women’s health globally. For 2025, the focus is on Lifestyle Medicine, and it couldn’t be more timely. We know that menopause is more than “low oestrogen.” Hormones interact with every system in the body: the brain, cardiovascular system, bones, metabolism, and mood regulation. But what’s becoming clearer is that hormones do not act alone. Their effects depend on the receptors they bind to, and those receptors are influenced by our daily lifestyle choices from the food we eat, to how we move, rest, and manage stress. Progesterone and Its Receptors While oestrogen often takes centre stage, progesterone is equally important in midlife health. Progesterone binds to progesterone receptors (PRs), found not only in the uterus and breast tissue but also in the brain. Here, PRs influence mood, sleep, and cognition by interacting with the brain’s calming neurotransmitter system (GABA). This is one reason why declining progesterone in perimenopause can contribute to anxiety, poor sleep, and mood changes. But here’s the key: the effectiveness of progesterone depends on the health of its receptors. And receptor activity is shaped by both biology and lifestyle factors such as diet, stress, and sleep. The Role of B Vitamins One of the clearest examples of lifestyle medicine in action is nutrition. In particular, the B vitamins, especially B6, B9 (folate), and B12 are essential for brain health and hormone receptor function. Vitamin B6 helps produce serotonin, dopamine, and GABA neurotransmitters that work alongside progesterone’s calming effects. Folate (B9) and B12 support methylation, a process that regulates gene expression, including hormone receptor sensitivity. Riboflavin (B2) and Niacin (B3) fuel mitochondrial energy, indirectly supporting hormone metabolism and brain function. Without these nutrients, even if hormones are present, their messages may not be fully received by the body. This is why nutrition is not a side note it’s a core pillar of hormone health. The Lifestyle Medicine Framework in Menopause Lifestyle medicine is built on six key pillars, each of which directly influences hormone signalling and overall health in menopause: Nutrition: Prioritise whole, nutrient-rich foods. Ensure adequate intake of B vitamins, protein, fibre, and phytonutrients to support receptor and metabolic health. Physical Activity: Regular movement improves insulin sensitivity, reduces inflammation, and enhances receptor responsiveness. Both resistance training and aerobic exercise are protective in midlife. Sleep: Consistent, restorative sleep helps regulate cortisol and supports hormone balance. Poor sleep, by contrast, disrupts receptor sensitivity. Stress Management: Chronic stress elevates cortisol, which competes with sex hormone pathways and blunts receptor activity. Practices like mindfulness, yoga, and breathing exercises make a measurable difference. Avoidance of Harmful Substances: Reducing alcohol, smoking, and ultra-processed foods helps protect receptor function, brain health, and cardiovascular resilience. Positive Social Connections: Strong relationships improve stress resilience, mood regulation, and long-term health outcomes all of which interact with hormonal systems. Why This Matters for Midlife Women Menopause care is too often framed as “replacing what is lost.” But the evidence shows that building resilience through lifestyle is equally powerful. Whether or not a woman chooses hormone therapy, supporting her nutritional status, physical health, and emotional wellbeing can amplify outcomes and reduce long-term risks of heart disease, osteoporosis, and cognitive decline. This year, World Menopause Day invites us to reframe menopause care: not as symptom management, but as whole-person health care, rooted in the daily choices that sustain hormone function and receptor health. 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 The Benefits of Floatation Therapy for Women’s Health: Relaxation at its best. Alternative Therapies, Managing Symptoms, Self-Care, Wellbeing, Stress he Benefits of Floatation Therapy for Women’s Health: Relaxation at its best. Life can feel like a whirlwind sometimes, juggling work, family, hormones, and self-care can be exhausting. If you’ve ever wished you could press the pause button, let your body rest, and reset your mind, then floatation therapy might just be the wellness game-changer you need. Floatation therapy, also known as sensory deprivation therapy, involves lying in a specially designed tank filled with warm water infused with Epsom salts. This creates a buoyant, zero-gravity experience where you can float effortlessly, free from external distractions. It’s like giving your nervous system a well-deserved holiday! I felt like I was lying on a tropical beach. Kim and I recently visited Bristol Float Centre at Back in Action , and I have to say, the experience was nothing short of magical. Whether you’re struggling with stress, hormonal imbalances, or aching muscles, spending time in a float tank can work wonders for your overall well-being. Let’s explore why this simple yet powerful practice can be so beneficial for women’s health. 1. Hormonal Balance & Menopause Support Hormones can be unpredictable at the best of times, but as we go through perimenopause and menopause, the fluctuations can wreak havoc on our sleep, mood, and energy levels. Floating helps regulate cortisol (the stress hormone) and increases the production of dopamine and serotonin—our ‘feel-good’ neurotransmitters. This means fewer mood swings, better sleep, and a sense of calm that lasts beyond the session. 2. Eases Stress and Anxiety Women are natural multitaskers, but that constant mental load can lead to anxiety and burnout. Floatation therapy provides deep relaxation by reducing sensory input, allowing the mind to slow down. It’s like meditation on steroids—without having to actually “do” anything! Studies have shown that floating significantly lowers anxiety and helps to regulate the nervous system, making it a fantastic tool for stress management. 3. Pain Relief for PMS, Endometriosis & Fibromyalgia Chronic pain conditions like fibromyalgia, endometriosis, and even PMS cramps can be incredibly debilitating. The magnesium in the Epsom salts is absorbed through the skin, helping to relax muscles and ease tension. The weightless environment also takes pressure off joints, reducing inflammation and promoting healing. For many women, this is a natural way to relieve discomfort without relying on medication. 4. Improved Sleep Quality Struggling with sleep? Whether it’s due to perimenopause, stress, or an overactive mind, floating can help reset your body clock. The deep relaxation experienced in the tank mimics the early stages of sleep, meaning your brain gets a taste of restfulness even if you’ve been struggling to nod off at night. Many people find that they sleep more deeply after a float session, which is a huge win for overall health and recovery. 5. Muscle Recovery and Fitness Support If you’re an active woman who enjoys exercise or even if you suffer from chronic aches and pains—floatation therapy is fantastic for muscle recovery. The zero-gravity effect relieves tension, speeds up healing, and reduces soreness. This is why so many athletes swear by floating as part of their recovery routine. 6. Mental Clarity and Creativity Boost Women often carry the mental load of managing a household, career, and personal well-being, leaving little space for creativity and self-reflection. Floating helps clear brain fog, enhances problem-solving skills, and even boosts creativity. If you’ve ever needed a mental refresh, stepping into a float tank is like hitting the reset button on your thoughts. Ready to Try Floating? If you’re curious about the benefits of floatation therapy, I highly recommend visiting Bristol Float Centre at Back in Action . Whether you’re looking for relief from pain, stress, or sleep troubles, or simply want to experience a deep sense of relaxation, floating is an amazing tool to add to your self-care routine. I would say when you get in and if your brain is working overtime do some simple deep breathing techniques such as 4-7-8. 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

PCOS Support Women, Polycystic Ovary Syndrome Treatment, Expert PCOS Care, Women’s Health Specialists, Personalised PCOS Management, Holistic Women’s Health, PCOS Guidance and Treatment PCOS/PMOS PCOS/PMOS Care At Bristol Menopause Clinic, we provide expert, evidence-based care for PCOS/PMOS to support you at every stage of your health journey. Whether you're struggling with irregular cycles, hormonal imbalances or weight concerns, our specialist-led appointments offer personalised guidance tailored to your needs. Our Doctors take the time to understand your unique concerns, offering expert advice on lifestyle strategies, medical management, and hormone balance. From insulin resistance and skin health to mood shifts and long-term wellbeing, we empower you with the knowledge and care you need to take control of your health. Book an appointment today and receive the specialist support you deserve for managing PCOS/PMOS with confidence. More information on PCOS/PMOS can be found here PCOS/PMOS Initial Consultation See the details PCOS/PMOS Follow up See the details

< Back How can pelvic physiotherapy support perimenopause? Alternative Therapies, Exercise, Managing Symptoms, Pelvic Organ Prolapse, Wellbeing Like puberty, menopause transition involves a complex cascade of hormonal changes. We spend on average over 40% of our lives in post-menopause, so it is crucial to understand and get ahead of these changes to optimise our long term well-being. Poor pelvic health, such as bladder, bowel and sexual dysfunction, is a leading barrier to continuing exercise and can be detrimental to our mental health. For much of our lives, oestrogen is our power house - it’s what keeps muscles, tendons and connective tissue stretchy, subtle and strong, our joints healthy and lubricated. It keeps the vaginal and urethral walls moist and elastic, with capacity for distention and constriction. We go through life not fully appreciating the wonderful things oestrogen does for us. A reduction in oestrogen levels can cause local changes to the vaginal and vulvar tissues and muscles which we call Genitourinary Syndrome of Menopause (GUSM). This describes a collection of symptoms which are all caused by this hormonal shift. Symptoms of GUSM include: Vaginal dryness, burning or sandpaper-like feeling Pain with sex and decreased lubrication Vaginal and vulvar itching - Changes in odor and discharge UTI’s or vaginal infections Skin irritation Change in orgasm Reduced strength or takes longer to achieve Smear tests or tampon insertion (if still using) become uncomfortable Symptoms of prolapse, such as heaviness or pressure - Increased frequency and urgency to empty bladder Leaking urine with exertion or not making it to toilet on time Firstly, bringing attention to our vulvar skin care, and use of lubricants, vaginal moisturisers (like YesYesYes ) and a prescription for vaginal oestrogen could be instrumental for managing these symptoms. Depending on the person, HRT can also play a role in improving these issues, too. Pelvic floor Physiotherapy can be a game changer, and is actually a gold standard treatment for managing GUSM symptoms. So how does physio work? Leaking urine on coughing, running or jumping (called stress urinary incontinence or SUI) is extremely common. If the pressure in our tummy is less than the pressure created by the muscles surrounding the urethra, then we are protected from leaking. This urethral closure pressure is created in two ways: 1. Like the vaginal walls, the urethral walls fold in on themselves to allow for considerable expansion when emptying the bladder, and creating a leakproof closure pressure when at rest. 2. Abdominal pressure presses down onto the bladder neck, and compresses it - stopping the flow of urine, like stomping on a garden hose. Any changes to tissue quality, like GUSM, can alter this mechanism, as the plump urethral walls become drier and thinner, and the connective tissue supporting the bladder weakens. However, learning how to fully contract and relax the pelvic floor muscles has been shown to increase blood flow, tissue elasticity and muscle bulk, improving tissue quality and often improving or resolving SUI. Pelvic organ prolapse (POP) symptoms may also begin or worsen during perimenopause or post-menopause. This is where there is an excess of downwards movement in the vaginal walls and connective tissue that provide support for your pelvic organs, causing descent to or past the entrance of the vagina. Childbirth, pregnancy, hypermobility and chronic straining are all examples of risk factors for pelvic organ prolapse, and declining oestrogen levels and tissue quality could contribute to an increase in symptoms. Types of pelvic floor prolapse Thankfully, we can use pelvic floor muscle training to create a hammock of support from underneath to manage prolapse symptoms. A pelvic floor physiotherapist will also look at your whole body biomechanics to help you optimise support from below and minimise pressure from above, as well as optimising bowel habits and toileting postures to minimise straining. Keep exercising! Pelvic health concerns should never be a barrier to exercise. Exercise and keeping muscles strong is especially crucial during this stage of life, as it also helps body weight, bone density, cardiovascular health, and supports mental well-being by managing anxiety and depression. Exercise has even been shown to improve vasomotor symptoms like hot flushes! If you’re experiencing pelvic floor symptoms or want to protect your pelvic floor for the future, reach out to a pelvic floor physiotherapist for support. Alma Physiotherapy offer a Menopause Pelvic Floor Assessment & Treatment appointment with their specialist physios, and you can get 10% off the first session with code BM10 . Meg is a sports (MSK) and pelvic health physiotherapist based at Alma Physiotherapy, 25 Lower Redland road, Bristol, BS6 6TB. Book via: www.almaphysiotherapy.co.uk/book-online Email her PA Zainab pa@almaphysiotherapy.co.uk or call 07942 494506 for help booking. References: Russo et al. Management of urinary incontinence in postmenopausal women: An EMAS clinical guide. Maturitas. 2021 Jan;143:223-230. doi: 10.1016/j.maturitas.2020.09.005. Epub 2020 Sep 30. PMID: 33008675. Mercier et al. Pelvic floor muscle training: mechanisms of action for the improvement of genitourinary syndrome of menopause. Climacteric. 2020 Oct;23(5):468-473. doi: 10.1080/13697137.2020.1724942. Epub 2020 Feb 27. PMID: 32105155. Mercier et al. Pelvic floor muscle training as a treatment for genitourinary syndrome of menopause: A single-arm feasibility study. Maturitas. 2019 Jul;125:57-62. doi: 10.1016/j.maturitas.2019.03.002. Epub 2019 Mar 29. PMID: 31133219. 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 Janet Howe British Menopause Society Registered Specialist Nurse Janet Howe is a British Menopause Society Registered Menopause Specialist and an independent Prescriber who has been in nursing for 37 years, 26 of those in general practice specialising in women's health. Janet is a distinguished figure in women's health, holds the esteemed title of being a British Menopause Society Registered Menopause Specialist and an independent Prescriber. With an impressive 37-year career in nursing, including 26 years dedicated to general practice with a specialisation in women's health, Jan brings a wealth of experience to her practice. Jan's expertise extends across contraception, sexual health, and in-depth knowledge of the menopause, including Hormone Replacement Therapy (HRT). Notably, she is proficient in fitting Mirena coils and contraceptive implants, showcasing her commitment to providing a comprehensive range of services as an independent prescriber. Currently on the path of academic advancement, Jan is working towards her Masters in Advanced Clinical Practice, a testament to her dedication to staying at the forefront of her field. Beyond professional expertise, Jan intimately understands the menopausal experience, having personally navigated its physical and mental aspects. Her empathetic approach is further highlighted by her memberships in both the British Menopause Society and the International Menopause Society. Jan's passion for women's health is evident in her desire to ensure that all women have the opportunity to access menopausal care. She envisions a landscape where women are supported through this transformative phase of life, emphasising her commitment to the well-being of her patients.

< Back Still Feeling Flat on HRT? Could Testosterone Be the Missing Piece? HRT, Managing Symptoms, Perimenopause, Post Menopause, Menopause Advice Understanding when testosterone replacement may help with low libido, fatigue, brain fog, and persistent menopausal symptoms despite HRT Many women start HRT for menopause expecting to feel fully like themselves again with improved energy, better mood, clearer thinking, and a return to normal wellbeing. For many women, Hormone Replacement Therapy (HRT) works extremely well. However, some women continue to experience symptoms such as low libido, fatigue, brain fog, poor concentration, reduced motivation, and low mood , even when their oestrogen treatment is working effectively. If this sounds familiar, testosterone for menopause may be worth considering. At the Bristol Menopause Clinic, we often see women who feel their HRT has helped, but they still do not feel fully themselves. In some cases, testosterone can be an important part of completing their menopause treatment plan. What Does Testosterone Do in Women? Although testosterone is often thought of as a male hormone, women naturally produce testosterone too, and it plays an important role in physical, emotional, and sexual wellbeing. Testosterone can help support: Libido and sexual desire Energy and motivation Mood and emotional wellbeing Confidence and resilience Focus and concentration Muscle strength and body composition General vitality and quality of life During perimenopause and menopause , testosterone levels naturally decline. This reduction can be more significant after surgical menopause , particularly if the ovaries have been removed. Symptoms of Low Testosterone in Menopause Low testosterone in women can contribute to symptoms such as: Low libido Ongoing fatigue Brain fog Poor memory and concentration Reduced confidence Low motivation Feeling emotionally flat Loss of enjoyment or drive Feeling unlike yourself despite being on HRT These symptoms can overlap with other aspects of menopause, which is why specialist assessment is important. When Is Testosterone Prescribed for Menopause? Testosterone replacement for women is not usually the first step in treatment. Before considering testosterone, it is important to ensure that standard menopause HRT is fully optimised, including: Oestrogen replacement Progesterone where required Lifestyle factors such as sleep, stress, nutrition, and exercise Testosterone may be considered when a woman is already using appropriate HRT but symptoms still persist. This should always be assessed by a qualified menopause specialist. Do You Need a Blood Test Before Testosterone? Yes and it must be a venous blood test , not a finger-prick test. Before prescribing testosterone, we assess: Baseline testosterone levels Sex Hormone Binding Globulin (SHBG) Free Androgen Index (FAI) Finger-prick tests are not accurate enough for assessing testosterone and should not be used for prescribing decisions. Is Testosterone Licensed for Women in the UK? Currently, there is no female-specific licensed testosterone product for menopause treatment in the UK. This means specialist menopause clinics prescribe carefully adjusted low doses of testosterone gel or cream originally licensed for men, following guidance from the British Menopause Society. This is known as off-licence prescribing , but it is common, safe, and evidence-based when managed correctly by an experienced clinician. Is Testosterone Safe for Women? When prescribed at female physiological doses and monitored correctly, testosterone is generally very safe. The goal is not to create “high testosterone” levels, but to restore levels within the normal female range to improve symptoms safely. Monitoring is essential to reduce the risk of side effects and ensure the treatment remains appropriate. How Long Does Testosterone Take to Work? Some women notice improvement within 6 to 8 weeks , particularly in libido, energy, and mental clarity. However, we usually allow 3 to 6 months to properly assess the full benefit of treatment. Regular follow-up appointments are an important part of safe testosterone prescribing. What If My GP Will Not Prescribe Testosterone? Many NHS GPs do not routinely prescribe testosterone for menopause , mainly because it is an off-licence treatment. This can leave many women feeling frustrated when symptoms continue despite being on HRT. As a specialist menopause clinic, we can: Assess whether testosterone is clinically appropriate Arrange the correct blood tests Prescribe safely where suitable Monitor treatment and blood levels Communicate with your GP for continuity of care Could Testosterone Be the Missing Piece? For the right patient, testosterone can make a significant difference to quality of life. It is not suitable for everyone, but for women experiencing persistent symptoms despite optimised HRT, it can be an important part of effective menopause treatment. If you are still feeling flat on HRT and wondering whether there is more that could help, a specialist menopause review may help determine whether testosterone therapy for women could be the next step. At Bristol Menopause Clinic, we provide expert assessment, evidence-based prescribing, and ongoing support to help women feel well, confident, and fully supported through menopause. Find out more information about our testsoterone packages 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

Coil retrieval and difficult IUD removal service including assessment of missing threads, embedded coils and expert gynaecological care in a safe clinical setting. Coil Retrieval £195 Book here Questionnaire and Pre-retrieval Requirements All patients are required to complete a pre-retrieval questionnaire at least 7 days prior to their appointment. Please note: For any coil fitting, removal, or change, patients must ensure reliable contraception has been used consistently for at least 7 days prior to the procedure. If you have experienced a failed coil removal or are unable to complete your screening forms, please contact the clinic prior to booking so that your situation can be reviewed by a clinician. Discussion & Options Review available coil options and the retrieval procedure. Offer a chlamydia/gonorrhoea test during the appointment (£85). Consultation Assess medical history, current medications, and allergies. Explain the Mirena/copper coil, including the removal and replacement process if applicable. Physical Examination Conduct a pelvic examination to determine the uterus's size, position, and suitability for a new coil if needed. Procedure Remove the Mirena/copper coil using a speculum and retrieval tools. If a new coil is fitted, insertion will be carried out using a speculum and inserter device. Some discomfort or cramping may occur during the procedure. Aftercare Provide guidance on post-procedure expectations, potential side effects, and aftercare advice. Book here

< Back HRT Myths Debunked: What Every Woman Should Know Hormone Replacement Therapy (HRT) is the most effective treatment for menopausal symptoms, yet many women avoid it due to outdated fears and misconceptions. Let's separate fact from fiction. The 2002 Study That Changed Everything Much of the fear surrounding HRT stems from a 2002 study that made alarming headlines about breast cancer and heart disease risks. However, subsequent analysis revealed significant flaws in that research, and the findings have since been reinterpreted. The women in that study were predominantly over 60 and more than a decade past menopause when they started HRT. We now know that timing matters enormously - starting HRT around the time of menopause is very different from starting it years later. Myth #1 : HRT Causes Breast Cancer The Reality: The relationship between HRT and breast cancer is more nuanced than headlines suggest. Oestrogen-only HRT (for women without a uterus) shows no increased breast cancer risk and may even offer slight protection. Combined HRT (oestrogen plus progesterone) shows a small increased risk, but it's considerably less than the risk associated with drinking two units of alcohol daily or being overweight. For perspective, out of 1,000 women taking combined HRT for five years, approximately four extra cases of breast cancer might be diagnosed. The risk returns to baseline within a few years of stopping HRT. Body-identical progesterone may carry even lower risk than older synthetic progestogens, which is why it's now the preferred option for most women. Myth #2 : Everyone Gains Weight on HRT The Reality: HRT itself doesn't cause weight gain. Studies show that women on HRT tend to gain less weight than women not on treatment. The weight gain many women experience during menopause is primarily due to hormonal changes, aging, and lifestyle factors—not the treatment designed to address those hormonal changes. In fact, by improving energy levels, mood, and sleep, HRT often helps women maintain more active lifestyles and better eating habits. Myth #3 : HRT Increases Your Risk of Blood Clots The Reality: The type of HRT matters significantly. Transdermal HRT (patches or gel) carries no increased risk of blood clots, unlike oral tablets which do slightly increase risk. This is why most menopause specialists now prescribe transdermal oestrogen as first-line treatment. For most healthy women, the absolute risk remains very small, but using transdermal HRT eliminates even this minimal concern. Myth #4 : You Shouldn't Start HRT After 60 The Reality: While it's true that starting HRT within 10 years of menopause offers the most benefits and lowest risks, being over 60 doesn't automatically rule out HRT. Each woman's situation is individual, and for those with persistent debilitating symptoms, HRT may still be appropriate with careful assessment. The key is individualized care based on your health history, symptoms, and personal circumstances. Myth #5 : You Can't Take HRT If You Have a Family History of Breast Cancer The Reality: Family history requires careful consideration but doesn't automatically exclude HRT. The decision depends on several factors: how many relatives were affected, their ages at diagnosis, whether they carried genetic mutations, and your personal risk assessment. Many women with family history can safely take HRT, particularly transdermal oestrogen-only HRT. A menopause specialist can help you understand your individual risk-benefit profile. Myth #6 : You Should Only Take HRT for a Few Years The Reality: There's no arbitrary time limit for HRT. Some women need it for a few years, others benefit from longer-term treatment. The decision should be based on ongoing symptom control and individual health considerations, reviewed regularly with your clinician. For women who start HRT early (before age 45) due to premature ovarian insufficiency or surgical menopause, continuing until at least the average age of natural menopause (51) is recommended for bone and cardiovascular health. What Modern HRT Looks Like Today's body-identical HRT bears little resemblance to the hormones used in that 2002 study. Current best practice involves: Transdermal oestrogen (patches or gel) to minimise clot risk Body-identical (micronised) progesterone for uterus protection Individualised dosing based on symptoms and needs Testosterone for women experiencing low energy, libido, or motivation Regular review and adjustment as needed Making an Informed Decision Every treatment carries both benefits and risks. The question isn't whether HRT is completely risk-free- no medication is- but whether the benefits outweigh the risks for your individual situation. For most healthy women experiencing menopausal symptoms, the answer is yes. HRT effectively relieves symptoms, protects bone health, and may offer cardiovascular benefits when started around the time of menopause. At Bristol Menopause Clinic, we provide comprehensive consultations to help you understand your personal risk-benefit profile and make informed decisions about your menopause management. Our approach is evidence-based, individualised, and focused on helping you achieve optimal wellbeing. Don't let outdated myths prevent you from accessing treatment that could transform your quality of life. British Menopause Society accredited. Evidence-based, personalised menopause care in Bristol. Book you initial HRT consultation today with Bristol Menopause Clinic 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 Understanding the Safe Use of HRT Gels and Sprays: Reducing the Risk of Unintentional Transfer What you need to know to safely use transdermal oestrogen around your family and pets Hormone Replacement Therapy (HRT) in the form of transdermal oestrogen gels, creams and sprays is a highly effective and commonly prescribed treatment for managing menopausal symptoms. These preparations are absorbed through the skin and provide a convenient alternative to oral therapy. However, an important and often overlooked consideration is the potential for unintentional transfer of oestrogen to others , particularly children and pets. Can HRT Be Transferred to Others? Yes, if the application site is touched or licked before the product has fully dried, small amounts of oestrogen can transfer to another person or animal. While the amount transferred is typically low, repeated exposure over time may lead to hormonal effects , particularly in more vulnerable individuals such as young children and animals. Reported effects may include: In children : breast or nipple changes, or signs of early puberty In pets : behavioural changes (such as signs resembling being “in heat”), or changes to coat or skin Although these situations are uncommon, they are preventable with appropriate precautions. How to Minimise the Risk Simple, practical steps can significantly reduce the likelihood of transfer: Apply the product only to the recommended area and avoid spreading beyond this Allow the product to dry fully before close contact (ideally around 60 minutes) Wash your hands thoroughly with soap and water after application Cover the application site with clothing before physical contact, such as cuddling children or allowing pets onto your lap Avoid allowing pets to lick the application area These measures are particularly important in the period immediately after application, when the risk of transfer is highest. What Should You Do If You Are Concerned? If you suspect that a child or pet may have had repeated exposure and you notice any physical or behavioural changes, it is important to seek advice: Contact your GP or paediatrician for children Contact your veterinary surgeon for pets Early assessment can help provide reassurance and guide any necessary next steps. Do These Risks Apply to All Forms of HRT? It is important to note that this risk does not apply in the same way to oestrogen patches . Oestrogen patches are sealed delivery systems , meaning the hormone is contained within the patch and delivered directly through the skin. When used correctly and kept intact, they are not thought to transfer oestrogen through skin contact , such as cuddling or lap-sitting. However, general safety precautions still apply: Keep both new and used patches out of reach of children and pets Fold used patches in half (adhesive sides together) before safe disposal Transdermal HRT remains a safe and effective treatment when used correctly. Awareness of this small but important risk allows you to take simple steps to protect those around you. Always: Follow the instructions provided in your HRT patient information leaflet Speak to your prescriber or pharmacist if you have any questions or concerns At Bristol Menopause Clinic, we are committed to providing clear, evidence-based guidance to support safe and effective menopause care. If you would like to review your HRT or discuss the most suitable options for you, our team is here to help. 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

PMDD Support, Premenstrual Dysphoric Disorder Care, Expert Women’s Health, Personalised PMDD Treatment, Holistic Women’s Wellbeing, PMDD Management Specialists Premenstrual Dysphoric Disorder Expert Premenstrual Dysphoric Disorder (PMDD) Care At Bristol Menopause Clinic, we provide expert, evidence-based care for Premenstrual Dysphoric Disorder (PMDD), supporting you at every stage of your health journey. Whether you're experiencing severe mood changes, emotional distress, cycle-related anxiety, or debilitating symptoms, our specialist-led appointments offer personalised guidance tailored to your needs. Our doctors take the time to understand your unique concerns, offering expert advice on lifestyle strategies, medical management, and hormonal balance. From mood stabilisation and sleep disturbances to coping strategies and long-term wellbeing, we empower you with the knowledge and care you need to regain control of your health. Book an appointment today and receive the specialist support you deserve for managing PMDD with confidence. PMDD Initial Consultation See the details PMDD Follow up See the details