< Back Iron Deficiency in Midlife Women: What Works, What Does Not, and Why Alternative Therapies Understanding Ferritin, Fatigue, Brain Fog, Hair Loss, and Why “Normal” Blood Tests Are Not Always Optimal Iron deficiency is one of the most overlooked contributors to fatigue, brain fog, low mood, poor concentration, hair thinning, and reduced exercise tolerance in women during perimenopause and menopause. Yet despite how common it is, many women are told their blood tests are “normal” when, clinically, their iron stores are far from optimal. At Bristol Menopause Clinic , we frequently see women whose menopausal symptoms only partially improve with HRT because an underlying iron deficiency has never been properly identified or treated. The reality is simple: treatment is not just about taking iron. The type of iron, how it is taken, what is preventing absorption, and understanding the root cause all matter enormously. Why Iron Deficiency Is So Common in Midlife Women Iron depletion often develops gradually over years. Heavy menstrual bleeding, restrictive dieting, gastrointestinal conditions, thyroid disease, stress-related digestive issues, and long-term medication use can all contribute. The challenge is that the symptoms overlap significantly with menopause itself: Fatigue Brain fog Poor concentration Anxiety or low mood Hair thinning Reduced stamina Poor sleep Palpitations Restless legs As a result, many women assume hormones are the only explanation. Treatment Options: What Actually Works 1. Iron Supplementation Iron supplementation can be highly effective — but the form of iron matters considerably. Many women are prescribed traditional ferrous salts, which are inexpensive and clinically effective, but often poorly tolerated. Gastrointestinal side effects are one of the biggest reasons women stop treatment too early. Form Typical Dose Tolerability & Clinical Notes Ferrous sulphate 200mg twice daily Effective but commonly causes constipation, nausea, bloating, and abdominal discomfort Ferrous fumarate 210mg twice daily Similar efficacy to ferrous sulphate; slightly better tolerated in some women Iron bisglycinate 25–50mg elemental iron Chelated form with superior absorption and significantly fewer gastrointestinal side effects Liquid iron As directed Useful for women unable to tolerate tablets; often gentler on digestion IV iron infusion Clinician-administered Reserved for severe deficiency, malabsorption, or failure of oral therapy Alternate Day Dosing: A More Effective Strategy Emerging evidence suggests that alternate-day dosing may actually improve iron absorption compared with daily supplementation. This relates to the hormone hepcidin, which rises after taking iron and temporarily blocks absorption for up to 24 hours. Taking iron every other day may therefore improve overall uptake while reducing gastrointestinal side effects. For many women, this approach is both more effective and easier to maintain long term. Optimising Iron Absorption Iron is one of the most absorption-sensitive nutrients in human physiology. Two women taking the same supplement can absorb vastly different amounts depending on timing, medications, and dietary habits. Take Iron with Vitamin C Vitamin C improves the absorption of non-haem iron by converting it into a more absorbable form. Helpful combinations include: Iron with kiwi fruit Iron with berries Iron with citrus juice Iron with tomatoes or peppers Avoid Tea and Coffee Around Supplement Timing Tea and coffee contain tannins that significantly reduce iron absorption. Even herbal teas such as peppermint may interfere. Avoid these for at least one hour either side of taking iron. Separate Iron from Calcium Calcium competes directly with iron absorption. Avoid taking iron alongside: Milk Cheese Calcium supplements Calcium-fortified products Ideally, allow a two-hour gap. Thyroid Medication Timing Matters Iron can reduce the absorption of levothyroxine. Women taking thyroid medication should separate iron and levothyroxine by at least two hours. Cooking in Cast Iron Cooking acidic foods such as tomato sauces or stews in cast-iron cookware can meaningfully increase the iron content of meals, a simple but clinically useful habit. Dietary Optimisation Diet alone is rarely enough to correct significant iron depletion, but it plays an essential role in long-term maintenance. Haem Iron: Best Absorbed Haem iron is absorbed efficiently regardless of other dietary factors. Best sources include: Red meat Lamb Dark poultry meat Shellfish Clams Oysters Liver (avoid during pregnancy) Non-Haem Iron: More Difficult to Absorb Plant-based iron sources are less efficiently absorbed and highly dependent on what they are eaten with. Sources include: Lentils Chickpeas Kidney beans Tofu Pumpkin seeds Quinoa Fortified cereals Dark leafy greens Improving Plant-Based Iron Absorption Pairing plant iron with vitamin C-rich foods significantly improves absorption. Examples include: Lemon juice on spinach Tomatoes with lentils Red peppers in bean dishes Citrus dressings on salads For vegetarian and vegan women with depleted ferritin levels, supplementation is often clinically necessary rather than optional. Addressing the Underlying Cause Correcting ferritin without understanding why it became depleted often leads to recurrence. Common reversible causes include: Heavy Menstrual Bleeding Perimenopausal bleeding changes are one of the most common contributors to iron depletion. Appropriate hormonal treatment, including HRT, may significantly reduce ongoing losses. Coeliac Disease Undiagnosed coeliac disease can impair iron absorption even in women with an otherwise healthy diet. Women with persistently low ferritin despite supplementation should be screened. Helicobacter pylori Infection This common stomach bacteria can interfere with iron absorption. Eradication therapy may restore normal absorption. Proton Pump Inhibitors (PPIs) Long-term reflux medications reduce stomach acid, impairing iron absorption. Medication reviews are often worthwhile. Thyroid Disease Hypothyroidism is associated with impaired iron absorption and reduced energy metabolism. Treating thyroid dysfunction frequently improves iron status. Monitoring Your Response Iron replacement is not a quick fix. Expect a 3–6 Month Process Ferritin restoration takes time. Many women feel discouraged when they do not notice immediate improvement. Meaningful replenishment usually takes: Around 3 months for early improvement Up to 6 months or longer for full restoration Recheck Blood Tests Repeat testing should ideally include: Ferritin Full blood count CRP Vitamin B12 Folate Monitoring ensures levels are improving appropriately and helps guide maintenance therapy. Optimal Ferritin Matters Many laboratories classify ferritin levels around 15–30 µg/L as “normal”. Clinically, however, many symptomatic women feel significantly better when ferritin reaches: 70–100 µg/L Normal is not always optimal. The Menopause Connection Iron deficiency and menopause frequently coexist — and they often amplify one another. In clinic, we commonly see women whose HRT has improved symptoms partially, but who continue to experience: Fatigue Brain fog Hair shedding Low resilience Reduced exercise tolerance When ferritin is investigated and corrected appropriately, the improvement can be significant. Equally, effective menopause management may help preserve iron stores by reducing heavy or erratic bleeding patterns. Treating hormones without addressing nutritional status often produces incomplete results. The best outcomes come from looking at the whole picture. When Should You Seek Further Investigation? If you are experiencing persistent: Fatigue Brain fog Hair loss Poor recovery Low mood Symptoms despite otherwise healthy lifestyle habits …it is worth investigating iron properly. Recommended blood tests include: Serum ferritin Full blood count Active B12 Folate CRP Thyroid function Vitamin D If ferritin is below 70 µg/L and symptoms are present, treatment may still be clinically appropriate, even if you are not anaemic. “Normal” is not always the same as optimal and you deserve to know 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 Why Many Women Are Misdiagnosed in Midlife (and How to Get the Right Care) HRT, Menopause Advice, Post Menopause The Silent Struggle of Women in Midlife. For many women, their 40s and 50s come with a cascade of mysterious health symptoms fatigue, anxiety, joint pain, brain fog, weight gain, and irregular periods. Yet, when they seek medical help, they’re often told: "It’s just stress." "You’re depressed, here’s an antidepressant." "It’s normal aging—nothing to worry about." But what if these symptoms are actually hormonal shifts linked to perimenopause and menopause? The truth is, many women in midlife are misdiagnosed or dismissed, leading to years of unnecessary suffering. This blog explores: Commonly overlooked conditions during perimenopause Why women’s symptoms are often misunderstood How to advocate for better healthcare. If you’ve felt unheard or misdiagnosed, you’re not alone—but with the right knowledge, you can take control of your health and life. Why Women in Midlife Are Often Misdiagnosed The Medical System Wasn’t Designed for Perimenopause Historically, women’s health research has been underfunded, and medical training often lacks education on perimenopause and menopause. Many doctors are trained to recognise menopause only when periods stop completely, but perimenopause can last 5-10 years before that. Symptoms of hormonal changes mimic other conditions (like depression, thyroid disease, or autoimmune disorders), leading to misdiagnosis. The Fix: Find a menopause specialist or doctor trained in hormonal health. Women’s Symptoms Are Often Dismissed as “Psychological” Did you know? Women are more likely than men to be prescribed antidepressants for unexplained symptoms—when the root cause is actually hormonal. Mood swings, anxiety, and brain fog are common symptoms of perimenopause due to fluctuating oestrogen and progesterone. Instead of investigating hormone levels, many women are told they have anxiety, depression, or burnout. The Fix: If your symptoms started in your 40s or 50s, ask your doctor: “Could this be perimenopause?” “Can we discuss hormone testing or HRT options?” Commonly Overlooked Conditions in Perimenopause Many women are misdiagnosed with other conditions when perimenopause is the culprit. Thyroid Disorders vs. Perimenopause Symptoms that Overlap: Fatigue, brain fog, weight changes, hair thinning Mood swings, anxiety, depression Irregular periods What’s Happening? Declining oestrogen impacts thyroid function, making perimenopausal women more likely to develop hypothyroidism. Thyroid disorders are often overlooked or not tested properly. What to Ask Your Doctor: “Can we check full thyroid function (TSH, Free T3, Free T4, thyroid antibodies)?” Depression & Anxiety vs. Hormonal Changes Symptoms that Overlap: Low mood, loss of motivation, increased anxiety Irritability, anger, panic attacks What’s Happening? Oestrogen and progesterone affect serotonin and dopamine (brain chemicals that regulate mood). Fluctuations in perimenopause can mimic depression or anxiety. Antidepressants may help some women but don’t address the root hormonal cause. What to Ask Your Doctor: “Could my mood symptoms be related to hormonal fluctuations?” “Can we discuss HRT as an option instead of (or alongside) antidepressants?” Fibromyalgia vs. Menopausal Joint Pain Symptoms that Overlap: Muscle and joint pain Fatigue and sleep disturbances Brain fog What’s Happening? Oestrogen supports joint lubrication and muscle recovery—low oestrogen increases pain sensitivity. Many women with menopausal joint pain are misdiagnosed with fibromyalgia. What to Ask Your Doctor: “Could my joint pain be hormone-related?” “Are there lifestyle or HRT options to help?” IBS (irritable bowel syndrome) vs. Oestrogen-Related Gut Issues Symptoms that Overlap: Bloating, constipation, diarrhoea Food intolerances Unpredictable digestion What’s Happening? Oestrogen and progesterone influence gut motility and microbiome health. Low oestrogen affects gut bacteria, leading to bloating and IBS-like symptoms. What to Ask Your Doctor: “Could my digestive symptoms be linked to perimenopause?” “Would probiotics or dietary changes help?” How to Work with Your Doctor for Better Care If you suspect perimenopause but aren’t getting the help you need, here’s how to advocate for yourself: Track Your Symptoms Keep a journal of: Changes in mood, sleep, energy, digestion Irregular periods or new symptoms Any triggers (stress, diet, sleep changes) Why? Having clear records makes it easier to discuss concerns with your doctor. Ask for the Right Tests Many doctors only check basic hormone levels, but in perimenopause, hormones fluctuate daily, making single tests unreliable. Recommended Tests for Midlife Women: Comprehensive Hormone Panel – Oestrogen, Progesterone, Testosterone, FSH, LH –these maybe difficult to get on the NHS. Thyroid Function – TSH, Free T3, Free T4, Thyroid Antibodies Vitamin Deficiencies – Vitamin D, B12, Iron, Magnesium Explore Treatment Options (Beyond Antidepressants) If your doctor immediately prescribes antidepressants or dismisses your symptoms, ask about: HRT (Hormone Replacement Therapy): Proven to relieve perimenopausal symptoms and protect long-term health Lifestyle changes: Strength training, diet adjustments, stress reduction Supplements: Magnesium, Omega-3s, adaptogens (like ashwagandha) Pro Tip: Find a BMS (British Menopause Society) Specialist or menopause-literate doctor who understands hormonal health. You Deserve the Right Diagnosis & Care Misdiagnosis in midlife is common—but it’s NOT normal. Your symptoms are real, and they deserve attention. If your doctor isn’t listening, seek a second opinion. Knowledge is power—track your symptoms, ask the right questions, and advocate for better care. Perimenopause is a natural transition, but you don’t have to suffer—there are treatments that work! Act Today: If you suspect perimenopause but feel unheard, book an appointment with a menopause specialist—because your health matters. 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 Perimenopause: A Transition Phase in Women's Health Managing Weight, Perimenopause, Managing Symptoms While menopause officially begins when a woman has not had a menstrual period for 12 consecutive months, perimenopause encompasses the years leading up to this significant milestone. I thought I’d write about perimenopause and how it marks the transitional phase before menopause, signalling changes in a woman's reproductive cycle. While menopause officially begins when a woman has not had a menstrual period for 12 consecutive months, perimenopause encompasses the years leading up to this significant milestone. What is Perimenopause? Duration and Onset: Perimenopause typically begins in a woman's 40s but can start earlier for some, lasting anywhere from a few months to several years before menopause. It's characterised by irregular menstrual cycles, hormonal fluctuations, and various physical and emotional symptoms. Hormonal Shifts: During perimenopause, the ovaries gradually produce less oestrogen, a key hormone regulating the menstrual cycle. This fluctuation can cause irregular periods, where cycles may be shorter or longer than usual, and menstruation might become heavier or lighter. Progesterone also drops at this point meaning that anxiety can worsen, and sleep can be affected by the loss of both hormones. Perimenopause Symptoms and Changes Irregular Periods: One of the hallmark signs of perimenopause is the erratic menstrual cycle. It's common for periods to become irregular as the body's hormonal balance shifts. Periods can be skipped as an egg has not been produced from the ovaries some months. Hot Flushes and Night Sweats: Many women experience hot flushes, sudden waves of heat that can lead to sweating and discomfort, especially at night. These can vary in intensity and frequency. Mood Swings and Emotional Changes: Fluctuating hormone levels can impact mood stability, leading to mood swings, irritability, and even anxiety or depression in some cases. Physical Changes: Other physical changes might include changes in libido, vaginal dryness, sleep disturbances, and fatigue. Managing Perimenopause Symptoms Healthy Lifestyle Habits: Adopting a balanced diet rich in nutrients, regular exercise, and stress management techniques can help alleviate some symptoms. I have already written about caring for yourself through menopause. It is important to increase your protein intake 25% of calories should be from protein. Increase your fruit and veg. Look at your exercise routine – now is the time to introduce strength training to maintain muscle mass and help prevent weight gain. Consultation with Healthcare Professionals: Seeking guidance from specialist healthcare professionals is crucial. They can provide tailored advice, suggest medications or hormone therapies if necessary, and rule out any underlying health concerns. Support Networks: Joining support groups or seeking guidance from friends, family, or counsellors can provide valuable emotional support during this transitional phase. While perimenopause represents a natural transition in a woman's life, the symptoms and changes it brings can vary widely among individuals. Understanding and managing these changes through healthy lifestyle practices and seeking professional guidance are essential for navigating this phase with confidence and minimal disruption to daily life. If you’re looking for compassionate, specialist support through perimenopause or menopause, the team at Bristol Menopause 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

< Back Strong, Stable & Menopausal: How to Exercise Safely with Hypermobility Alternative Therapies, Exercise, Managing Symptoms, Managing Weight, Self-Care, Wellbeing When you hit menopause, your body goes through some significant changes. Falling oestrogen levels can mean: A slow but steady loss of muscle mass Weaker bones, making fractures more likely Stiffer joints or a “creaky” feeling after sitting Longer recovery after workouts or daily activity Now add hypermobility into the mix joints that move more than they should because the connective tissues are stretchier than average and you’ve got a unique challenge. Your joints may feel “loose” or unstable, and without the right muscle support, you’re at higher risk of aches, sprains, or even long-term injury. The good news? The right kind of exercise can protect your joints, build strength, improve posture, and even boost bone density all while making you feel more confident and capable in daily life. Why Strength & Stability Are Non-Negotiable For women with hypermobility, stability is everything. Think of your muscles as scaffolding that holds your joints in place. If the scaffolding is weak, your joints take the strain. The stronger your muscles, the more protected your joints are and the better you’ll move now and in decades to come. Your Midlife Training Blueprint Here’s how to train smarter, not harder: 1. Strength Training (2–3x/week) Focus on slow, controlled resistance exercises that strengthen without over-stretching: Lower body: Supported squats, step-ups, glute bridges, resistance-band side steps Upper body: Seated rows, wall push-ups, light dumbbell presses Core: Bird dogs, dead bugs, side planks (on knees if needed) Tip: When you start, gym machines can offer extra stability while you build control. 2. Posture & Stability Work (Daily or 3–4x/week) Menopause can alter posture shoulders round forward, core muscles weaken. Combat this with: Single-leg balance holds near a wall Heel-to-toe walking Band pull-aparts for shoulder blade strength Pilates or yoga but avoid deep stretches that push joints beyond their safe range 3. Cardiovascular Exercise (150 mins/week) Supports heart, mood, and bones. Brisk walking, cycling, swimming, or low-impact classes are great. If running, build up gradually and pair with stability work. 4. Flexibility (Controlled, Not Extreme) If you’re hypermobile, you don’t need to stretch more you need to control your range of motion. Swap long passive stretches for active mobility drills where your muscles guide the movement. Golden Rules for Safety Warm up for 5–10 minutes Never lock out knees or elbows — keep a soft bend Increase weights or reps slowly over weeks Rest at least 48 hours between hard sessions for the same muscle group Listen to your body — sharp pain means stop Fuel & Recovery Protein : 1–1.2g per kg body weight daily Vitamin D & calcium : For bone health Sleep : 7–8 hours to recover Hydration : Drink regularly, especially before and after exercise Having menopause and hypermobilityis a difficult combination, you can get stronger, more stable, and more confident in your body. The goal isn’t extreme flexibility or chasing your 20-year-old self it’s building the strength to live well, move well, and keep doing the things you love for years to come. 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

Women’s testosterone therapy follow-up including blood test review, symptom assessment, side effect monitoring and personalised treatment adjustments from experienced menopause specialists. Testosterone Package Initial Blood Test, Consultation, Follow Up Package Overview | £475 Comprehensive Testosterone Package for New Patients, Just £475. Take control of your menopause journey with our comprehensive support package, designed for new patients. For just £475, you’ll receive both a hormone profile blood test, 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 Basic hormone profile blood test 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. Book here Benefits of Booking this 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 £475, 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 Testosterone Support Package Today For just £475, you’ll receive a complete testosterone consultation, hormone profile blood test and follow-up plan tailored to your needs. Follow link below to book now. £475 * A blood test is required to assess your testosterone levels and confirm that treatment is appropriate. This must be carried out via a venous blood draw; finger-prick tests are not accepted. Finger-prick tests are not sufficiently accurate for clinical decision-making in menopause care. The blood test costs £110 in addition to the consultation.* 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 here

Women’s testosterone therapy follow-up including hormone monitoring, symptom assessment and personalised treatment optimisation with specialist clinical support. Testosterone Follow Up Consultation Review | £165 If you’ve already had your initial menopause consultation with us, this follow-up review appointment is the perfect way to check on your progress, adjust your treatment plan, and ensure you’re on track for managing your menopause effectively. Our experienced menopause doctor will guide you through any changes, improvements, or challenges, and provide ongoing support tailored to your evolving needs. What’s Included in Your 30-Minute Review Appointment: Progress Review with Your Menopause Doctor A detailed check-in to assess how you’ve been feeling since your initial consultation. We’ll review any symptoms, treatment effectiveness, and lifestyle changes. Treatment Adjustments if Necessary Based on your feedback and progress, we’ll adjust your treatment plan, whether it involves medication changes, lifestyle recommendations, or further investigations. Ongoing Support and Advice Receive expert guidance on any new symptoms or concerns that may have arisen, helping you continue managing menopause with confidence. Private Prescribing (if needed) If there’s a need for further medications, such as hormone therapy adjustments or new prescriptions, they will be issued during the consultation, ensuring you have the care you need without delay. Letter to Your GP A summary letter will be sent to your GP, outlining your progress and any changes to your treatment plan, ensuring seamless continuity of care. Please note: If you have not been seen within the past 12 months, you will be required to book an initial consultation. Book here Benefits of Booking a 30-Minute Review Appointment: Continued Expert Care Stay on top of your menopause journey with ongoing support from a menopause specialist who knows your history and understands your unique needs. Tailored Adjustments Your treatment plan will evolve with you. We’ll make sure you’re getting the most effective care, whether through changes in medication, lifestyle adjustments, or other interventions. Peace of Mind Regular reviews ensure that you’re on the right track, helping you manage menopause symptoms effectively and minimise any discomfort. Seamless Communication with Your GP Your GP will be updated on your progress and any treatment changes, promoting collaborative care and ensuring your full healthcare team is aligned. Confidential and Convenient Have a private, supportive space to discuss your progress and concerns, allowing you to feel confident in your treatment and decisions moving forward. Book Your 30-Minute Review Appointment Today Stay on top of your menopause journey with expert care and ongoing support. Schedule your 30-minute review appointment to ensure your menopause management remains personalised, effective, and up to date. £165 * A blood test is required to assess your testosterone levels and confirm that treatment is appropriate. This must be carried out via a venous blood draw; finger-prick tests are not accepted. Finger-prick tests are not sufficiently accurate for clinical decision-making in menopause care. The blood test costs £110 in addition to the consultation.* 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. If you have not been seen within the past 12 months, you will be required to book an initial consultation. Book here

< Back Redefining Healthy Ageing: Menopause as the Gateway, Not the End Challenging Old Narratives: Menopause has long been painted as the start of decline. Lifestyle medicine reframes it as a gateway to healthy ageing. Midlife is an opportunity to protect health for decades to come A Pivot Point in Women’s Health Evidence shows that lifestyle choices in midlife have long-lasting effects on health outcomes: Bone health: Weight-bearing exercise and adequate vitamin D/calcium support stronger bones. Heart health: A Mediterranean-style diet and regular physical activity reduce cardiovascular risk. Brain health: Quality sleep, lifelong learning, and social connection help protect memory and cognition. Emotional wellbeing: Purpose, community, and mindfulness practices act as natural mood stabilisers. Menopause as Motivation While hormone changes are not fully within our control, how we live each day is. Menopause can be the turning point where women actively choose to build strength, energy, and resilience for the years ahead. The real question is not “how do I get through menopause?” but “how do I thrive in the decades that follow?” Lifestyle medicine provides the practical steps to make this possible. 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 Cervical Screening Awareness Month: Why Cervical Screening Saves Lives Learn why cervical screening is essential for cervical cancer prevention, what HPV testing involves, and how menopause can affect screening comfort. Cervical Screening Awareness Month is an important reminder of the vital role that cervical screening plays in protecting women's health. Regular cervical screening, often referred to as a smear test, is one of the most effective ways to prevent cervical cancer by identifying changes before they become serious. Despite its proven benefits, many women delay or avoid attending cervical screening appointments due to anxiety, embarrassment, uncertainty, or concerns about discomfort. Understanding what cervical screening involves and why it matters can help women feel more confident about attending this important health check. What Is Cervical Screening? Many people believe that cervical screening is a test for cervical cancer. In reality, the primary purpose of cervical screening is prevention. The NHS Cervical Screening Programme first checks for the presence of high-risk strains of Human Papillomavirus (HPV), a common virus that most sexually active people will encounter at some point in their lives. If high-risk HPV is detected, the sample is then examined for abnormal cervical cell changes. Identifying and monitoring these changes allows treatment to be provided before cancer develops. This preventative approach has significantly reduced rates of cervical cancer across the UK. Why Is Cervical Screening Important? Cervical abnormalities often develop without causing any symptoms. This means that many women feel completely well while changes are occurring within the cervix. Regular cervical screening can: Detect high-risk HPV infection Identify abnormal cervical cell changes early Reduce the risk of cervical cancer developing Provide reassurance when results are normal Support long-term gynaecological health Attending routine cervical screening appointments remains one of the most effective ways to protect your health, even if you have no symptoms. Why Do Women Avoid Cervical Screening? Many women feel anxious about cervical screening, and these concerns are completely understandable. Common reasons for delaying a smear test include: Fear of discomfort or pain Embarrassment Previous difficult experiences Anxiety about the results Lack of time Believing screening is unnecessary if symptoms are absent Healthcare professionals perform cervical screening every day and understand that intimate examinations can feel uncomfortable or worrying. If you feel anxious, it is important to discuss your concerns before the appointment so adjustments can be made to help you feel more comfortable. Cervical Screening During Perimenopause and Menopause For women approaching menopause or experiencing menopause, cervical screening can sometimes feel more uncomfortable than it did previously. Declining oestrogen levels can lead to: Vaginal dryness Increased tissue sensitivity Vaginal atrophy Discomfort during intimate examinations Fortunately, there are several ways to improve comfort during cervical screening. These may include: Discussing concerns with the clinician beforehand Requesting a smaller speculum where appropriate Asking for extra time during the appointment Using vaginal oestrogen treatment for several weeks before the test if clinically suitable Many women find that treating vaginal dryness significantly improves their screening experience. Symptoms That Should Never Be Ignored Although cervical screening is designed to detect changes before symptoms develop, certain symptoms should always be assessed by a healthcare professional. Seek medical advice if you experience: Unexplained bleeding between periods Bleeding after sexual intercourse Bleeding after menopause Unusual vaginal discharge Persistent pelvic pain or discomfort These symptoms do not necessarily indicate cervical cancer, but they should always be investigated promptly. Prioritising Preventative Women's Healthcare Cervical Screening Awareness Month highlights the importance of preventative healthcare. A cervical screening appointment typically takes only a few minutes but can have a significant impact on your long-term health and wellbeing. Regular cervical screening remains one of the most effective tools available for cervical cancer prevention. Early detection of HPV and abnormal cervical cells allows treatment to take place before more serious problems develop. At Bristol Menopause Clinic, we encourage all women to prioritise routine health checks and seek support if concerns about menopause, vaginal dryness, or previous experiences are preventing them from attending cervical screening appointments. Your health matters, and prevention remains one of the most powerful tools in modern healthcare. References NHS Cervical Screening Programme Jo's Cervical Cancer Trust World Health Organization (WHO) 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 ADHD, Autism, and Women in Menopause HRT, Menopause Advice, Mental Health, Self-Care For women navigating ADHD or autism during menopause, a comprehensive approach that includes medical, psychological, and lifestyle interventions can offer significant relief and improve quality of life. It can be a lonely time especially at menopause when symptoms can worsen significantly, and it may be a shock to have a diagnosis of ADHD or autism whilst trying to navigate through menopause. ADHD (Attention Deficit Hyperactivity Disorder) and autism spectrum disorders (ASD) are neuro-developmental conditions that can affect individuals across the lifespan, including women. These conditions are characterised by distinct patterns in behaviour, communication, interaction, and cognitive functioning. While historically these diagnoses have been more commonly identified in men and boys, increasing awareness and understanding have highlighted that women and girls are also significantly affected, often with unique presentation and challenges. ADHD and autism in women ADHD in women often presents differently than in men. Women with ADHD may experience more inattentiveness, internal restlessness, and disorganisation, rather than the more overt hyperactivity and impulsivity often seen in boys. These differences can make ADHD in women less noticeable to parents, teachers, and even healthcare professionals, leading to under diagnosis. Autism in women and girls often manifests as differences in social communication and interaction, along with restricted, repetitive patterns of behaviour, interests, or activities. Women and girls with autism might be better at masking or camouflaging their difficulties, making their struggles less apparent to others. This ability to mask, while helping them to navigate social situations, can delay diagnosis and lead to internal stress, anxiety, and depression. Why do women get a late diagnosis? Many women with ADHD or autism are diagnosed late, often in adulthood, for several reasons: Stereotypes and Bias: There's a historical bias toward identifying these conditions primarily in boys, based on more visible and disruptive behaviours, leading to a lack of awareness and understanding of how they present in girls and women. Masking and Compensation: Women are often more adept at masking symptoms or developing compensatory strategies to manage their difficulties, which can hide the underlying condition. Comorbidity: ADHD and autism in women are often accompanied by other conditions like anxiety, depression, and eating disorders, which can complicate the clinical picture and lead to misdiagnosis. Why do symptoms worsen during menopause? The hormonal changes during menopause can exacerbate symptoms of ADHD and autism. Oestrogen, in particular, plays a crucial role in brain function, and its fluctuation can impact mood, memory, and cognitive function, worsening the symptoms of these neuro-developmental conditions. Hormone Replacement Therapy (HRT) and other supports HRT can be beneficial for some women during menopause, including those with ADHD or autism, by stabilising hormone levels and potentially mitigating some of the exacerbated symptoms related to these conditions. However, the decision to use HRT should be made on an individual basis, considering the potential benefits and risks. Additional strategies to help women during this time Education: Learning about how ADHD and autism intersect with menopause can empower women to seek appropriate support and accommodations. Structured Support: Therapy, including cognitive behavioural therapy (CBT), can help in developing strategies to manage symptoms more effectively. Medication: For ADHD, medication might be adjusted during menopause under medical guidance to better manage symptoms. Lifestyle Changes: Regular physical activity, a balanced diet, and sufficient sleep can help manage symptoms of both menopause and ADHD/autism. Social Support: Connecting with others going through similar experiences, through support groups or online communities, can provide emotional support and practical advice. For women navigating ADHD or autism during menopause, a comprehensive approach that includes medical, psychological, and lifestyle interventions can offer significant relief and improve quality of life. It can be a lonely time especially at menopause when symptoms can worsen significantly, and it may be a shock to have a diagnosis of ADHD or autism whilst trying to navigate through menopause. 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

A comprehensive menopause guide covering symptoms, perimenopause, HRT options, lifestyle strategies and expert advice to help you understand and manage midlife hormonal changes with confidence. Menopause Guide Request Menopause Guide Please take a moment to fill out the form. First Name Last Name Email I agree to be added to mailing list Submit Click here to download Menopause Guide

Menopause support packages including follow-up consultations, blood testing, hormone therapy optimisation and lifestyle advice for safe, structured long-term care. Ongoing Menopause Support Standard Plan 3 month review & Hormone Profile Blood Test 6 month review 12 month review & Hormone Profile Blood Test £53.65 per month, saving of 10% over 12 months Book here Please note: Our support packages are available for existing patients only. If you have not yet had your initial consultation, please ensure this is completed before signing up for any support package. Premium Plan 3 month review & Hormone Profile Blood Test 6 month review 9 month review & Hormone Profile Blood Test 12 month review £66 per month, saving of 10% over 12 months Book here Please note: Our support packages are available for existing patients only. If you have not yet had your initial consultation, please ensure this is completed before signing up for any support package. Platinum Plan 3 month review & Hormone Profile Blood Test 6 month review 9 month review & Hormone Profile Blood Test 12 month review & Ultimate Wellwoman Blood Test £87.75 per month, saving of 10% over 12 months Book here Please note: Our support packages are available for existing patients only. If you have not yet had your initial consultation, please ensure this is completed before signing up for any support package. What’s Included in Your 30-Minute Review Appointment: Progress Review with Your Menopause Doctor A detailed check-in to assess how you’ve been feeling since your initial consultation. We’ll review any symptoms, treatment effectiveness, and lifestyle changes. Treatment Adjustments if Necessary Based on your feedback and progress, we’ll adjust your treatment plan, whether it involves medication changes, lifestyle recommendations, or further investigations. Ongoing Support and Advice Receive expert guidance on any new symptoms or concerns that may have arisen, helping you continue managing menopause with confidence. Private Prescribing (if needed) If there’s a need for further medications, such as hormone therapy adjustments or new prescriptions, they will be issued during the consultation, ensuring you have the care you need without delay. Letter to Your GP A summary letter will be sent to your GP, outlining your progress and any changes to your treatment plan, ensuring seamless continuity of care. What's included in your Blood Tests: Ultimate WellWoman Blood Test Full Blood Count: Kidney and Electrolytes Liver Function Lipids and Metabolic Markers Diabetes and Insulin Thyroid Function Vitamins and Nutrients Inflammatory Markers Hormone Profile Basic Hormone Profile Oestradiol Testosterone Sex Hormone Binding Globulin (SHBG)

Download our GSM guide for expert advice on Genitourinary Syndrome of Menopause, including symptoms, treatment options and vaginal health support. Understanding Genitourinary Syndrome of Menopause Request GSM Guide Please take a moment to fill out the form. First Name Last Name Email I agree to be added to mailing list Submit Click here to download GSM GUIDE