< 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

Menopause Research, Menopause Studies, Hormone Therapy Research, Midlife Health, Evidence-Based Menopause Care, Clinical Projects Women’s Health, Menopause Publications, Medical Team Research, Women’s Health Research Bristol Research Dr Jo Burgin | Honorary researcher at the University of Bristol At Bristol Menopause Clinic, we are committed to advancing women’s health through evidence-based practice, innovation, and collaboration. Our clinical lead, Dr Jo Burgin, plays a central role in this mission. About Dr Jo Burgin Dr Jo Burgin is a Clinical Lead at Bristol Menopause Clinic and an Honorary Researcher at the University of Bristol. Her academic work focuses on menopause and midlife women’s health, with a particular interest in improving diagnosis, access to care, and the lived experience of women going through hormonal transition. Jo’s dual role in both clinical practice and academic research allows her to bridge the gap between real-world patient experience and emerging scientific evidence. Her research contributes to shaping better understanding, treatment, and support for women across the UK and beyond. Mental health consultations during the perimenopausal age range: a qualitative study of GP and patient experiences British Journal of General Practice | 7 October 2025 Research Paper Factors affecting shared decision-making concerning menopausal hormone therapy Annals of the New York Academy of Sciences | 17 July 2024 Research Paper Helping women prepare for menopause British Journal of General Practice | July 2024 Research Paper Towards a more accurate global picture of perimenopause Bull World Health Organ | 2024 Research Paper Factors affecting shared decision-making concerning menopausal hormone therapy Annals of the New York Academy of Sciences | 17 July 2024 Research Paper Helping women prepare for menopause British Journal of General Practice | July 2024 Research Paper

< Back Why Perimenopause Symptoms Vary So Much And What You Can Do About It Perimenopause symptoms can be confusing and unpredictable. Learn why they vary so much and discover practical, specialist-approved strategies to feel more in control. Why Perimenopause Symptoms Vary So Much - And What You Can Do About It Perimenopause is different for every woman and if your symptoms feel unpredictable, you're not alone. Some experience sudden anxiety, others struggle with sleep, while many notice brain fog, low mood or heavy, erratic periods. The truth is: there is no “typical” perimenopause. And that’s why so many women feel lost. At Bristol Menopause Clinic, we see this every day and we want you to feel informed and supported, not overwhelmed. Why Symptoms Vary So Much Perimenopause isn’t caused by low hormones it’s caused by fluctuating hormones. Oestrogen can rise one week and crash the next, leaving your brain, mood, and body struggling to keep up. This can lead to: Weeks of high anxiety followed by weeks of low energy Periods that alternate between heavy, light or absent Sleep that feels fine one month and terrible the next Increasing sensitivity to stress and blood sugar dips It’s not you. It’s your hormones and it is treatable . Practical Ways to Feel Better 1. Track your symptoms weekly A weekly diary identifies patterns and helps your clinician tailor your treatment. 2. Stabilise your blood sugar Eat protein at each meal and prioritise complex carbs later in the day. 3. Move daily A 30-minute brisk walk can improve mood, energy and reduce hot flushes. 4. Don’t wait for symptoms to worsen Specialist support early on can prevent years of unnecessary suffering. When to Seek Help If symptoms are affecting your daily life, relationships, work, sleep, confidence it’s time for a specialist review. You deserve to understand what’s happening and regain control. Ready to take back control of your perimenopause? Book your personalised consultation at Bristol Menopause Clinic today. 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 Navigating Menopause in Shift Work & Irregular Schedules If you work night shifts or irregular hours and you’re going through menopause, you might be feeling doubly exhausted. Hot flushes, night sweats, mood changes and poor sleep are difficult at the best of times and even more challenging when your body clock is constantly shifting Circadian Rhythms & Menopause Your body relies on a 24-hour clock, known as the circadian rhythm, to regulate sleep, hormones, and energy. Irregular work patterns can disrupt this rhythm and worsen menopausal symptoms such as: Sleep disturbances Low mood or anxiety Brain fog Hot flushes or night sweats Tips for Managing Symptoms Create a wind-down routine after night shifts: use blackout curtains, earplugs, and maintain a consistent sleep schedule when possible. Stay cool : Layer breathable sleepwear and keep your sleeping area ventilated. Hydrate and nourish : Night shifts can lead to skipped meals or caffeine overload. Keep balanced snacks on hand. Try CBT-I : Cognitive Behavioural Therapy for Insomnia can be particularly helpful for sleep issues. Hormone Therapy Considerations If you're considering HRT, timing your doses to suit your work patterns can help. For example, using a transdermal patch or gel in the morning after a night shift may align better with your sleep schedule. Always discuss personalised options with your prescriber. Menopause in shift work doesn’t have to be unmanageable. With lifestyle adjustments and the right clinical support, you can take back control. If your work schedule is affecting your menopause journey, our team is here to support you with tailored advice and treatment. Get in touch with Bristol Menopause Clinic today. 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

Dedicated menopause and women’s health support for Bristol City Council staff. Access expert consultations, hormone advice, health screening and workplace wellbeing services from Bristol Menopause & Wellwoman Clinic. Bristol City Council In Partnership with Bristol Menopause & Wellwoman Clinic We are committed to prioritising women’s health in the workplace, creating a supportive environment where every woman feels valued, empowered, and cared for! Exclusive 15% off Initial Consultations Initial Menopause Consultation Your consultation will include: Health assessment Review current lifestyle Provide advice and guidance on treatment options Prescribe appropriate treatments Discuss supplements and lifestyle changes Personalised management plan Letter Informing GP of consultation £216.75 Book here Initial Testosterone Consultation Your review will include: Review Current Symptoms & Assess Needs Review Health Assessment Review Current Lifestyle Adjust Treatment if Necessary & Prescribe Update Your GP Personalised management plan Please note: A blood test will be required to assess current testosterone levels and ensure that the therapy is suitable for you, at an additional charge of £110. £216.75 Book here

< Back The Benefits of Joining a Menopause Support Group Menopause Advice, Perimenopause, Post Menopause, Self-Care, Wellbeing Menopause is a significant life transition that can bring about a variety of physical and emotional changes. While the experience is different for every woman, one thing remains the same: having a strong support system can make a world of difference. Menopause support groups provide a safe and understanding environment where women can share their experiences, gain insights, and receive both emotional and practical help. In this blog post, we’ll explore the key benefits of joining a menopause support group and why it could be the perfect solution for navigating this important phase of life. 1. Emotional Support and Shared Understanding One of the biggest benefits of joining a menopause support group is the emotional support it provides. Menopause can often feel isolating, especially if those around you aren’t experiencing the same symptoms or challenges. In a support group, you’ll connect with women who are going through similar experiences and truly understand what you’re dealing with. Why It Matters : Having a community where you can share your frustrations, fears, and even your successes can be incredibly empowering. When you realise that others are experiencing the same things, it helps to normalise the process and reduce feelings of loneliness or anxiety. This emotional support is crucial for managing stress and maintaining mental well-being during menopause. 2. Access to Expert Knowledge and Resources While family and friends can offer comfort, they may not always have the specialised knowledge to help you manage your symptoms. A high-quality menopause support group often includes access to health professionals who specialise in menopause and other experts who can provide reliable, evidence-based information on managing your symptoms. What to Expect : Many groups offer expert-led discussions, webinars, or Q&A sessions that cover everything from hot flashes and mood swings to hormone replacement therapy (HRT) and alternative treatments. Having access to expert knowledge can help you make informed decisions about your health and explore a variety of treatment options to suit your personal needs. 3. Practical Tips for Managing Symptoms Menopause symptoms like night sweats, fatigue, and irritability can make daily life challenging. Support groups are an excellent place to learn practical strategies for managing these symptoms. Group members often share their own experiences and what has worked for them, from lifestyle changes to natural remedies. Practical Advice : Dietary changes : Learn how certain foods can help manage hot flashes and other symptoms. Exercise tips : Discover what types of exercise are most beneficial for maintaining energy levels and bone health. Sleep hygiene : Get advice on improving sleep quality to reduce fatigue. These practical tips can empower you to take control of your symptoms and improve your overall quality of life during menopause. 4. A Sense of Community and Belonging The sense of community that comes from being part of a support group is invaluable. You’ll meet women from different walks of life, all coming together to support and learn from one another. This feeling of belonging can help you build strong, lasting relationships that extend beyond the support group itself. Why It’s Important : Feeling connected to others can improve your mood, reduce stress, and even enhance your physical health. In a support group, you’ll be part of a community where everyone is on the same journey, working together to navigate the challenges of menopause. Many women find lifelong friendships through these groups, which offer companionship, encouragement, and understanding. Up-to-Date Information on Menopause Treatments Menopause is an ever-evolving field of research, and staying informed about new treatments, studies, and lifestyle strategies is essential. A menopause support group can be a valuable resource for keeping up with the latest scientific research and recommendations on how to manage your symptoms effectively. Why It Helps : Whether you’re interested in hormone replacement therapy, alternative treatments, or lifestyle changes, being part of a group allows you to stay on top of the newest developments. Many support groups offer access to guest speakers, articles, and workshops that provide insights into managing menopause from both a medical and holistic perspective. Final Thoughts Navigating menopause can be tough, but you don’t have to do it alone. Joining a menopause support group offers a wealth of benefits, including emotional support, expert advice, practical tips, and a strong sense of community. These groups provide a safe and understanding space where you can share your experiences and learn from others who are going through the same journey. If you’re feeling overwhelmed or just want to connect with women who understand what you’re experiencing, consider joining a menopause support group. The connections you make and the advice you gain could be life-changing, helping you feel more empowered and informed during this important time of life. 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 Is It Burnout or Perimenopause? How to Spot the Difference Understanding the overlap and the key differences between stress burnout and hormonal change You’re exhausted. You can’t concentrate. Your mood is all over the place. Sleep is elusive, and your motivation has taken a nosedive. Is it burnout from the constant juggle of work, home, and life? Or is it perimenopause your body’s natural hormonal transition that can start in your 40s (or even earlier)? For many women, the symptoms look and feel alarmingly similar, and it can be hard to know what’s really going on. The good news? You’re not imagining it. And with the right knowledge, you can get the right support. At Bristol Menopause Clinic, we see this overlap all the time. Here’s how to start untangling the signs of burnout from perimenopause and why it matters. What Is Burnout? Burnout is a state of chronic stress that leads to emotional, physical, and mental exhaustion. It’s common in women who are juggling multiple roles career, caregiving, parenting, or managing a household. Common symptoms of burnout include: Constant fatigue, even after rest Difficulty concentrating (brain fog) Feeling emotionally drained or detached Low mood, anxiety, or irritability Trouble sleeping Physical symptoms like headaches, gut issues, or frequent illnesses Burnout is often triggered by external pressures but it’s not just “in your head.” Your stress hormones, particularly cortisol, are often out of balance. What Is Perimenopause? Perimenopause is the transitional phase before menopause, when hormone levels especially oestrogen and progesterone start to fluctuate. This stage can begin anywhere between your late 30s and mid-40s and may last several years before periods stop completely. Common symptoms of perimenopause include: Irregular periods or heavier bleeding Hot flushes and night sweats Mood swings, anxiety, or low mood Fatigue and brain fog Poor sleep Vaginal dryness, urinary changes, or reduced libido New onset of joint aches or weight gain around the middle Sound familiar? That’s because there’s often significant overlap with burnout. Why It’s Easy to Confuse the Two Burnout and perimenopause both affect the nervous system, sleep patterns, mental clarity, and emotional wellbeing. And in many cases, they co-exist making symptoms worse. You might be burning the candle at both ends and navigating shifting hormones without realising it. Adding to the confusion, blood tests in perimenopause are often normal, especially if taken at the wrong time in your cycle. And burnout isn’t always “diagnosed” as a medical condition. That’s why a holistic health check is so important. Key Questions to Ask Yourself To help differentiate (or spot both), consider: Are my periods changing? If your cycle is irregular, heavier, or different than usual, this could indicate perimenopause. Did my symptoms come on after a period of extreme stress or pressure? If yes, burnout might be the primary driver. Do I feel physically hot, get night sweats, or feel flushed? These are classic signs of hormone shifts—not typically seen in burnout. Am I getting recurring infections, gut issues, or low immunity? This could point to long-term stress and adrenal dysfunction. Do I feel like I’m not myself even though nothing specific is ‘wrong’? This is a hallmark of both don’t ignore it. What You Can Do About It Whether it’s burnout, perimenopause, or both you deserve support. Here’s how to start: 1. Talk to Your GP or a Menopause Specialist Don’t downplay your symptoms. Keep a diary, ask about hormone changes, and explore HRT if appropriate. 2. Address Stress & Burnout Prioritise rest, say no where you can, and get help if you’re overwhelmed. Cognitive Behavioural Therapy (CBT), journaling, and stress management tools can make a big difference. 3. Nourish Your Body Midlife is not the time to under-eat or overwork. Choose whole foods, support your gut, and balance blood sugar with protein-rich meals. ️ 4. Move Gently, But Consistently Exercise helps regulate hormones, boost mood, and reduce stress but overtraining can backfire. Find the right pace for you . 5. Prioritise Sleep Like It’s Medicine Create a wind-down routine, reduce screen time, and consider magnesium, CBT-i strategies, or HRT if sleep issues persist. You’re Not Broken—You’re Evolving Whether you’re facing burnout, perimenopause, or both, the most important thing is this: You are not alone, and you are not weak. These are real, valid, and treatable challenges. At Bristol Menopause Clinic, we’re here to help you untangle the symptoms, explore your options, and find a path forward that works for you . Because midlife should be a time of power not survival. 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

Book an initial testosterone consultation to assess low libido, fatigue, brain fog and mood changes with expert hormone testing and tailored treatment planning. Initial Testosterone Consultation Package Overview | £245 This 45-minute consultation is designed for women already on a stable Hormone Replacement Therapy (HRT) plan who are considering testosterone supplementation to further optimise their health during menopause. The session is tailored to provide a comprehensive understanding of the role of testosterone in menopause, how it can be beneficial, and how it integrates with an existing HRT plan. What’s Included: Detailed Consultation: A thorough discussion about testosterone therapy, its uses, and how it can improve symptoms commonly experienced during menopause such as fatigue, low libido, mood swings, and decreased muscle mass. Private Prescriptions: If appropriate, your GP will provide a private prescription for testosterone to address your specific needs. Follow-up GP Letter: After the consultation and blood test results, a detailed letter from the GP will be sent outlining the recommendations and treatment plan, including any follow-up or adjustments to your HRT. Book here **Blue Light Card holders receive 15% off initial consultations; a valid card must be shown at the appointment.** Benefits of the Appointment: Improved Energy and Vitality: Testosterone therapy can help reduce fatigue and increase energy levels, supporting overall well-being and enhancing day-to-day functionality. Enhanced Libido: Testosterone supplementation has been shown to improve sexual desire and response, which can be impacted by hormonal changes during menopause. Mood Stabilisation: Many women report improvements in mood and a reduction in irritability, anxiety, and depressive symptoms with testosterone supplementation. Increased Muscle Strength and Mass: Testosterone helps maintain muscle strength, tone, and bone health, which can be affected during menopause, promoting overall physical health and fitness. Cognitive Clarity and Mental Sharpness: Testosterone may help improve memory, focus, and mental clarity, often helping women feel more cognitively sharp and alert. Holistic Menopause Management: This appointment is a comprehensive part of managing your menopause symptoms, helping to ensure a balanced hormonal approach for both short-term relief and long-term health benefits. £245* * 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

< Back HRT Explained: What the Latest Guidelines Really Say (2025 Update) HRT Confused about HRT? Get clear, evidence-based guidance on safety, dosing, benefits, and who is eligible according to the 2025 BMS and NICE updates. HRT Explained: What the Latest Guidelines Really Say (2025 Update) HRT is one of the most misunderstood treatments in women’s health. Many women are unsure whether it’s safe, whether they’re “allowed” it, or which type they need. Here’s the good news: the latest BMS and NICE guidelines confirm that HRT is safe and effective for most women under 60. Let’s break it down simply, clearly, and with zero scaremongering. H2: Key Facts Every Woman Should Know 1. Transdermal oestrogen is the safest option This includes patches and gels and carries the lowest clot risk. 2. Micronised progesterone is body-identical It is usually much better tolerated and has a favourable safety profile. 3. Testosterone can help some women It supports libido, energy and cognition in women with low levels. 4. A family history of breast cancer doesn’t always mean “no HRT” Most women can still use HRT safely with the right guidance. Practical Tips for Using HRT Well Apply gels/patches at consistent times Don’t be afraid of adjusting the dose - “low dose” isn’t always enough Review your treatment every 6–12 months Always use progesterone if you have a uterus Not sure which HRT is right for you? Book your HRT review with Bristol Menopause Clinic and get a personalised treatment plan. 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

Explore our women’s health services including menopause, PCOS, PMDD and POI consultations, hormone therapy, health screening, testosterone support and personalised midlife care. Our Services 20% OFF Platinum Wellwoman Check * 15% OFF Cervical Screening * 15% OFF Iron Infusion Treatment Package * Wellwoman Checks Access here Menopause Care Access here Testosterone Therapy Access here Premature Ovarian Insufficiency (POI) Access here PCOS/PMOS Access here Premenstrual Dysphoric Disorder (PMDD) Access here Blood Test Access here Iron Infusion Treatment Package Access here Coil IUD Access here Sexual Health Access here Prescriptions Access here Gift Vouchers Access here

Read the Terms and Conditions for our clinic services, appointments, payments, cancellations, and patient responsibilities. Terms & Conditions 1. Appointment Booking and Cancellation Policy: a. Booking Appointments: We welcome you to Bristol Menopause & Wellwoman Clinic, where we prioritise your health and well-being. To book an appointment, please contact our clinic through phone, email, or our website. b. Cancellation Policy: We understand that unforeseen circumstances may arise. If you need to cancel or reschedule your appointment, kindly provide at least 48 hours' notice to allow us to accommodate other patients. Appointments cancelled within 48 hours will not be refunded. Appointments cancelled earlier than 48 hours will be refunded subject to a £25 administration charge. 2. Complaints Policy: a. Patient Feedback: We value your feedback and strive to provide the best possible care. If you have any concerns or complaints about your experience at Bristol Menopause & Wellwoman Clinic, please follow these steps: b. Informal Resolution: In most cases, concerns can be resolved informally by speaking with our clinic staff or the healthcare provider involved. We encourage open communication to address your concerns promptly. c. Formal Complaint: If you feel your concern has not been adequately addressed, you may submit a formal written complaint to our Clinic Manager. Please provide details of your complaint, including the date of the incident and the names of any staff members involved. d. Complaint Review: Upon receiving your formal complaint, we will conduct a thorough review of the matter. We aim to acknowledge your complaint within five working days and provide a comprehensive response within 20 working days. We will keep you informed throughout the process. 3. Urgent Medical Attention: a. Emergency Situations: In case of a medical emergency, please dial 999 or seek immediate assistance at the nearest hospital. Bristol Menopause & Wellwoman Clinic is not equipped to provide emergency medical care. b. Urgent Concerns: If you have an urgent medical concern related to your menopause or women's health treatment, please contact our clinic during regular office hours. We will make every effort to address your concern promptly. 4. Third-Party Suppliers: a. Referrals and Services: Bristol Menopause & Wellwoman Clinic may refer patients to third-party suppliers for specialised services or diagnostics, such as laboratory tests or imaging. These referrals are made in your best interest and to enhance your care. b. Terms and Conditions: When using services provided by thirdparty suppliers, patients are subject to the terms and conditions of those suppliers. Bristol Menopause & Wellwoman Clinic is not responsible for the actions or policies of third-party providers. 5. Privacy and Data Protection: a. Confidentiality: Your p ersonal and medical information will be handled with the utmost confidentiality and in compliance with data protection regulations. For more information, please refer to our Privacy Policy. 6. Changes to Terms and Conditions: a. Updates: Bristol Menopause & Wellwoman Clinic reserves the right to update these terms and conditions periodically. Any changes will be communicated to patients through our website or other appropriate means. By scheduling an appointment and receiving care at Bristol Menopause & Wellwoman Clinic, you acknowledge that you have read, understood, and agreed to these terms and conditions. Thank you for choosing Bristol Menopause & Wellwoman Clinic for your women's health and menopause care. We are committed to providing you with the highest standard of care and service. If you have any questions or require further clarification on any aspect of these terms and conditions, please do not hesitate to contact us

< Back Testosterone in Women: Symptoms, Decline & Why It Matters in Menopause Discover the role of testosterone in women, symptoms of low levels, and why it matters in perimenopause and menopause. Expert guidance from a menopause specialist. Testosterone is often incorrectly described as a “male hormone.” In reality, it plays a significant and well-established role in female physiology across the lifespan. Despite this, its clinical relevance in women remains under-recognised, particularly in the context of perimenopause and menopause. This article, the first in a two-part series, outlines: The physiological role of testosterone in women The causes and timing of decline The clinical features associated with reduced levels The second article will address assessment, diagnosis, and prescribing within current UK guidance. Androgen Function and Clinical Relevance Testosterone is an androgen and represents the most abundant biologically active steroid hormone in women during both reproductive and post-reproductive life.¹ It is produced by: The ovaries The adrenal glands Peripheral conversion in tissues including adipose Testosterone exerts its effects through: Direct binding to androgen receptors Conversion to oestradiol via aromatisation Androgen receptors are widely distributed, including in: Central nervous system Bone and skeletal muscle Cardiovascular tissue Skin and hair follicles Vulvovaginal and urogenital tissues This distribution underpins the broad clinical impact of testosterone in women. Clinical Features of Low Testosterone in Women Reduced testosterone levels may present with a constellation of symptoms affecting multiple domains: Reduced sexual desire, arousal, and response Persistent fatigue and reduced motivation Low mood and diminished emotional resilience Impaired concentration, memory, and cognitive function Loss of muscle strength and reduced physical performance Reduced bone mineral density Changes in skin integrity, hair quality, and joint health Vulvovaginal and urogenital symptoms The 2019 Global Consensus Position Statement (endorsed by the British Menopause Society and other international bodies) identifies hypoactive sexual desire disorder (HSDD) as the primary evidence-based indication for testosterone therapy in women.³ However, in clinical practice, presentations are frequently multifactorial and extend beyond sexual function alone. Timing and Causes of Testosterone Decline Testosterone levels decline progressively from the late twenties onwards .⁴ While gradual, several factors may accelerate or exacerbate this reduction: Perimenopause and Menopause The most common cause of clinically significant androgen decline, reflecting changes in ovarian function. Surgical Menopause Bilateral oophorectomy results in an abrupt reduction of approximately 50% of circulating testosterone , often associated with significant symptom burden. Combined Oral Contraceptive Use Suppression of ovarian androgen production Increased Sex Hormone Binding Globulin (SHBG) Reduced free (bioavailable) testosterone Chronic Stress Sustained cortisol elevation may impact androgen synthesis and availability. Endocrine Disorders Including hypothyroidism and hyperprolactinaemia. Medications Including: Antidepressants Antihypertensives Long-term corticosteroids Surgical Menopause: A Clinical Gap Women undergoing surgical menopause experience a sudden and substantial reduction in androgen production . Despite this, testosterone replacement is not routinely incorporated into standard management alongside oestrogen and progesterone.⁷ This may contribute to persistent symptoms such as: Fatigue Reduced libido Mood disturbance Cognitive changes This remains an area where clinical awareness and practice continue to evolve. Relevance in Perimenopause and Menopause Hormone Replacement Therapy (HRT) effectively addresses many symptoms related to oestrogen deficiency, including: Vasomotor symptoms Sleep disturbance Vaginal dryness However, some women report ongoing symptoms despite appropriate oestrogen therapy, including: Reduced libido Persistent fatigue Cognitive symptoms Reduced sense of wellbeing In such cases, androgen insufficiency may be a contributing factor. Clinical Importance The focus of women’s hormonal health has traditionally centred on oestrogen. While appropriate, this approach does not fully reflect the complexity of endocrine physiology. The evidence base supporting testosterone therapy in women has expanded , with international consensus recognising its role within defined clinical indications.³ However: Awareness among patients remains limited Training in prescribing testosterone for women is variable Access to specialist assessment is inconsistent Next Steps The second article in this series will address: Clinical assessment of suspected androgen insufficiency Appropriate use of blood testing Prescribing considerations in line with NICE and British Menopause Society guidance Monitoring and safety Testosterone is a physiologically important hormone in women, with effects across multiple systems. Declining levels, particularly during midlife or following surgical menopause, may contribute to a range of symptoms affecting quality of life. Recognition of its role is essential to ensure a comprehensive and evidence-based approach to women’s 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