Menopause and HRT Assessment- Getting the Diagnosis and the Treatment Plan Right
Aug 2026
Menopause care in the UK has improved enormously in public awareness terms and has not always improved at the same pace in clinical practice, and the result is a common and frustrating pattern: symptoms dismissed as stress, a single hormone test used to rule perimenopause in or out when the diagnosis is actually clinical, and HRT started or withheld without a proper conversation about the individual risks and benefits involved. The Wellness runs menopause assessments from a £450 baseline consultation through to a £3,995 annual programme with ongoing physician oversight, bone density scanning and ongoing HRT titration across the year. Fees for every level appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Ask about a menopause assessment on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
Why a single hormone test often isn't the answer
Perimenopause is, for most women, a clinical diagnosis based on symptoms and age rather than a single blood test, because hormone levels fluctuate significantly during this stage and a normal result on one particular day does not rule out that you are in the middle of a genuine transition. This is exactly why a five-minute conversation that ends with "your bloods are normal, it's probably stress" is so often the wrong answer, and why a proper assessment starts with a genuine history, cycle changes, sleep, mood, hot flushes, joint pain, brain fog, and reads any hormone testing that is done in that context rather than as a stand-alone verdict.
What a proper assessment actually covers
The consultation itself is where most of the value sits, a genuine conversation about your symptoms, their impact on your life, your personal and family medical history, and any specific concerns or contraindications that shape whether HRT is appropriate and in what form. Where blood tests add value, oestrogen, FSH and LH alongside a full thyroid panel help build the picture, particularly in younger women or where the diagnosis is genuinely unclear, and a broader cardiovascular and metabolic check makes sense given how significantly cardiovascular risk shifts around menopause. Bone health deserves specific attention too, since bone density loss accelerates during this transition, and a DEXA scan, where age or risk factors warrant it, catches this early enough to act on rather than after a fracture has already happened.
Ask what your assessment would actually include on WhatsApp or email team@thewellnesslondon.com.
HRT, decided properly rather than defaulted either way
The conversation about HRT should go in both directions, neither reflexively prescribing it nor reflexively withholding it, and should be built around your specific history, symptoms and risk profile rather than a generic policy applied to everyone. For most women, the benefits of HRT for symptom control and long-term bone and cardiovascular health outweigh the risks, particularly when started within ten years of menopause, but the right form, oestrogen alone or combined with progesterone, the route, tablet, patch or gel, and the dose are individual decisions that deserve proper discussion rather than a single default prescription. Once started, treatment is not a set-and-forget decision either. Follow-up review to assess symptom control, adjust dose where needed and monitor over time is what actually determines whether HRT delivers the benefit it is capable of, in the same way we set out in our guide to what health screening in London should really cost: the value is in the ongoing relationship with a doctor, not a single transaction.
What it costs in London
NHS menopause care varies considerably by area and can involve a wait for a specialist appointment that leaves symptoms unmanaged for months in the meantime, while some private providers offer a rushed consultation with a prescription handed over with little ongoing review. Neither extreme is what a genuinely well-run assessment looks like.
At The Wellness, all figures are from prices.
Menopause Baseline Assessment — a full history and symptom review, core hormonal and thyroid panel, and an initial treatment plan with a doctor, from £450.
Menopause Advanced Programme — the above plus a DEXA bone density scan, extended cardiovascular and metabolic screening, and a follow-up consultation to review and adjust your plan, from £950.
Menopause Longevity Programme — full biomarker profiling, DEXA bone density scanning, cardiovascular risk assessment and 12 months of ongoing physician oversight with HRT titration and review, from £3,995 per year.
Assessments are held in Marylebone, three minutes from Baker Street, with appointments available within the week.
Why The Wellness is the right clinic for this
Because menopause care done well is a relationship, not a single appointment, symptoms and treatment needs change over the years of this transition, and ongoing review is what actually keeps a treatment plan working rather than leaving you on a dose decided once and never revisited. Every assessment here starts with a genuine conversation rather than a single hormone test used as a verdict, and because The Wellness is a full clinic, bone density scanning, cardiovascular assessment and ongoing HRT management all happen through the same team rather than being scattered across different providers.
Frequently asked questions
Can perimenopause be confirmed with a single blood test?
Usually not on its own. For most women it is a clinical diagnosis based on symptoms and age, since hormone levels fluctuate significantly during this stage and a normal result on one day does not rule out a genuine transition.
Is HRT safe?
For most women, particularly when started within ten years of menopause, the benefits for symptom control and long-term bone and cardiovascular health outweigh the risks, but the right form, route and dose depend on your individual history and should be discussed properly rather than defaulted either way.
Do I need a bone density scan?
It is recommended where age, family history or other risk factors indicate raised risk, since bone density loss accelerates during the menopausal transition and is far easier to catch early than to reverse.
How often should HRT be reviewed once started?
Regular follow-up is recommended to assess symptom control, adjust dose where needed and monitor over time, since treatment needs can change as you move through the transition.
Do I need a GP referral?
No. You can book directly, and a doctor takes a full history and agrees the right assessment and, where appropriate, treatment plan with you.
The Wellness is a doctor-led private clinic in London. All doctors are GMC-registered. This article is general information and not a substitute for medical advice about your own health.
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