Menopause and HRT: Private Doctor Consultations in London
Menopause affects every woman, yet many find that their NHS GP appointment does not allow enough time to properly discuss the wide-ranging symptoms, explore treatment options, weigh up the individual risks and benefits of HRT, and develop a personalised management plan. The Online GP by The Wellness provides private menopause consultations from £79 at our Marylebone clinic, giving you the time, expertise, and personal attention that menopause care deserves. Our GMC-registered doctors assess your symptoms across all affected systems, offer hormone testing where appropriate, prescribe the full range of HRT formulations, and provide ongoing monitoring and support. Approximately 13 million women in the UK are currently perimenopausal or post-menopausal (Menopause Charity, 2025), and the demand for accessible, thorough menopause care has never been greater.
Book a Menopause Consultation - WhatsApp | Email: team@thewellnesslondon.com | Call: 020 3951 3429
Why Private Menopause Care Makes a Difference
The average NHS GP consultation lasts 9.6 minutes. Menopause, with its potential to affect sleep, mood, cognition, joints, skin, sexual function, cardiovascular health, bone density, weight, and urinary function, cannot be adequately addressed in this time. Many women describe feeling dismissed, being told their symptoms are "just stress" or "normal ageing," or being offered antidepressants when HRT would be more appropriate.
A private menopause consultation at The Online GP by The Wellness takes 20 to 30 minutes as standard, with the flexibility to extend if needed. Your doctor reviews your symptoms across every affected system, takes a detailed medical and family history relevant to HRT prescribing decisions (breast cancer history, cardiovascular risk, clotting history), discusses all treatment options thoroughly (not just HRT, but also non-hormonal approaches and lifestyle modifications), answers your questions without time pressure, and develops a management plan that is genuinely personalised to your individual situation.
Understanding Your Symptoms
Perimenopause and menopause are not just hot flushes. The decline in oestrogen affects receptors throughout the body, producing symptoms that many women and, unfortunately, many doctors do not immediately connect to hormonal change.
Vasomotor symptoms (hot flushes, night sweats) are the most recognised, affecting approximately 75% of menopausal women. They can range from mild and infrequent to severe and debilitating, disrupting sleep, work, and social life.
Psychological symptoms (anxiety, low mood, irritability, tearfulness, loss of confidence, brain fog, difficulty concentrating) affect a significant proportion of women and are among the most distressing. These are frequently misdiagnosed as depression or generalised anxiety disorder. While antidepressants have a role in some cases, HRT is the more appropriate first-line treatment when symptoms are driven by hormonal change (NICE NG23).
Musculoskeletal symptoms (joint stiffness, muscle aches, frozen shoulder) are increasingly recognised as menopause-related. Oestrogen has anti-inflammatory properties, and its decline contributes to joint and muscle symptoms.
Urogenital symptoms (vaginal dryness, painful intercourse, recurrent UTIs, urinary urgency and frequency) are caused by genitourinary syndrome of menopause (GSM), a direct consequence of oestrogen decline in the vaginal and urinary tract tissues. These symptoms do not improve without treatment and often worsen over time. Topical vaginal oestrogen is highly effective and carries minimal systemic risk.
Cardiovascular changes. Oestrogen has protective effects on blood vessels and cholesterol levels. After menopause, cardiovascular risk in women rises significantly, eventually matching that of men. Heart disease is the single biggest killer of women in the UK (British Heart Foundation, 2025). Early HRT (within 10 years of menopause) may reduce cardiovascular risk.
Bone health. Oestrogen maintains bone density. After menopause, bone loss accelerates, increasing the risk of osteoporosis and fractures. HRT is one of the most effective treatments for preventing post-menopausal bone loss.
HRT: Your Options
HRT replaces the oestrogen (and, if you have a uterus, the progesterone) that your body is no longer producing in sufficient quantities. There is no single "best" HRT. The right choice depends on your symptoms, your medical history, your risk profile, and your personal preferences.
Oestrogen delivery methods. Transdermal oestrogen (patches, gels, or sprays applied to the skin) is generally preferred over oral tablets because it carries a lower risk of blood clots and is metabolised differently, avoiding the first-pass effect through the liver. Oral tablets remain an option for women who prefer them and have no elevated clotting risk. Vaginal oestrogen (creams, pessaries, or rings) is used specifically for urogenital symptoms and can be used alongside systemic HRT or on its own.
Progesterone. Required alongside oestrogen for women who have a uterus, to protect the endometrial lining from thickening. Micronised progesterone (Utrogestan) is the body-identical option preferred by many women and doctors, associated with a lower breast cancer risk than older synthetic progestogens. It can be taken cyclically (12 to 14 days per month) or continuously depending on your stage of menopause.
Testosterone. Not routinely prescribed but can be considered for women with persistent low libido that has not improved with oestrogen replacement alone. Prescribed off-label in the UK (there is no testosterone product specifically licensed for women). Your doctor will discuss the evidence and monitor levels if prescribed.
At The Online GP by The Wellness, your doctor will explain all options, discuss the evidence for each, and recommend a starting regimen. Follow-up appointments (typically at 3 months, then 6 to 12 monthly) monitor your response, manage any side effects, and adjust the dose or formulation as needed.
Start Your Menopause Consultation - WhatsApp
Blood Tests and Monitoring
Before starting HRT, your doctor may recommend baseline blood tests including FSH and oestradiol (if the diagnosis is uncertain or you are under 45), thyroid function (thyroid disorders mimic many menopause symptoms), lipid profile (cholesterol, HDL, LDL, triglycerides), HbA1c (diabetes screening), full blood count, liver function, and vitamin D. These can all be done at our Marylebone clinic at the same appointment.
During HRT, monitoring appointments assess symptom improvement, check blood pressure, and may include repeat blood tests. The aim is to find the lowest effective dose that controls your symptoms and to adjust over time as your needs change.
Beyond HRT: Comprehensive Menopause Support
HRT is the most effective treatment for menopausal symptoms, but it is not the only tool available, and menopause management is most effective when approached holistically.
Cardiovascular risk assessment. Our Heart Health Scan at £495 (echocardiogram, carotid Doppler, AAA screening) combined with lipid and diabetes blood tests provides a thorough cardiovascular risk evaluation, particularly important for post-menopausal women whose risk profile is changing.
Bone health. Blood tests for calcium, vitamin D, and other bone markers. Referral for DEXA bone density scanning if osteoporosis risk is elevated.
Weight management. Menopause-related weight gain (particularly central adiposity) increases cardiovascular and metabolic risk. Our doctors can discuss dietary strategies, exercise recommendations, and medical weight management options (including GLP-1 medications for eligible patients).
Mental health support. If mood symptoms are significant, your doctor can provide assessment, prescribe appropriate medication, and refer to psychology or psychiatry services as needed.
Ultrasound. Pelvic ultrasound (from £195) is indicated if you experience post-menopausal bleeding (which always requires investigation), or if endometrial assessment is needed during HRT monitoring.
Book Your Appointment - WhatsApp | Email: team@thewellnesslondon.com | Call: 020 3951 3429
Frequently Asked Questions
Can I get HRT from your clinic? Yes. Full range of HRT including transdermal, oral, vaginal oestrogen, micronised progesterone, and testosterone where indicated.
Do I need blood tests? Not always for diagnosis (symptoms alone are sufficient over 45), but useful for baseline assessment and ruling out other causes. Available at the same appointment.
How much does it cost? Consultations from £79. HRT prescription included at no extra charge. Blood tests priced separately.
Is HRT safe? For most women, benefits significantly outweigh risks when started within 10 years of menopause. Your doctor conducts an individualised risk-benefit assessment.
Can I switch from NHS HRT to your clinic? Yes. Bring your current prescription and any recent blood results.
What symptoms does menopause cause? Hot flushes, night sweats, mood changes, brain fog, joint pain, sleep disturbance, vaginal dryness, recurrent UTIs, weight gain, palpitations, and many more. Proper assessment identifies which are menopause-related.
At what age should I consider HRT? Whenever symptoms affect your quality of life. Most women begin during perimenopause (typically mid-40s). For early menopause (under 45), HRT is strongly recommended.
The Online GP by The Wellness provides private doctor-led healthcare from our Marylebone clinic. All HRT prescribed by GMC-registered doctors in accordance with NICE NG23. Contact us on WhatsApp at +44 7961 280835, email team@thewellnesslondon.com, or call 020 3951 3429.
References
NICE. Menopause: diagnosis and management. NG23. Updated 2024.
British Menopause Society. HRT prescribing guidelines. Updated 2025.
The Menopause Charity. Menopause prevalence UK. Updated 2025.
British Heart Foundation. Women and heart disease. Updated 2025.
Royal Osteoporosis Society. HRT and bone health. Updated 2025.
