Menopause Frequently Asked Questions
What is Menopause?
Menopause refers to the stage in a woman's life characterised by symptoms stemming from fluctuating and declining hormone levels, ultimately leading to the cessation of monthly periods. Medically, menopause is defined as the day following 12 consecutive months without menstruation.
How is it Diagnosed?
According to the National Institute for Health and Care Excellence (NICE) menopause guidance, initial diagnosis of perimenopause can rely solely on symptoms for healthy women over 45, without the necessity for blood tests. This is because blood tests may yield unreliable results due to fluctuating hormone levels, providing only a snapshot rather than a comprehensive assessment. For those under 45, blood tests may be considered, but if symptoms strongly indicate menopause, they may not be required. Women under 40 who experience four months or more without periods or exhibit symptoms suggesting oestrogen deficiency may require at least two blood tests, spaced approximately four to six weeks apart, for a conclusive diagnosis. Further tests and specialist referral may follow if necessary.
Can My GP Prescribe Testosterone?
Testosterone replacement therapy is currently not licensed for use in women in the UK. However, based on recommendations from the local medication’s optimisation team, specialists may prescribe it "off license" for select women who meet specific criteria. This typically includes those experiencing early menopause (aged 45 and under) or surgical menopause (bilateral oophorectomy), and who continue to experience distressing symptoms of low libido despite optimised oestrogen and progesterone hormone replacement therapy (HRT), along with confirmed low free androgen index in blood tests. If you meet these criteria, you can discuss the option with your GP, who may refer you for further evaluation and potential ongoing prescription if deemed effective.