​This is the phase leading up to the menopause. Women may notice a change in their menstrual cycle which can become heavier or lighter, closer together or further apart. Hormone levels start to fluctuate and symptoms can very daily and weekly.

An early menopause is defined between the age of 40 and 45. Menopause under the age of 40 is known premature ovarian insufficiency (POI). This affects approximately 1 in 100 women under 40. Women with POI carry an increased risk of cardiovascular disease and osteoporosis. It is important that women with POI replace hormones to protect their long term future health.

Menopause is the general term used to describe a stage in a women's life when the ovaries stop produce eggs. This is defined when menstrual periods have stopped for 12 consecutive months. The average age in the UK is 51 years old. ​

The time in your life one day after the menopause when menstrual periods have stopped for 12 consecutive months. ​

Surgical menopause occurs when both ovaries have been surgically removed, known as bilateral oophorectomy. This leads to a sudden onset of menopausal symptoms due to a decrease in oestrogen and testosterone level. ​

Medical menopause occurs when ovarian function is disrupted or permanently changed due to medical treatment, e.g. radiotherapy, chemotherapy or treatment for some other medical conditions. There can also be other causes of an early or premature menopause

Hot flushes Difficulty sleeping Sweating at night Irritability Crying spells Low mood Mood swings Loss of joy Heart beating quickly or strongly Feeling tense or nervous Anxiety Attacks of anxiety or panic Palpitations Feeling faint Weight gain Digestive symptoms Tinnitus Reduced confidence Lack of motivation Memory problems (names & words) Poor construction of daily routines or work schedules Headaches, migraines Restless legs Feeling tired and lacking in energy Difficulty concentrating Dry eyes Feeling dizzy Pressure or tightness in head Muscle and joint pains Pins and needles to hands and feet Breathing difficulties Mood swings Feeling faint Weight gain Digestive symptoms Dry itchy skin Hair loss Brittle nails Changes in periods and vaginal symptoms Feeling the need to pass urine often Loss of interest in sex Low libido Pain on intercourse Vaginal dryness

This is a broad spectrum description related to depleting levels of oestrogen affecting the vulva, vagina and lower urinary tract. It used to be known as Vulvovaginal atrophy and atrophic vaginitis. The symptoms can be vaginal dryness, irritation, itching, and burning per genitalia. Some women experience discomfort on intercourse. Women may also suffer frequent and urgency of urination and recurrent of urinary tract infections. This can be helped by replacing hormones systemically or local to the vaginal and vulval area. There are also non hormonal options available. This can be discussed with your menopause specialist.

This varies the average duration in 7-8 years if not treated. Some women may experience symptoms for longer.

Yes, when oestrogen depletes there can be long term health risk such as Osteoporosis and Cardiovascular disease. There are proven benefits when HRT is started early (within 10 years of the menopause) HRT helps control menopausal symptoms. Maintains BMD (bone mineral density) and reduces the risk of osteoporotic fractures. Additional Potential Benefits for women taking HRT: Reduced risk coronary heart disease Reduced risk Alzheimers disease when oestrogen started early. Reduced risk colorectal cancer. Reduced risk Type 2 DM (diabetes mellitus). (Evidence based information, see BMS HRT guide)

After the age of 45 you do not need a blood test to confirm you are Peri/Menopausal . A blood test is advised to confirm premature ovulation insufficiency under the age of 40 years old. This can be discussed during your consultation.

Yes you can start HRT whilst still having periods.

Yes you can use HRT but it should be as a patch, gel or spray (transdermal).

There is no arbitrary age limit for initiating treatment. Menopause can affect women at different ages. Usually starting during the mid forties. However, its important to note that some women may experience symptoms earlier. If you start noticing symptoms such as irregular periods, hot flushes. night sweats, or mood changes, it's a good idea to consult with a menopause specialist. HRT treatment is advised for women with an early or premature menopause below the age of 45. This is to ensure symptoms relief, bone protection, cardiovascular health protection and cognitive benefits. We understand the diverse needs of women going through this transition and aim to provide a supportive environment where you can explore various treatment options and strategies for managing menopause symptoms. At Llyn Menopause we are dedicated to offering personalized care to help you navigate this stage of life with comfort and confidence.

Starting HRT within 10 years of the menopause before the age of 60 may offer you a better long term health for menopause, however it's never too late to consider help and this is an individualised discussion to see if menopause is still affecting you.

No - There is no time limit on HRT use, however, you do need an annual review.

Body Identical HRT is the safest & most regulated type of hormone replacement therapy ( HRT) This includes oestrogen taken through the skin in a patch, gel, or spray. If you have a womb you will require progesterone. We prescribe micronised progesterone. These hormones are similar in structure to those naturally occurring in the body. Body identical HRT is recommended by the National Institute of Health and Care Excellence (NICE) guidelines.

Some women can start to feel better in a few weeks. It can take up to three months to notice the full benefits of taking HRT. It is important to have a follow up review to check your symptoms and ensure your HRT dose is right for you. Life style modifications can also help.

We do not prescribe Compounded Bioidentical hormones at Llyn Menopause as they are unregulated and not endorsed by the British Menopause Society.

70% of Women can suffer Genitourinary Syndrome of the Menopause (GSM) This relates to the vulva, vaginal and lower urinary tract due to low oestrogen levels. There are various treatment options such as: Vaginal pessaries, gels, creams and a vaginal ring called an E-String that releases oestrogen over a three month period. There are non hormonal options available that can be bought online. Treatment options can be discussed during your consultation.

Yes, this is an excellent option for the progesterone component of HRT. The Mirena coil IUS (intrauterine system) also called a hormonal coil. This device can be used for up to 5 years as part of HRT for endometrial protection. The IUS provides various benefits such as contraception and reduces heavy menstruation.

Starting Hormone Replacement Therapy (HRT) can help manage menopause symptoms, but it may come with some temporary side effects within the first few weeks. The most common side effects include breast tenderness, bloating, mood changes often referred to as "the blues" and bleeding. These symptoms usually resolve. We recommend giving your body time to adjust. If side effects have not resolved within 3 months this can be discussed with your clinician during your review appointment. There are various treatment options, doses and routes of administration that can be tried to ensure an individual balance with your treatment plan.

Do you prescribe Testosterone? Yes we do this is for women who are already established on HRT and continue to experience low libido. Testosterone has been known to improve energy and motivation, cognitive function, as well as bone and muscle strength, however more research is needed. Women who go through a surgical menopause may notice a drop in Testosterone. NICE Guidance on menopause state that testosterone can be considered for those who need it. (NG23) The NICE menopause guidelines (NG23) and the BMS recommend a trial of HRT before testosterone supplementation is considered. Testosterone prescribing is an individualised assessment. A base line blood test is required before initiating a trial of testosterone. Testosterone products are unlicenced for female use in the UK. AndroFeme 1 is a regulated formulated product for female use in Western Australia and is imported into the UK under special MHRA guidance. This can be obtained on a private prescription. Testogel is a gel formulated for male use and can be used at a reduced dose for female use and prescribed off license. This costs less that AndroFeme 1. It can take 3-6 months to notice a difference with Testosterone. Blood monitoring is required as per BMS guidelines to ensure a normal female physiological range. If no improvement is noted there would be no reason to continue the treatment. Please see the links below for further information on Testosterone. Testosterone for women Testosterone replacement in menopause

A base line testosterone blood test is advised before starting testosterone This is a safety check to ensure you are not getting too much on top of your own natural levels.

After starting testosterone you will need to have a repeat blood test in 2-3 months to ensure your levels are within female range. It is important that monitoring continues every 6-12 months to ensure that levels remain within the female physiological range in order to minimise adverse effects.

An Holistic approach is always considered looking and life style and modifications to help symptom control and this can be discussed during your consultation with Llyn menopause. Please see link below to further information on complementary and alternative therapies: Complementary and alternative therapies

The cost can vary according to the amount of products and dose. The cost for basic HRT can be from £10 to £35 per item. The pharmacy also charges a small postage fee. You can get your HRT from your own GP on the NHS if you prefer.

No, you can self-refer to the clinic by making an appointment If you have any blood test results or relevant letter you can bring these with you or email them in ready for your consultation.

Yes we can arrange a video link from the comfort of your own surroundings. If you have booked a video consultation please ensure you are prepared on time and have a good Wi-Fi or mobile connection if using a mobile device. You will be sent a link prior to your appointment for you to connect with ease and then we will welcome you to Llyn menopause.

Yes we can do by arrangement. ​

Our appointments page will guide you through the process Go to the appointments page and submit your details. You can submit the form on the appointments page of the website and ask for your desired date and time you would like to be seen and we will get back to you as soon as possible. You can send us an email on: admin@llynmenopause.wales Feel free to call us to discuss an appointment on 07300 552066 You do not need a referral from your GP to book an appointment at Llyn menopause.

You will be sent a Medical History Questionnaire and Symptom Checker. Please fill out these 2 forms and submit them well before your consultation. * Both of these forms are required prior to your Consultation. 1. Medical history questionnaire: This is to help ensure we take a thorough detailed medical history. It is also helpful to send in any information, medical letters, blood results that may be relevant before your consultation to help determine your treatment plan. 2. Symptom Checker: This will help identify your symptoms for discussion during your initial consultation and help track your progress and identify any unresolved issues during your follow up consultation. It maybe useful to plan and write down any questions you wish to discuss during your consultation.

If we determine after reviewing your health questionnaire, or any medical information you have sent in, that you would be better served by an a different service, we will refund you the cost of your appointment and direct you to a health care professional that would be more appropriate to suit your clinical need.

Nefyn, Gwynedd, North Wales

Yes there is private parking

We provide a secure payment link with your invoice at the point of booking an appointment. Most major Debit & Credit Cards are accepted or BACS to our bank.