Frequently Asked Questions
Why can’t I refer myself to the Menopause Clinic? The Menopause Clinic at Highland Sexual Health is an NHS specialist service providing additional expertise and care for those who have complex medical needs. Your GP should be able to provide you with routine menopause care and can refer to the clinic if appropriate. You can also request a referral to the clinic if you feel your symptoms are not well controlled, persistent side effects or have additional concerns you wish to discuss. There is currently a waiting list for an appointment.
Is there a blood test for diagnosing menopause? FSH (follicle stimulating hormone) levels rise in postmenopausal women in response to low oestrogen levels. During perimenopause, FSH levels can be variable. You could have a normal FSH level and still be perimenopausal from your symptoms and therefore checking an FSH level is not a useful test. FSH levels are checked in women under the age of 40 who have symptoms of menopause and their periods have stopped for at least 4-6 months (to diagnose POI). In women over the age of 45, the diagnosis is made based on symptoms and an FSH blood test is not usually required.
I have a family history of breast cancer. Can I still take HRT? Having a family history of breast cancer may not exclude you from taking HRT if you feel you need it to control your symptoms. You may have a higher background risk of developing breast cancer. Your GP can refer you to the Menopause clinic to have a discussion of the risks and benefits to help you make an informed decision.
HRT is not working for me. You may need a higher dose of HRT (especially if you are younger or have had your ovaries removed) or a different type of HRT such as changing from oral to transdermal. Some women may also need testosterone.
I am having side effects from the HRT. Depending on the side effects you are experiencing, you may need to lower the dose of oestrogen or change the type of progestogen. If irregular or heavy bleeding is an issue, you may need to increase the progestogen dose or change to a Mirena.
I have heard that HRT is dangerous. There have been many studies over the last 20 years and long term follow up evidence suggest that for the majority of women, the benefits of taking HRT outweigh the risk in women under the age of 60. Whether or not you take HRT is your choice.
I am over the age of 60, can I start HRT? Starting HRT after the age of 60 or 10 years or more since your menopause may not give you the same benefit (such as protecting your heart) as starting it earlier. However, if you are still having symptoms such as hot flushes and sweats, then taking HRT can help.
I am over the age of 70, can I start HRT? There are more risks than benefits to starting HRT much later in life. There is a higher risk of breast cancer and heart disease as you get older and some studies have suggested that starting HRT after the age of 70 can increase the risk of dementia.
I have a medical condition – can I take HRT? Depending on the medical condition, your GP may wish to seek advice or refer you to the Menopause clinic for a consultation to find the best option for you. There are certain medical conditions where it will be more beneficial to you to take HRT (E.g. conditions which raise the risk of osteoporosis) and some medical conditions or their treatments (E.g. past history of a blood clot, HIV) where a transdermal HRT would be safer - A to Z of Menopause & Medical Conditions
I have been told I cannot take the contraceptive pill, does that mean I cannot take HRT? The combined oral contraceptive pill / patch is completely different from HRT and most women who are unable to take the combined contraceptive pill (E.g. due to migraines, risk of blood clots) can be prescribed transdermal HRT safely.