Our Menopause service provides a thorough, multidimensional approach to women’s midlife health. Menopause affects hormones, the brain, pelvic structures, sleep systems, cardiovascular health and emotional wellbeing. Many women experience symptoms long before their final menstrual period, and these may fluctuate unpredictably. We offer clear diagnosis, structured treatment planning and continuing support so that women feel informed and in control of their health.
Our team includes menopause clinicians, pelvic health physiotherapists and practitioners trained in CBT-based menopause strategies. This joined-up approach ensures that we can address hormonal symptoms, bladder and bowel issues, sexual discomfort, mood changes, sleep disturbance and long-term wellbeing within a single pathway. Every woman receives a tailored plan that reflects her personal goals, medical history, concerns and lifestyle.
Our Menopause service provides a thorough, multidimensional approach to women’s midlife health. Menopause affects hormones, the brain, pelvic structures, sleep systems, cardiovascular health and emotional wellbeing. Many women experience symptoms long before their final menstrual period, and these may fluctuate unpredictably. We offer clear diagnosis, structured treatment planning and continuing support so that women feel informed and in control of their health.
Our team includes menopause clinicians, pelvic health physiotherapists and practitioners trained in CBT-based menopause strategies. This joined-up approach ensures that we can address hormonal symptoms, bladder and bowel issues, sexual discomfort, mood changes, sleep disturbance and long-term wellbeing within a single pathway. Every woman receives a tailored plan that reflects her personal goals, medical history, concerns and lifestyle.
Women choose our clinic because we combine medical expertise with a holistic, person‑centred style of care. Consultations allow time for detailed discussion, and we prioritise clear explanations so women understand why their symptoms are happening and what options are available.
Pelvic health physiotherapists support women with bladder urgency, stress incontinence, prolapse symptoms, pelvic pain and changes in sexual comfort. Physiotherapy is tailored to each woman’s anatomy, symptoms and activity level.
CBT-informed care provides practical strategies for managing hot flushes, night sweats, sleep disruption, anxiety, irritability and loss of confidence. These tools are especially helpful for women who prefer non-hormonal treatment or want to enhance the benefits of HRT.
We provide full contraceptive care, including fitting and removing coils and implants, and advising women on how contraception aligns with HRT plans. Many women are uncertain about when they can safely stop contraception, and we offer clear guidance.
Women value the flexibility of our service. Consultations can be face‑to‑face or remote, and follow‑ups are planned to ensure safety, continuity and long‑term wellbeing.
Perimenopause often begins years before periods stop. Hormones fluctuate from month to month, which can cause hot flushes, night sweats, temperature swings, heart racing and sudden feelings of heat. These symptoms disturb sleep and may lead to fatigue, low motivation and reduced resilience to stress.
Cognitive changes such as brain fog, forgetfulness and difficulty concentrating are common. Many women describe losing their train of thought mid‑sentence or finding it harder to multitask. These symptoms relate to hormonal changes affecting memory networks and sleep disruption.
Emotional wellbeing may shift significantly. Women may notice anxiety, irritability, emotional sensitivity or reduced confidence. Hormones influence neurotransmitters involved in mood regulation, making familiar pressures feel harder to manage.
Sleep disturbance is a major source of difficulty. Women may wake repeatedly, struggle to fall asleep or wake early. Poor sleep affects mood, concentration and tolerance for day‑to‑day stress.
Genitourinary changes such as dryness, discomfort, burning, pain with intercourse and increased urinary urgency occur because low oestrogen alters the elasticity and hydration of pelvic tissues. These symptoms are progressive without treatment but respond well to local oestrogen and pelvic health strategies.
Physical symptoms may include joint aches, stiffness, headaches, palpitations, weight redistribution, bloating and fluctuations in energy.
Bleeding changes are common in perimenopause. Cycles may become heavier, lighter, shorter or unpredictable. Heavy or prolonged bleeding may indicate fibroids, adenomyosis or hormonal imbalance and requires proper assessment.
Fibroids and adenomyosis can cause pelvic pressure, bloating, cramping, heavy periods and discomfort during intercourse. We assess symptoms, impact and treatment preferences to create an individualised plan.
Ovarian cysts may be detected during investigation of pelvic pain or bloating. Some require monitoring; many resolve naturally. We ensure appropriate follow‑up and reassurance.
Any bleeding after menopause requires assessment to exclude underlying causes. Timely investigation ensures women receive clarity and peace of mind.
Stress incontinence—the leakage of urine during coughing, sneezing or exercise—can worsen around menopause when pelvic tissues lose elasticity. Pelvic health physiotherapy can significantly improve muscle coordination and bladder support.
Overactive bladder symptoms may include strong urges to urinate, difficulty postponing urination and frequent trips to the toilet. These symptoms disrupt sleep and daily routines.
Prolapse symptoms such as heaviness, dragging or a bulge sensation may appear gradually.
Physiotherapy helps strengthen pelvic support and guides women through safe lifestyle adjustments.
Bowel symptoms such as urgency, reduced control or constipation often relate to pelvic floor dysfunction and abdominal pressure. Physiotherapy addresses coordination and movement patterns to improve bowel control.
Pelvic pain may arise from hormonal changes, muscle imbalance, nerve sensitivity, scar tissue or postural factors. A whole‑body assessment helps identify contributing factors.
Vaginal dryness, reduced lubrication, pain during intercourse and recurrent urinary symptoms relate to low oestrogen. These symptoms respond well to vaginal oestrogen, pelvic floor physiotherapy and guidance around comfort, lubrication and confidence.
Changes in libido may stem from hormonal shifts, stress, fatigue, emotional strain or physical discomfort. We provide sensitive, supportive care to help women restore sexual wellbeing and confidence.
Pregnancy is possible until menopause is confirmed, so contraception is needed during perimenopause. Options include hormonal coils, copper coils, implants and progestogen‑only pills.
Hormonal coils provide reliable contraception, support heavy bleeding control and can be used as the progesterone component of HRT.
We guide women through safely transitioning off contraception and integrating coils or implants with hormonal therapy where appropriate.
We diagnose perimenopause, menopause, early menopause and premature ovarian insufficiency through clinical evaluation, targeted tests and careful exploration of symptoms. Women receive personalised guidance on modern HRT, including body‑identical oestrogen and micronised progesterone.
We support women with surgical menopause and complex medical histories such as cardiovascular risk, migraines or previous cancer treatment. Management focuses on safety, symptom control and long‑term wellbeing.
Pelvic health physiotherapy supports women with bladder urgency, incontinence, prolapse symptoms, pelvic pain and sexual discomfort. Assessment includes pelvic floor strength, breathing mechanics, posture, movement habits and abdominal pressure.
Treatment may involve pelvic floor training, manual therapy, movement re‑education, bladder retraining and guidance on exercise suitable for midlife health.
CBT offers practical strategies to manage hot flushes, night sweats, sleep disturbance, anxiety and low mood. Women learn how thoughts, behaviours and physical sensations interact, and develop tools for confidence and symptom control.
We provide contraceptive counselling and full coil and implant services. Hormonal coils may be used within an HRT plan for womb protection and bleeding control.
We support women transitioning off contraception safely and understanding how contraceptive hormones interact with menopausal changes.
Diagnosis of menopause is primarily clinical in women over 45, based on symptoms and menstrual patterns. Blood tests may be used for younger women, for suspected premature ovarian insufficiency or when diagnosis is unclear.
Investigations such as pelvic examination, ultrasound or endometrial assessment may be appropriate for changes in bleeding patterns or pelvic symptoms.
Pelvic floor evaluation helps identify factors contributing to bladder, bowel or pelvic pain symptoms.
We also consider bone health, cardiovascular risk and thyroid function as part of long‑term menopause care.
HRT reduces vasomotor symptoms, sleep disruption, anxiety, low mood and vaginal discomfort. Oestrogen is usually delivered via patches, gel or spray, while progesterone is provided through tablets or hormonal coils. Treatment is tailored and reviewed regularly.
Women who do not use HRT may benefit from non‑hormonal medication, CBT strategies and lifestyle adjustments. These may reduce flushes, improve sleep and support emotional stability.
Pelvic health physiotherapy addresses bladder control, urgency, prolapse, bowel changes and pelvic pain. Treatment incorporates manual therapy, targeted exercise and movement re‑education.
CBT offers structured techniques to manage flushes, sweats, sleep disruption and emotional distress. Women learn to identify triggers and develop practical coping techniques.
We provide ongoing monitoring, adjusting treatment as needed and supporting bone, heart and metabolic health through midlife.
Nutritional guidance supports energy, digestive comfort, weight balance and bone health.
Women receive advice on protein intake, calcium, vitamin D, phytonutrients and hydration.
Mind‑body strategies such as paced breathing, grounding, mindfulness and relaxation help reduce stress, flush severity and emotional intensity.
Movement therapy includes resistance training, walking, Pilates‑style conditioning and postural work to support joint stability and bone density.
Sleep support focuses on bedtime routines, temperature regulation, stress reduction and behavioural strategies for waking episodes.
Sexual wellbeing support includes pelvic floor relaxation, lubrication guidance, communication strategies and confidence building.
Complementary approaches such as stretching, breathwork and gentle alignment routines help restore balance and regulate stress.
Your first consultation includes a detailed discussion of symptoms, medical history, menstrual patterns, lifestyle factors and personal goals. This is followed by assessment tailored to your needs, which may include pelvic examination or pelvic floor evaluation.
Blood tests or imaging may be recommended depending on symptoms. For bladder, bowel or sexual symptoms, pelvic health physiotherapy assessment is offered.
You will receive a personalised plan including treatment options, lifestyle recommendations and follow‑up arrangements. We provide written summaries so you can review information at home.
We offer remote consultations for symptom reviews, medication adjustments and CBT sessions. Online appointments are convenient for follow‑up care and ongoing support.
Initial assessments are usually completed in person so we can provide physical examination and diagnostics when needed. Your clinician will advise whether online or in‑clinic care is most suitable.
What are the first signs of perimenopause?
Early signs often include changes in menstrual cycles, hot flushes, night sweats, breast tenderness, increased anxiety, irritability, difficulty sleeping or new sensitivity to stress. Some women also notice brain fog, reduced concentration or joint aches.
How is menopause diagnosed?
For women over 45, menopause is diagnosed based on symptoms and changes in menstrual patterns. Blood tests are usually not required unless symptoms are atypical or you are under 45.
Do I need blood tests?
Blood tests are used selectively, mainly for women under 45, those with suspected premature ovarian insufficiency or where symptoms suggest other conditions such as thyroid issues.
What is the safest HRT option?
For most women, body-identical oestrogen delivered through the skin [patch, gel or spray] combined with micronised progesterone is considered the safest, modern option. The best choice depends on your medical history, symptoms and preferences.
What if I cannot take HRT?
Non-hormonal medicines, CBT approaches, lifestyle modifications and pelvic health physiotherapy can all improve symptoms. Many women who cannot use HRT still achieve significant relief with non-hormonal options.
Can HRT cause weight gain?
HRT does not cause weight gain. Many women find that HRT helps stabilise metabolism and reduces bloating, making weight management easier.
How long should I stay on HRT?
There is no fixed limit. Many women use HRT for years. Decisions are based on symptom control, personal preference, benefits and individual risk factors. Regular review ensures ongoing safety.
Do I still need contraception?
Yes, pregnancy is still possible until menopause is confirmed. Women under 50 should continue contraception for two years after their last period. Women over 50 should continue for one year.
Can I have a coil fitted at the clinic?
Yes. We fit, check and remove hormonal and copper coils. Hormonal coils can also be used as the progesterone component of HRT.
Can menopause affect bladder control?
Yes, low oestrogen and pelvic floor changes can cause urgency, frequency, leaks during exertion or a sensation of incomplete emptying. Pelvic health physiotherapy is highly effective for many women.
When should I see a specialist?
You should seek specialist care if symptoms affect daily life, if you have heavy or irregular bleeding, new pelvic pain, bladder or bowel concerns, sexual discomfort, or if you are unsure whether your symptoms are hormonal or require investigation.
To book an appointment or discuss which clinician you should see first:
Phone: 01623 624137
Location: Nottingham Road Clinic, 195 Nottingham Road Mansfield NG18 4AA
