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Am I in Perimenopause, Menopause or Postmenopause?

Am I in Perimenopause, Menopause or Postmenopause?

One of the most common things women say to me is:

“I don’t even know where I am in all of this.”

You may still be having periods but feel different.
You may have irregular cycles but “normal” blood tests.
You may have stopped bleeding and expected everything to settle, but it hasn’t.

The language around menopause can feel confusing. So let’s make it clearer.

Premenopause

Premenopause refers to the years before hormonal transition begins.
Cycles are generally regular. Ovulation happens consistently. Oestrogen and progesterone rise and fall in a predictable pattern.
That doesn’t mean everything feels perfect. PMS, heavy periods or mood changes can still occur. But the overall hormonal rhythm remains steady. If your cycles are consistent and you feel broadly well, you are likely still in this stage.

Perimenopause

Perimenopause is the transitional phase leading up to menopause. It often begins in the 40s, although some women notice changes in their late 30s. Others continue having periods well into their 50s.

Some women are still having periods at 50 or beyond and worry that something must be wrong. In many cases, this can still fall within the perimenopausal transition.

This is where things start to feel less predictable.

Ovulation becomes less consistent, which means progesterone often declines first. Oestrogen does not simply drop, it fluctuates. Some days it may be high, other days low. Testosterone gradually reduces over time.

That fluctuation is often what drives symptoms.

Sleep becomes lighter. Anxiety rises. Resilience drops. Brain fog appears. Periods change, sometimes heavier, sometimes lighter, sometimes closer together.

Early on, symptoms may feel cyclical. Later, they can become erratic, which in itself can feel stressful.

Blood tests may still sit within “normal” ranges because hormones are fluctuating rather than steadily declining. That is why perimenopause is primarily a clinical diagnosis.

Menopause

Menopause is defined as twelve consecutive months without a period. At this point, ovarian hormone production has declined significantly and oestrogen levels become consistently low.

The turbulence of fluctuation settles, but low hormone levels may bring their own symptoms. Hot flushes, vaginal dryness, sleep disturbance, reduced bone density and metabolic shifts can become more noticeable.

Postmenopause

Postmenopause refers to the years after menopause.

Hormone levels remain consistently low unless hormone therapy is used. Some women feel more stable once the hormonal turbulence of perimenopause ends. Others continue to experience symptoms that affect sleep, mood, cognition or physical health.

At this stage, attention often turns toward longer-term health, bone strength, cardiovascular health, muscle preservation and cognitive resilience.

It is not about chasing youth.
It is about supporting healthy ageing.

Why Does Knowing the Stage Matter?

Understanding where you are helps guide decisions.

Perimenopause may require flexibility. Progesterone support can be particularly relevant. HRT in perimenopause often needs more careful adjustment because hormones are fluctuating rather than consistently low.

Menopause and postmenopause may benefit from steadier oestrogen replacement and a broader focus on long-term health strategy.

The approach is not identical across all stages.

When Should You Seek Support?

If you feel different from yourself, more anxious, more tired, less resilient or less clear-headed, it is reasonable to seek assessment, even if you are still having periods.

You do not need to wait for things to become severe.

Many women seek a private menopause consultation when they feel their symptoms have been minimised or when appointment time has been too limited to explore the full picture.

Hormonal transition rarely follows a textbook timeline.

Personalised Menopause Care

At The Bespoke Clinic, we support women through premenopause, perimenopause, menopause and postmenopause with structured, doctor-led assessment.

If you are looking for a menopause doctor in Newcastle or would prefer an online menopause consultation elsewhere in the UK, appointments are available in clinic and remotely. Investigations can be arranged locally where required, and follow-up is individualised.

If you are unsure which stage you are in, or feel that something has shifted but cannot quite explain it, we would be pleased to support you.

Book a Consultation

Bioidentical vs Body-Identical HRT

Bioidentical vs Body-Identical HRT

A Balanced View

If you’ve spent time researching menopause treatment online, you will have noticed how divided the conversation can be.
Some clinics dismiss compounded bioidentical hormones entirely. Others promote them as the only safe or “natural” option.
When opinions are that polarised, the truth usually sits somewhere in the middle.
Let’s clarify it properly.

What Do These Terms Actually Mean?

Both body-identical and bioidentical hormones are structurally identical to the hormones your body produces naturally.

The difference is not the molecule. It is the manufacturing and licensing pathway.

Licensed body-identical HRT refers to preparations such as transdermal oestradiol and micronised progesterone that are produced by pharmaceutical manufacturers and hold formal marketing authorisation.

Compounded bioidentical HRT refers to prescriptions prepared individually by specialist compounding pharmacies. These may allow flexibility in dose or combination when clinically required.

Both use pharmaceutical-grade hormones identical to endogenous hormones.

The distinction lies in authorisation and standardisation, not in whether one is “natural” and the other “synthetic.”

What Do Professional Guidelines Say

The British Menopause Society advises that compounded bioidentical HRT is not routinely recommended. Their position reflects:

  • Greater published outcome data for licensed preparations
  • The availability of regulated alternatives
  • Limited evidence supporting routine saliva-based dose adjustment

These are reasonable population-level safety principles. However, guidelines are written for broad application. Clinical medicine is practised with individuals.

Are Compounded Hormones Unregulated?

You may have read that compounded hormones are “unregulated.” That is not accurate.

In the UK, specialist compounding pharmacies are registered with the General Pharmaceutical Council and operate within the Human Medicines Regulations framework. They are inspected and must comply with defined professional and manufacturing standards. The hormones used are pharmaceutical-grade and produced under Good Manufacturing Practice standards.

The key difference is this:

Licensed products undergo large commercial trial programmes tied to marketing authorisation.

Compounded prescriptions are prepared for individual patients and therefore do not follow that commercial licensing pathway.

That distinction matters in terms of evidence hierarchy. It does not mean absence of oversight.

What Does the Evidence Show?

Licensed body-identical oestradiol and micronised progesterone have reassuring safety data and are appropriate for many women.

For compounded formulations, large-scale outcome trials are more limited. That reflects differences in commercial licensing rather than differences in molecular structure.

The pharmacology of oestradiol, progesterone and testosterone is well established. What determines safety in practice is appropriate indication, careful dosing and ongoing review.

Medicine rarely operates in absolutes

When Might Compounding Be Considered?

For many women, licensed body-identical HRT works extremely well and should be first-line.

However, some women:

  • Do not tolerate standard progesterone regimens
  • Require dose adjustments outside available strengths
  • Have persistent symptoms despite optimisation
  • Need combinations not commercially available

In such cases, carefully supervised compounded therapy may be considered.
The key word is supervised.
Compounding should be clinically justified, not trend-driven.

What About Hormone Testing?

A single blood test taken in isolation, such as FSH, taken in isolation, is not a reliable way to decide on hormone replacement requirements
However, broader hormone assessment, when integrated with full clinical evaluation, may offer additional insight in complex cases.
Testing should inform judgement, not replace it.

My Position

I practise within established menopause guidance, including that of the British Menopause Society.

Licensed body-identical preparations are often entirely appropriate and effective.

Where individual circumstances require flexibility, intolerance management or bespoke dosing, compounded bioidentical therapy may be considered within a structured medical framework.

This is not about rejecting pharmaceutical medicine. Nor is it about embracing hype. It is about applying evidence thoughtfully to the individual woman in front of you. Menopause care should be balanced, proportionate and personalised.

If you would like to discuss which approach may be appropriate for you, consultations are available in clinic and remotely across the UK.

Book a Discovery Call

The DUTCH tests

When Is the Best Time to Test Your Hormones?

One frequent question we get from patients at our clinic is about the optimal timing for hormone testing. This can vary depending on several factors, such as whether you have regular menstrual cycles, the length of your cycles, and whether you are approaching menopause.

Here at The Bespoke Clinic, we often use the DUTCH Plus test to provide a comprehensive hormone profile and information about adrenal health. Understanding when to test is crucial to getting accurate and useful results.

The typical menstrual cycle – see image

The menstrual cycle begins on the first day of the period, which also marks day one of the cycle. At this stage, both oestrogen and progesterone levels are quite low. As the cycle progresses, oestrogen levels start to climb, peaking just before ovulation. After the egg is released from the ovary, the corpus luteum forms from the leftover follicle and begins to produce progesterone. This increase in progesterone prepares the body for a potential pregnancy, supporting the uterine lining in case the egg is fertilized. The term progesterone itself hints at its role: PRO-GEST(ation), essential for maintaining a pregnancy. If no fertilization occurs, the corpus luteum breaks down, leading to a drop in both progesterone and oestrogen levels, and the cycle resets with the onset of another period.

Testing During a Regular Cycle

For women with regular monthly cycles, the ideal time to conduct a test is during the mid-luteal phase, roughly 5-7 days post-ovulation. In a typical 28-day cycle, this would correspond to days 19 to 22. This phase is significant because it’s when progesterone levels peak and oestrogen reaches the high point of its luteal plateau. This timing can offer invaluable insights into your menstrual health and hormonal balance.

Here’s a brief overview of what these results might indicate:

  • Low Progesterone with Normal or Low Estrogen: This might suggest that ovulation hasn’t occurred.
  • Normal Progesterone with Low Estrogen: Ovulation likely occurred, but the lower estrogen levels could affect the quality of the endometrial lining and egg, potentially impacting implantation.
  • High Estrogen with Normal Progesterone: Ovulation occurred, but there may be a dominance of estrogen, which can lead to symptoms like migraines, PMS, breast tenderness, and heavier menstrual bleeding.
  • Both Hormones Within Normal Range: Ovulation has occurred, indicating a typically healthy cycle.

Adjusting for Different Cycle Lengths

If your cycle is shorter or longer than the standard 28 days, we’ll adjust the testing day accordingly to align with your specific luteal phase. For instance, if you have a 25-day cycle, the collection would likely be between days 16 and 19; for a 35-day cycle, it would be around days 26 to 28.

Peri-Menopausal Women and Irregular Cycles

For those experiencing perimenopause or irregular cycles, using an ovulation predictor kit (OPK) can help determine the best time to collect your sample. Once the OPK indicates that ovulation is imminent, count forward 5-7 days to find your optimal testing window. Alternatively, the DUTCH Cycle Mapping Test might be recommended, where you would provide samples nearly every morning of your cycle. This method allows us to chart the fluctuations of your hormones throughout the month, offering a detailed view of your hormonal health.

Further help?

Choosing the right day for your DUTCH test might seem overwhelming, but we’re here to help. Don’t hesitate to contact our clinic on 01916941232 or email hello@thebespokeclinic.uk for guidance. Our doctor led team is dedicated to supporting your health journey with personalised, expert advice every step of the way.

Hormones and Bloating: Understanding the Connection

Welcome to our latest insightful exploration at The Bespoke Clinic. Today, we’re diving into a common yet often overlooked aspect of female health: the link between hormones and bloating. Bloating isn’t just an uncomfortable inconvenience; it can be a crucial indicator of your hormonal health. Let’s delve into how hormonal changes affect bloating, the significance of gut health, and how personalised care through functional medicine and gut microbiome testing can lead to targeted solutions.

The Hormone-Bloating Connection

Bloating can often be a sign of imbalances in female hormones, particularly oestrogen and progesterone. These hormones fluctuate throughout the menstrual cycle, affecting fluid retention and digestive function. Just before menstruation, higher levels of oestrogen can lead to water retention, while lower levels of progesterone can slow down digestion, leading to that all-too-familiar bloated feeling.

Impact of Gut Health on Hormones

The health of your gut microbiome plays a crucial role in hormonal balance. An imbalanced microbiome can lead to increased oestrogen levels, a condition known as oestrogen dominance, which can exacerbate bloating. Furthermore, gut health significantly impacts overall digestion and absorption, influencing how bloated you feel.

Functional Medicine Testing: A Personalised Approach

At The Bespoke Clinic, we emphasise the importance of understanding each individual’s unique health profile. Through functional medicine testing, we can assess hormone levels and identify imbalances. This insight allows us to tailor our approach specifically to your needs, targeting the root cause of your symptoms, including bloating.

The Power of Gut Microbiome Testing

Gut microbiome testing is a game-changer in personalised healthcare. By analysing your gut bacteria, we gain valuable information about your digestive health, immune system, and even hormonal balance. Understanding your gut microbiome enables us to:

  1. Identify Specific Imbalances: Knowing which bacteria are overgrown or lacking can guide our approach to your diet and lifestyle changes.
  2. Personalise Your Dietary Plan: With detailed knowledge of your gut microbiome, we can recommend specific foods that will help balance your gut flora.
  3. Customise Supplement Recommendations: Instead of a one-size-fits-all approach, we can suggest targeted supplements that influence your gut bacteria positively, often reducing the need for antibiotics.

Managing Hormonal Bloating

Diet and Lifestyle

  • Balanced Nutrition: Focus on a fibre-rich diet with plenty of vegetables, fruits, and whole grains to support gut health and hormonal balance.
  • Hydration: Adequate water intake can alleviate water retention and improve digestion.
  • Regular Exercise: Physical activity is beneficial for hormonal balance and can help reduce bloating.

Supplements

  • Probiotics and Prebiotics: These can help maintain a healthy gut microbiome, influencing oestrogen metabolism.
  • Magnesium: Particularly beneficial around menstruation, it can help with water retention and muscle relaxation.
  • Herbal Remedies: Herbs like dandelion or green tea can support natural detoxification processes and hormonal balance.

Conclusion

Understanding the intricate relationship between hormones, bloating, and gut health is vital for addressing these issues effectively. At The Bespoke Clinic, we’re dedicated to providing personalised care based on in-depth functional medicine and gut microbiome testing. This approach allows us to create customised plans that address not just the symptoms, but the underlying causes, providing you with a pathway to better health and comfort.

 

Note: This article is for informational purposes only and does not constitute medical advice. It’s always recommended to consult with a healthcare professional for personalised health recommendations

 

 

Magnesium: The Unsung Hero in Your Wellness Journey

Welcome to our latest exploration into the world of supplements, where we spotlight the often-overlooked yet crucial nutrient – Magnesium. In this month’s feature, we delve into why Magnesium is a key player in your wellness regimen and how its inclusion can significantly bolster your health. Let’s discover how this mighty mineral can be a game-changer for you.

Why Magnesium?

Magnesium is an essential mineral, pivotal for over 300 biochemical reactions in the body. It plays a critical role in:

  1. Bone Health: It works in tandem with calcium and vitamin D to maintain strong bones, crucial as we age.
  2. Heart Health: Magnesium aids in maintaining a healthy heart rhythm and supports normal blood pressure.
  3. Muscle Function: It is vital for muscle contraction and relaxation, which includes the heart muscle.
  4. Nerve Function: Magnesium helps in regulating neurotransmitters, which send messages throughout your brain and nervous system.
  5. Stress and Sleep: It’s known for its ability to help soothe the nervous system, aiding in better sleep and stress management.

Magnesium and Disease Prevention

Regular intake of magnesium can play a role in preventing and managing chronic diseases:

Heart Disease : Magnesium’s role in heart health is well-documented, with adequate intake linked to a lower risk of coronary heart disease.

Type 2 Diabetes : It helps regulate blood sugar, and studies show a correlation between higher magnesium intake and a reduced risk of type 2 diabetes.

Osteoporosis : By aiding in bone formation and influencing the actions of vitamin D and parathyroid hormone, magnesium is essential in bone health, reducing the risk of osteoporosis.

Are You Getting Enough Magnesium?

Despite its importance, many of us fall short of the daily recommended magnesium intake. Factors like diet, lifestyle, and certain medications can contribute to this deficiency. Symptoms of magnesium deficiency include muscle cramps, fatigue, and irregular heartbeat, to name a few.

Magnesium Supplements: Your Wellness Ally

To bridge this gap, magnesium supplements can be an excellent solution. They come in various forms, such as magnesium citrate, oxide, and glycinate, each serving different purposes. For tailored advice on which type and dose of magnesium supplement would best suit your needs, feel free to consult our experts at The Bespoke Clinic

Incorporating Magnesium into Your Routine

Besides supplements, you can increase your magnesium intake through diet. Foods rich in magnesium include leafy greens, nuts, seeds, and whole grains. Pairing a balanced diet with the right supplement can ensure you meet your daily magnesium needs.

Conclusion

Embracing magnesium supplements as part of your daily routine can be a simple yet impactful step towards enhanced health and wellbeing. At The Bespoke Clinic we are committed to guiding you through this journey with personalised advice and high-quality supplements tailored to your unique health needs. Let’s unlock the full potential of your health together!

 

Note: This article is intended for informational purposes and should not replace professional medical advice. Always consult with a healthcare professional before starting any new supplement regimen.

 

Functional Medicine: A Cornerstone at The Bespoke Clinic

At The Bespoke Clinic, we embrace the principles of Functional Medicine, a holistic approach that focuses on identifying and addressing the root causes of diseases. Unlike traditional medicine, which often isolates and treats symptoms, Functional Medicine delves deeper, considering the intricate web of interactions in a patient’s history, physiology, and lifestyle that can lead to illness. Our approach is patient-centred, acknowledging the unique health needs and goals of each individual. By integrating the latest in genetic science, systems biology, and understanding of how environmental and lifestyle factors influence the emergence and progression of disease, we offer personalised care plans. This approach is particularly effective in managing chronic conditions and optimizing overall well-being, making it a perfect complement to our discussions on essential nutrients like magnesium. At The Bespoke Clinic, we’re not just treating symptoms; we’re nurturing your overall health and empowering you with knowledge and care that’s tailored just for you.

 

Energize Your Life: Unlocking the Secrets of Mitochondrial Health

In our quest for sustained vitality and wellness, understanding and nurturing our mitochondria – the powerhouses of our cells – is essential. Often overlooked, these tiny structures within our cells play a pivotal role in energy production and overall well-being. Let’s dive into the fascinating world of mitochondria and discover practical ways to enhance their function for optimal energy levels.

What Are Mitochondria and Why Are They Important?

Mitochondria are the energy factories of our cells. They convert the food we eat and the air we breathe into energy (ATP – adenosine triphosphate) that our cells can use. This process is vital for everything from moving muscles to sending nerve signals. Essentially, the health and efficiency of our mitochondria directly impact our energy levels and overall vitality.

The Link Between Mitochondrial Health and Energy Levels

When mitochondria function optimally, we feel more energetic and alert. Conversely, when they are not functioning at their best, it can lead to reduced energy levels, fatigue, and can even impact various health aspects, including aging and metabolic health.

How to Support Your Mitochondria

  1. Nutrition for Mitochondrial Health:
    • Eat a Balanced Diet: Focus on nutrient-dense foods that are rich in antioxidants, vitamins, and minerals to fuel mitochondria.
    • Include Healthy Fats: Foods high in omega-3 fatty acids, like fish, nuts, and seeds, support mitochondrial membrane health.
    • Stay Hydrated: Proper hydration is crucial for optimal mitochondrial function.
  1. Exercise Regularly:
    • Physical activity boosts mitochondrial density – meaning it increases the number of mitochondria in your cells. This enhances your body’s ability to produce energy, leading to improved energy levels and endurance.
  1. Manage Stress:
    • Chronic stress can be detrimental to mitochondrial health. Practices like mindfulness, yoga, and meditation can help manage stress and thereby support mitochondrial function.
  1. Get Quality Sleep:
    • Adequate sleep is vital for mitochondrial health. Poor sleep can lead to reduced mitochondrial energy production. Aim for 7-9 hours of quality sleep per night.
  1. Consider Supplements:
    • Certain supplements can support mitochondrial health. These include Coenzyme Q10 (CoQ10), Alpha-lipoic acid, Magnesium, and B-vitamins. Always consult with a Doctor at The Bespoke Clinic before starting any new supplement.

 

The Future of Your Energy

By understanding the crucial role mitochondria play in our energy levels and overall health, we can adopt lifestyle habits that nurture these cellular powerhouses. A balanced diet, regular exercise, stress management, adequate sleep, and the right supplements are key strategies for maintaining robust mitochondrial health.

Through the guidance and expertise available at The Bespoke Clinic, you can embark on a journey to revitalize your energy levels by focusing on the health of your mitochondria. Let us help you unlock your body’s full energy potential and lead a life brimming with vitality.

 

Note: The information in this article is for educational purposes and should not substitute for professional medical advice. Always consult healthcare professionals for personalized health guidance.

My personal skin journey

I have always been lucky enough to have clear and healthy skin. I did not get many spots when I was younger, and I managed to get away with not needing make up or foundation to cover and hide blemishes or poor skin tone.

I was obsessed with using high factor SPF even in my 20s. I vaguely recall the skin cancer campaign which ran in the 90s ‘SKIN KNOW HOW’ and thinking how lucky we were not to be living in Australia but SPF was the only skin regime I had. (Ahead of the curve!)

However, a few years ago I developed an autoimmune skin condition, and this is one of the many reasons I feel so passionate about what I am doing at The Bespoke Clinic. I understand personally, how it can feel to have a disorder which can affect you so dramatically, both physically and psychologically.

I developed a condition called Lichen Planus. Lichen planus involves the immune system mistakenly attacking skin cells or mucous membranes, leading to the development of itchy, flat-topped bumps or lesions. The exact cause of lichen planus is not fully understood but in my case, it was almost certainly triggered by extreme stress.

My initial management was by way of topical emollients (moisturising creams), then topical steroid creams, before I was referred to see a dermatologist. The consultant tried Phototherapy (Light Therapy) which I attended the hospital for, three times a week, for what felt like a lifetime. It did not help.

My symptoms of itching and lack of sleep started to have a hugely negative impact on my emotional health. I tried to keep going as I knew the next step would be high dose oral steroids and then a disease modifying drug which would have an impact on my immune system in itself.

In the end, things got so bad that I had to take the advice of the specialist and I took the oral steroids. Within 3 days, I felt better. Steroids are an anti-inflammatory so all they were really doing was taking away the inflammation, which was necessary at the time, but I knew the root cause of the problem had not really been addressed.

As soon as I was on the steroids, was able to think clearly again and get some sleep, I knew I wanted to be off them! So, I embarked on further medical reading and learned all that I could about our immune system and what we could do to help ourselves. Basically, I did not EVER want to go through it again, I did NOT want the steroids even though they helped and I wanted to BETTER UNDERSTAND the why.

I researched gut health and regimes which could help with addressing the gut microbiome.

There were many scientific research papers, maybe not in well recognised UK journals, but a lot internationally at the time, talking about the impact of pre and probiotics and digestive enzymes on autoimmune conditions. I felt I was already doing what I could nutritionally through food. I then investigated where I could obtain the highest quality supplements from, what ingredients they had in them, what the source of those were and what research they had done to support their product.

I found a company based in the USA, and decided they were the gut supplements I wanted.

With the stress I had been under prior to the skin condition developing, I was already looking after myself more than I had in the past. I continued to engage in Yoga, breathing exercises, time restricted eating, nutritional foods, trained at the gym. I used high quality essential oils, topically, diffused and ingested. I also engaged with my conventional medical treatment of the Prednisolone steroids, and Sertraline.

I was able to wean off my steroids, sooner than anticipated, I dodged the need to go on another medication to dampen my immune response. In my opinion, and from my own doctor experience, I felt the results of the additional holistic interventions I took were remarkable.

My skin is almost back to normal. Even several years down the line, I have some hyperpigmentation (darkened skin lesions) and scarring but you would not notice!

I remain on my gut supplements and continue to self–care. I must admit, I am not as avid about it as I was, but I do know the need to look after yourself fully and as a priority and I hope I am able to help you do the same.

Neet

 

 

 

Sexual Health and the Menopause

We know there is an impact of hormone reduction during the perimenopause on our physical and psychological health. One aspect of women’s health which is often overlooked, and definitely not talked about enough is the affect it can have on a woman’s libido, vaginal health, and overall sexual satisfaction.

So, what are the challenges?

  • Vaginal Dryness: Declining oestrogen levels during the perimenopause can cause vaginal dryness, making sexual intercourse uncomfortable or painful. This can negatively impact a woman’s sexual desire and overall enjoyment of sexual activities. ‘sandpaper’, ‘cutting inside’ and ‘risk of bleeding’ are some descriptions I have heard in my medical practice.
  • Decreased Libido: Changes in hormone levels can lead to a decrease in sexual desire or a lower libido. Many women report a decline in their interest in sex during the perimenopause, which can be attributed to hormonal fluctuations, physical discomfort, or emotional factors. Women may be more anxious, experience lower mood, along with feeling it is not going to be enjoyable so avoiding the experience of sex altogether.
  • Changes in Orgasm: Some women experience changes in the intensity or frequency of orgasms during menopause. This can also be attributed to hormonal imbalances, reduced blood flow to the pelvic region, or psychological factors such as stress or anxiety.

What can be done to help?

  • Open Communication: Discussing concerns and experiences with a partner is crucial. Open and honest communication can help create a supportive and understanding environment, fostering emotional intimacy and reducing anxiety or stress related to sexual health. It is also important to talk to your doctor or healthcare professional. They can advise you on the best way to manage your symptoms for you as an individual.
  • Vaginal Moisturisers: There are so many on the market, many of which are available over the counter. It is important you chose one which is ‘body-similar’ and does not adversely change the pH of your vagina or the microbiome of your vagina (yes that is a thing!) Ask Dr Neet for advice on this, as there are some fantastic ones around which can really help with daily comfort and sexual intimacy without using any hormones.
  • Vaginal Oestrogen: Whether you are on regular HRT or not, vaginal oestrogen can really help genitourinary symptoms, such as vulval itching, soreness, pain on sex, frequency of urine, feeling of recurrent urine infections. It comes in various forms, such as creams, pessaries, and even a small oestrogen ‘ring’ like a hair bobble which can last 3months! These are prescription only and there are some contraindications, so again speak to Dr Neet about the possibility of using this.
  • The Emsella Chair: Strengthening the pelvic floor muscles through exercises like Kegels can improve vaginal tone and increase sexual satisfaction. However, did you know that most people can only engage around 30% of the muscle fibres in our pelvic floor, if done perfectly, with physio help and with a pelvic floor tool to help. The Emsella Chair delivers almost 12,000 kegels, engaging 100% of the pelvic floor muscle, over just 28 minutes! Sexual health and orgasms have been proven to improve in many women when the right protocol has been used. Ask at reception and get booked in! (this also can help with incontinence problems which can of course have an impact on our sexual health too)
  • The Exilis Ultra Femme 360: This is a revolutionary, non surgical vaginal rejuvenation device and only takes 8minutes. It stimulates blood flow and collagen production targeting vaginal laxity (looseness) and can also be used externally for labial remodelling. Female sexual satisfaction has been proven to improve and this can only be a good thing!
  • Regular Physical Activity: Engaging in regular exercise has numerous benefits for overall health, including sexual health. Exercise increases blood flow, boosts mood, reduces stress, and improves self-esteem, all of which can positively influence sexual well-being. The Bespoke Clinic runs one to one Personal training sessions and small group work, and the aims of these sessions will be led by you.

Take home message

The perimenopause is an expected but challenging phase in a woman’s life, and sexual health deserves attention and care during this time. By understanding the challenges and being proactive in managing sexual health concerns, women can maintain a fulfilling and satisfying sex life well into their postmenopausal years. Open communication, seeking professional guidance when needed, and incorporating self-care practices can help navigate the changes and embrace this new chapter with confidence and vitality. Remember, sexual health is an essential aspect of overall well-being, and taking care of it is an empowering choice every woman deserves to make.

Make an appointment for a confidential and thorough consultation.

Be Sexual

 

P.S. Don’t forget about the risk of sexually transmitted infections. Any change in partner at any age can be a risk, and there is an increase in the prevalence of STIs in the over 50s now, so be safe and get checked if in doubt!

 

Exercise & Menopause

The importance of exercise

When people ask if they exercise there can be such a variety of responses- understandably! These include:

  • ‘No, I don’t have any time’
  • ‘Yes, I am on my feet all day’
  • ‘I go swimming twice a week’
  • ‘I walk the dog twice a day’
  • ‘I cycle to and from work’
  • ‘I am a member of a gym and sometimes go to classes’

The most important type of exercise women can do, in my opinion, is strength-based exercises and the reason for this is that women are at a much higher risk of developing osteoporosis. As we go through the ages, our oestrogen levels drop and this has an impact on bone density and structure. It happens at a much higher rate than seen in men. There are additional risk factors as well, such as smoking or excessive alcohol intake, extremely low body weight, poor nutrition, some autoimmune and endocrine conditions, and long term oral steroid use.

By doing some strength-based exercises not only during the perimenopause, but throughout our lives, we can improve our bone density and reduce our risks going forwards.

And this is not about getting massive or entering a bikini body competition ladies! This is about getting stronger, fitter, improving mobility and being more functional in our day to day lives.

Strength based exercises can be done by using our own body weight or using dumbbells and Olympic bars. Whatever your ability, (or lack of) the Personal Trainers at The Bespoke Clinic will help you develop your strength, improve your confidence in moving and lifting and help reduce your risks of age related and hormone linked conditions like osteoporosis, metabolic syndrome, cardiovascular disease. You will see results and be motivated to keep it going!

Other benefits of exercising in general are:

  1. Hormonal regulation: Regular exercise can help regulate hormones and mitigate some of the symptoms associated with menopause, such as hot flushes, mood swings, and sleep disturbances.
  2. Weight management: Menopause often leads to weight gain, particularly around the abdomen. Regular exercise, including aerobic activities and strength training, can help control weight by boosting metabolism and maintaining muscle mass, which tends to decrease with age.
  3. Cardiovascular health: As oestrogen levels decline, women become more susceptible to cardiovascular disease. Exercise improves cardiovascular health by lowering blood pressure, improving cholesterol profiles, reducing the risk of heart disease, and enhancing overall cardiovascular function.
  4. Mental well-being: Menopause is often accompanied by mood swings, anxiety, and depression. Exercise stimulates the release of endorphins, which are natural mood-enhancing chemicals, leading to improved mental well-being and reduced symptoms of depression and anxiety.
  5. Sleep quality: Many women experience disrupted sleep patterns during menopause. Regular exercise has been shown to improve sleep quality and duration, helping women get better rest and reducing sleep disturbances.
  6. Cognitive function: Hormonal changes during menopause can also affect cognitive function and increase the risk of cognitive decline. Exercise has been associated with improved cognitive function, including enhanced memory, attention, and overall brain health.

Make an appointment with one of our amazing personal trainers who can help you continue or even start your journey. Izzy is also trained in Nutrition and Josie is a Yoga Teacher. Tap into their expertise so we can look after the whole of you.

Be strong 

 

 

 

What is the Andropause?

Testosterone naturally starts to drop in men around their 30s. However, studies have shown, that this drop in testosterone can lead to significant symptoms in around 30% of men over the age of 50, with some men, having symptoms much earlier in their lives.

The Andropause, or Male Menopause, or even MANopause, is an increasingly recognised condition, affecting men with a lowered level of testosterone. The trouble is, every man has a different presentation and a different level of testosterone at which they develop symptoms so it is important we unpick that during a consultation.

Symptoms

There are a number of issues which are linked to the fluctuating levels of hormones in men:

  • Poor sleep
  • Fatigue
  • Erectile dysfunction
  • Low sex drive
  • Mood swings
  • Weight gain
  • Decreased muscle and bone mass

But we must check and remember that these symptoms may be exacerbated or caused entirely by external factors such as stress or anxiety.

If you are troubled by any of these symptoms, or just not feeling yourself, it may be a hormonal imbalance, or it may just be a normal part of ageing. Many men are embarrassed to talk about it, and tend to keep their symptoms to themselves, but you should not suffer in silence. Just trying to make sense of it can help and The Bespoke Clinic will undertake a thorough medical consultation and order appropriate investigations if required, to ensure we are looking after you and your needs.

Make an appointment, and let’s work this out together.

Be You again

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