Menopause Management at The Cherwell Hospital in Banbury

Menopause and perimenopause are natural stages of life, but for many women, symptoms can significantly impact day-to-day well-being. They can affect your sleep, mood, energy levels, relationships, and overall quality of life, making even routine activities feel more challenging.

At Ramsay Health Care, our experienced consultant gynaecologists provide personalised, expert-led menopause and perimenopause management designed around your symptoms, health history, and lifestyle. With hospitals located across the UK, we offer convenient access to specialist menopause care close to you.

Whether you’re experiencing perimenopause symptoms, navigating menopause itself, or managing postmenopausal health, we’re here to help you understand your symptoms and explore treatment options that support your long-term health and quality of life.

Book a menopause consultation

What is menopause?

Menopause is the point in time when periods stop permanently due to a natural decline in oestrogen produced by the ovaries. Clinically, menopause is confirmed after 12 consecutive months without a menstrual period.

In the UK, the average age of menopause is 51, with most women experiencing it between 45 and 55 years of age¹.

Menopause usually occurs naturally as part of ageing, but it may also happen earlier due to:

• Surgical menopause - for example, after removal of the ovaries (oophorectomy)

• Medical treatments - such as chemotherapy or radiotherapy

• Certain health conditions affecting hormone production – such as autoimmune disease or chronic infection

While menopause is most commonly discussed in relation to women, it affects anyone who menstruates, including some transgender and non-binary individuals.

The three stages of menopause

Menopause is not a single moment but part of a gradual hormonal transition that happens over time, usually experienced in three broad stages:

Stage 1: Perimenopause

Perimenopause is the transitional stage leading up to menopause. It often begins in the early to mid-40s, although some people notice symptoms as early as their mid-30s.

During perimenopause, the ovaries begin to produce less oestrogen. Oestrogen levels can fluctuate over time, both dropping and rebounding. This can lead to a range of perimenopause symptoms (often also called early menopause symptoms) that you may gradually become aware of, including:

• Irregular periods, with cycles becoming shorter, longer, heavier or lighter

• Mood changes, including irritability, anxiety, and depression

• Sleep disturbances

• Night sweats

• Hot flushes

• Vaginal dryness

• Reduced libido

• Fatigue

• Weight gain

• Brain fog (difficulties with concentration and memory)

This stage typically lasts about four years, but it can range from a few months to 10 years in some women.

Stage 2: Menopause

Menopause itself is diagnosed as one specific point in time rather than a long phase. It’s confirmed when you’ve gone 12 months without a menstrual period.

In the UK, the average age at which menopause occurs is 51, but it can vary for each person².

Once you reach this milestone, your body enters the next stage: postmenopause.

Stage 3: Post menopause

The postmenopause stage begins after you reach the 12-month period-free milestone.

Some menopause symptoms may ease throughout this stage, but sustained low oestrogen levels can increase the risk of certain long-term health conditions, including osteoporosis and heart disease. Understanding these risks is an important part of long-term menopause care and is something we can guide you through.

You can learn more about this stage on our postmenopausal information page.

Menopause symptoms: what to look out for

There are up to 34 recognised menopause symptoms, but they can vary widely from person to person. Some women experience only mild symptoms, while others find that symptoms significantly affect daily life. Even in more disruptive cases, it’s rare for someone to experience all 34 menopause symptoms.

The most common menopause symptoms include hot flushes and night sweats, which can disrupt sleep and leave you feeling tired during the day. Many women also notice vaginal dryness, changes in sexual desire (usually reduced libido), and urinary symptoms such as increased frequency or recurrent urinary tract infections.

Hormonal fluctuations can also affect your emotional wellbeing. This can include anxiety and low mood, alongside cognitive symptoms like brain fog, forgetfulness and difficulty focusing. Sleep disturbances and insomnia are also common, even without night sweats.

Physical symptoms may include fatigue, joint pain, headaches, weight changes (particularly around the abdomen), and thinning hair. Some women also experience heart palpitations, dry skin, or changes in body odour.

Menopause symptoms can be difficult to identify, as they often appear gradually and can come and go. They can also overlap with other health conditions, such as thyroid disorders, depression, or chronic fatigue syndrome. This can make it difficult to identify whether menopause is the underlying cause or something else.

If you're unsure whether your symptoms are menopause-related, our consultant gynaecologists can help assess your case and provide expert diagnosis and guidance.

Early menopause and premature menopause

For some women, menopause occurs earlier than expected.

• Early menopause happens when periods permanently stop before the age of 45.

• Premature ovarian insufficiency (POI) occurs when menopause develops before the age of 40.

Both conditions can happen for a range of reasons, including genetic factors and autoimmune conditions. They can also be caused by certain cancer treatments or surgery, such as the removal of one or both ovaries (oophorectomy).

Experiencing menopause early can have emotional as well as physical implications. You may be concerned about fertility, relationships, and your sense of identity during what should still be your reproductive years. Early menopause can also increase the long-term risk of certain health conditions like osteoporosis and heart disease, due to prolonged oestrogen deficiency.

These rarer presentations of menopause require specialist support and understanding. Our gynaecology consultants have experience managing early and premature menopause and can help you navigate both the medical and emotional aspects of this diagnosis. We can guide you through available treatments, discuss fertility preservation options if appropriate, and provide support for the psychological impact of early menopause. 

How long does menopause last?

The menopause transition usually happens over the course of several years, although the timeline varies from person to person.

• Perimenopause: Typically lasts around four years but may range from a few months to more than 10 years.

• Menopause: The specific moment when you have gone 12 months without a period.

• Postmenopause: Begins after menopause and continues for the rest of your life, although symptoms often improve two to five years after your final period.

For some women, symptoms such as hot flushes, sleep disturbances, or mood changes may continue for 10 years or longer.

[Source: https://www.local.gov.uk/our-support/workforce-and-hr-support/wellbeing/menopause/menopause-factfile]

Postmenopause

Postmenopause is the stage after menopause has been confirmed. During this time, oestrogen levels remain low but stable.

Although many menopause symptoms gradually improve during postmenopause, the risk of certain health conditions increases due to sustained low oestrogen levels. These include osteoporosis (weakening of the bones) and cardiovascular disease. It’s important to maintain regular monitoring of your bone health and overall wellbeing during this stage.

Maintaining a healthy lifestyle, including weight-bearing exercise, adequate calcium and vitamin D intake, and cardiovascular health monitoring, becomes increasingly important. Your consultant can advise on appropriate screening and preventative measures.

For more detailed information about postmenopause and the potential long-term health considerations, visit our postmenopausal management page.

Testing for menopause

Menopause is often diagnosed based on symptoms alone – particularly if you’re over 45 – without requiring a menopause test.

Testing can be helpful in certain other situations, such as if you’re under 45 and experiencing symptoms of early menopause, or if your symptoms are unclear or could be linked to another condition, and menopause needs to be ruled out.

The most widely used menopause test is a simple blood test that measures hormone levels, including follicle-stimulating hormone (FSH) and oestrogen. These markers can help confirm whether your body is transitioning through menopause. FSH levels typically rise as the ovaries produce less oestrogen, so elevated FSH combined with low oestrogen can indicate menopause or perimenopause.

In line with NICE guidelines, most people over 45 don’t require testing, as a clinical diagnosis can be made based on symptoms alone. However, where testing is appropriate, we can arrange this quickly and conveniently at Ramsay, without lengthy wait times. Results are typically available within a few days, allowing you to move forward with treatment planning promptly.

Talk to us today about booking a menopause blood test

Menopause treatments available at Ramsay

At Ramsay Health Care, we tailor our menopause treatments to your symptoms, medical history, and preferences. Our expert consultant gynaecologists will guide you through the options available and help you make informed decisions about your care.

Hormone replacement therapy (HRT)

For most women, hormone replacement therapy (HRT) is considered the most effective treatment for menopause symptoms.

There are two main types of HRT:

1. Combined HRT (oestrogen and progestogen): Recommended for women who still have a uterus, as the progestogen protects the womb lining from overgrowth

2. Oestrogen-only HRT: Typically used after a hysterectomy, when progestogen protection is not needed

HRT is available in several forms, allowing your treatment to be tailored to your lifestyle and preferences:

• Tablets – taken daily, convenient and familiar. Available in different strengths.

• Skin patches – changed once or twice weekly, delivering steady hormone levels through the skin. Discreet and easy to use.

• Gels – applied daily to the skin (usually arms, shoulders, or inner thighs). Dosage can be easily adjusted.

• Sprays – applied to the skin, quick-drying and convenient for daily use.

• Implants – small pellets inserted under the skin during a minor procedure, lasting several months before replacement is needed.

Your consultant will help you choose the most suitable type and delivery method based on your symptoms, medical history, and personal preferences.

Benefits of HRT:

HRT can significantly improve menopause symptoms, including hot flushes, night sweats, vaginal dryness, and sleep disturbances. It also supports mood and concentration, helps maintain bone density (reducing osteoporosis risk), and may reduce the risk of heart disease when started around the time of menopause. 

Risks and considerations:

As with any treatment, HRT carries some potential risks. These include a small increased risk of breast cancer (particularly with combined HRT used for more than 5 years) and a slightly increased risk of blood clots in some individuals. Some women may also experience side effects, such as bloating, breast tenderness, or mood changes, particularly when starting treatment, though these often settle within a few weeks. 

Your Ramsay consultant will carry out a full health assessment and discuss the benefits and risks with you in detail, taking into account your personal and family medical history. This ensures the treatment chosen is appropriate for your individual circumstances and that you can make a fully informed decision.

Non-hormonal and lifestyle treatments

Some women prefer not to take HRT or may not be suitable candidates due to underlying health conditions. Alternative treatments can still provide meaningful symptom relief.

Non-hormonal medical options may include:

• SSRIs or SNRIs (Selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors) – certain antidepressants that can help manage mood symptoms and reduce hot flushes. 

• Cognitive behavioural therapy (CBT) - can support mood, anxiety and sleep difficulties through structured psychological support.

• Vaginal oestrogen – localised treatment effective for vaginal dryness without significantly affecting hormone levels throughout the body. Can be used alongside systemic HRT or as a standalone treatment.

Lifestyle changes can also play an important role in managing menopause symptoms:

• Regular exercise – particularly weight-bearing activities for bone health and cardiovascular fitness

• Dietary adjustments - reducing alcohol and caffeine intake, eating a balanced diet rich in calcium and vitamin D

• Weight management – maintaining a healthy weight can reduce some symptoms and lower long-term health risks

• Sleep hygiene – establishing regular sleep routines and creating a cool sleeping environment

• Stress management – improves overall health and reduces some menopause-related risks

Menopause supplements

Some women also explore menopause supplements, such as black cohosh or soy isoflavones (phytoestrogens). While these may offer benefits for some individuals, evidence for their effectiveness varies. It’s important to speak to a healthcare professional before taking any supplements, as they can interact with other medications and may not be suitable for everyone. Your consultant can advise whether supplements might be appropriate as part of your treatment plan.

Why choose private menopause treatment?

Choosing private menopause treatment can offer a range of benefits, including:

• Enhanced privacy and dignity – Your own private room during consultations, giving you the comfort and discretion you need when discussing sensitive symptoms.

• Faster access to specialist care – See an expert consultant gynaecologist quickly, without lengthy NHS waiting times. When menopause symptoms are affecting your quality of life, prompt specialist care can make a real difference.

• Continuity of care – You'll be cared for by the same consultant throughout your treatment journey, building a relationship with a specialist who understands your individual needs.

• Flexible appointments – Consultations arranged at times that work around your schedule, including evenings and weekends at some locations.

What is the cost of private menopause treatment?

Menopause treatment costs with Ramsay Health Care will depend on the type of consultation, any diagnostic tests required (such as blood tests or scans), and your treatment plan, including whether HRT or other medications are prescribed. Costs also vary depending on which Ramsay hospital you attend.

Following your initial consultation, we’ll provide you with a personalised quote for your menopause management, which will be valid for up to 60 days.

We offer a range of payment options for your treatment, including:

• 0% Payment Plans – Allowing you to spread the cost of your treatment with fixed monthly payments made over a time period that suits you.

• Self-fund treatment – With our all-inclusive Total Care package, you’ll make a one-time payment at a pre-agreed price that covers all the treatment you’ll need.

• Your own medical insurance – Your private healthcare insurance may cover your menopause treatment. You should get written confirmation from your insurance provider before booking.

For a personalised quote or to discuss payment options in more detail, please contact our friendly team.

Menopause treatment and management at Ramsay Health Care

Have your menopause treatment with Ramsay to get quick access to the expert care you need, delivered in a hospital close to you. With 34 hospitals across the UK, we make specialist menopause care accessible and convenient.

At Ramsay Health Care, menopause management is led by experienced consultant gynaecologists with expertise in hormonal health, ensuring specialist-led care from your first appointment. Our approach is multidisciplinary and collaborative, drawing on expertise from specialist physiotherapists, dietitians, psychologists, and other healthcare professionals where needed. This enables a comprehensive assessment of your symptoms and overall health, supporting both short-term symptom relief and long-term wellbeing.

Your Ramsay experience includes:

• Convenient locations across the UK, many with on-site parking.

• State-of-the-art facilities with access to the latest diagnostic tools and treatments.

• Comprehensive care from initial consultation through to ongoing management.

• Dedicated patient support with easy access to your specialist team throughout your journey.

• Experienced consultants with subspecialty expertise in menopause management.

Whether you're experiencing perimenopause symptoms, navigating menopause itself, or managing postmenopausal health, our expert team is here to help you regain your wellbeing and quality of life.

Ready to take the next step? Contact us today to speak with one of our friendly advisors, find out more about menopause management at Ramsay Health Care, and book your consultation.

Book a menopause consultation with us today

Menopause FAQs