Our menopause clinic is a specialist service within the Northern Trust. We support women who are experiencing symptoms of perimenopause and menopause.

Most women can get advice and treatment for menopause from their GP. However, our clinic is here to help women who have more complex needs.

This includes women who:

• Go through menopause early (before age 40)
• Have a complicated medical history
• Have a personal or family history of breast cancer or other cancers
• Have tried different hormone replacement therapies (HRT) but are still struggling with symptoms

We provide expert care and support to help manage these more complex situations.

What are menopause and perimenopause?

Menopause is when a woman has not had a period for 12 months. In the UK, the average age for menopause is 51. Most women go through it between the ages of 45 and 55, but for some it can happen earlier.

After menopause, the body produces much less oestrogen. This can cause a range of symptoms. Lower oestrogen levels can also increase the risk of conditions such as weak bones (osteoporosis) and heart disease later in life.

For most women, menopause is a natural part of ageing. However, some women may go through menopause earlier because of surgery to remove the ovaries, or as a result of cancer treatments such as chemotherapy or radiotherapy.

The time leading up to menopause is called perimenopause. This can last for several years. During this time, periods may change — they may become lighter or heavier, and cycles may get shorter or longer.

These changes, along with symptoms, are usually enough for a doctor to recognise perimenopause, so blood tests are often not needed.

What are typical symptoms?

Most women will have some symptoms during menopause. Around 3 in 4 women experience at least one symptom, and about 1 in 4 have more severe symptoms.

Changes in periods are often the first sign. Symptoms can start at this stage and may last for months or several years. On average, they last around 7 to 8 years.

Common symptoms include:

• Hot flushes and night sweats
• Trouble sleeping
• Anxiety or low mood
• Heart palpitations
• Headaches
• Poor memory or difficulty concentrating
• Joint pain
• Reduced sex drive
• Vaginal dryness

This is not a complete list, as symptoms can vary widely from person to person.

Because these symptoms can have other causes, it’s important to speak to your GP to rule out any other health issues.

What can I do?

Not all women will need treatment for menopause symptoms. Making healthy lifestyle changes can help and may reduce how severe symptoms feel.

Being overweight, smoking, or drinking too much alcohol can make symptoms like hot flushes and night sweats worse.

You can help manage symptoms by:

• Eating a healthy, balanced diet
• Exercising regularly
• Cutting down on alcohol
• Stopping smoking
• Getting enough good-quality sleep
• Finding ways to manage stress

These steps can improve your overall health as well as helping with menopause symptoms.

What treatment options are available?

Hormone replacement therapy (HRT) is the most effective treatment for menopausal symptoms. However, it is not suitable for everyone, and some women may choose not to use it. For most women, the benefits of HRT are greater than the risks.

There are also non‑hormonal treatment options. These can help with symptoms like hot flushes and night sweats. Your GP can discuss these with you and may suggest medications or talking therapy, such as cognitive behavioural therapy (CBT).

CBT is recommended by NICE and can help with anxiety, low mood, and coping with symptoms. Some women find it also reduces how distressing hot flushes feel.

Some people choose to try herbal remedies. These may help some women, but research has not shown clear evidence that they work better than a placebo.

HRT replaces hormones such as oestrogen, progesterone, and sometimes testosterone. It comes in different forms, including tablets, patches, gels, and sprays. Your doctor can help you choose the option that suits you best.

Women who go through menopause early (before age 40) are usually advised to take HRT until around the natural age of menopause. This helps protect heart and bone health, even if they do not have symptoms.

Who provides this specialist service?

The menopause service is run by a team of specialist doctors working within Gynaecology and Sexual and Reproductive Healthcare. As we are a teaching hospital, doctors and nurses in training as well as medical students may be present at our clinic.

Appointments may be by telephone or in person. Gynaecological investigations and minor procedures are also part of the service if necessary.

In patients for whom English is a second language, we offer consultations with an interpreter or through Big Word telephone translation service.

Where to find us

Antrim Area Hospital
Gynaecology Outpatient Department, Bush Road, Antrim, BT41 2RL

Causeway Hospital
Contraceptive and Sexual Health Services Hub, 4 Newbridge Road, Coleraine, BT52 1HS

Braid Valley
Contraceptive and Sexual Health Services Department, 86 Cushendall Road, Ballymena, BT43 6HL

How to access the service

To use this service, you must live within the Northern Trust area and meet the referral criteria.

We accept referrals from GPs and other hospital specialists. All referrals are reviewed by our specialist doctors and prioritised based on clinical need, so waiting times can vary.

In many cases, we can give advice directly to your GP without the need for an appointment. This helps you start treatment sooner and allows us to see patients with more complex needs more quickly.

Once your treatment is working well, your care will be handed back to your GP.

All treatment provided by our clinic follows national guidance from NICE and the British Menopause Society.

Useful resources

A Dieticians guide to Perimenopause and Menopause (playlist)
Women’s Health Concern: Confidential Advice, Reassurance and Education
Women’s Health Concern: WHC factsheets and other helpful resources
Menopause Together Ltd
NHSCT Contraceptive Services
The Daisy Network: Charity for Women with POI 
Menopause Matters: Menopausal symptoms, remedies, advice
Royal Osteoporosis Society: Better Bone Health for Everybody
Menopause and Cancer with Dani Binnington
Breast Cancer Now