Menopause Service

What the service does
Who provides the service
How to access the service
Location of service
Useful links

What the service does

The Menopause service which is based in the Mater Hospital. The clinic provides expertise for women with problems associated with the menopause and perimenopause.

Most women who require HRT can access treatment and advice from their GP. The HRT clinic provides care for women with premature ovarian insufficiency and early menopause, women with complex medical backgrounds who are suffering with symptoms associated with menopause/perimenopause, and women with complications associated with HRT.

What is menopause?

The menopause is a woman’s last menstrual period and the average age of the menopause in the UK is 51. 1 in 100 women will have a premature menopause under the age of 40. After menopause oestrogen is no longer produced by the ovaries. This contributes to the increased risk of osteoporosis related fractures in older women.

What is the perimenopause?

The perimenopause is the transition phase between having regular periods and the menopause when the ovaries stop producing any hormones. It can last for several months or even years. Periods usually become irregular, often more frequent in the first instance, and heavy bleeding is common. Symptoms can come and go as hormone levels fluctuate.

What are typical menopausal symptoms?

Not all women get symptoms. 75% of women have some symptoms but only approximately 25% have severe symptoms. Symptoms include hot flushes, night sweats, sleep disturbance, anxiety, low mood, palpitations, headaches, poor memory and concentration, joint pains, loss of libido, and vaginal dryness.

What is the most effective treatment?

Not all women need treatment. Lifestyle modification including optimising weight, maintaining a healthy diet and engaging in regular exercise can be helpful.

However, women with a premature or early menopause should take HRT up until the age of natural menopause, even if asymptomatic, for the hidden benefits of bone and heart protection.

For women with persistent troublesome symptoms HRT is the most effective treatment and the benefits outweigh the risks for the majority of women.

Who provides the service

The service is provided by a team of doctors and specialist nurses. As we are a teaching hospital doctors and nurses in training, and medical students may also be in attendance at clinics.

Appointments may be virtual via telephone call or face-to-face in the clinic. Gynaecological investigations and minor procedures are part of the service provided if necessary.

Interpreting services- We can offer telephone or face-to-face consultations for those who cannot speak English. These consultations are with an interpreter or through The Big Word telephone translation service.

What is HRT?

Hormone Replacement Therapy (HRT) is used to replace the hormones a woman’s ovaries stop producing after menopause.

Oestrogen is used to treat the symptoms associated with menopause. It is available as a tablet, gel, spray or patch.

Progestogen is also required in all women, except those who have had a hysterectomy, to prevent thickening of the lining of the womb. Progestogen can be given with oestrogen in a single combined tablet or patch, or as a separate tablet or via a levonorgestrel containing coil (commonly Mirena). Refer to Information leaflet.

Vaginal oestrogen is useful for vaginal or bladder symptoms, taken vaginally as a tablet, cream, gel or ring. This can be used on its own or in combination with other HRT.

HRT can be taken ‘cyclically’ or ‘continuously’.

Cyclical (also known as sequential) HRT involves taking oestrogen every day but progestogen only 12-14 days month.

This sequence of hormone mimics the hormones produced in a normal menstrual cycle and is usually associated with a monthly bleed like a period.

This is the most suitable form of HRT for women who are still having periods or those who have had a period less than 12 months before starting HRT.

Continuous combined HRT is made up of oestrogen and progestogen both given every day. As long as a woman is not producing any additional oestrogen from her ovaries, the continuous progestogen should prevent the lining of the womb thickening up, and she should experience minimal or no bleeding.

This form of HRT is therefore only suitable for women who have not had a period for more than 12 months or who have had their ovaries removed.

See Factsheet link for information.

Non-hormonal options are available, particularly in those where HRT is best avoided. Refer to Non-hormonal Factsheet link.

Testosterone is not currently licensed for use in women in the UK. It is occasionally used as a trial to treat low libido in postmenopausal women. Refer to Factsheet.

Bleeding problems can occur when taking HRT and sometimes investigations are required. To understand more, see the WHC Factsheet. You can also see our leaflet for more information. Refer to Information leaflet.

If you are taking HRT and taking, or considering, weight loss injections, please discuss with your doctor as they may affect the absorption of some HRT preparations.

How to access the service

You must fulfil referral criteria and live within the Belfast Trust.

We accept referrals from GPs and other hospital specialties.

Referrals are triaged according to clinical priority and waiting times can vary. Once effective treatment has been established you will be discharged back to the care of your GP.

Downloading the MyChart app allows you to access information like appointments, medications and some test results.