What We Do

Menopause

All women go through the menopause.  It is part of the ageing process and something that can’t be avoided. It happens when a woman’s periods stop, usually between the ages of 45 and 55, because of declining hormone levels in the body.  

Menopause affects all women differently. Common symptoms include night sweats, hot flushes, anxiety, fatigue, weight gain, poor concentration, and bladder problems, but there are many more.

Three in every four women experience symptoms associated with the menopause and for one in four women, these are debilitating and life changing.

We believe no woman should suffer the effects of hormone imbalance and that replacing hormones is necessary to maintain bone, cardiovascular, and brain health.

“No woman should suffer the effects of hormone imbalance or be deprived of hormone replacement therapy if she wants it.  Bio-identical hormones do not cause blood clots, cancer, or strokes.”

Our Approach

• We know that every patient has different needs and requires personalised treatment.

• We believe the key to managing the menopause is to replace the hormones that have been lost. This relieves symptoms and helps to prevent osteoporosis, Alzheimer’s, and heart disease in later life.

• We use body/bio-identical hormones - these are hormones with exactly the same chemical structure as the hormones the body makes, meaning they do exactly what they are supposed to do, without risks or side effects.

• We always start with medications available at high street pharmacies. If patients don’t tolerate these we use alternative medication from licensed pharmacies.

• Because we believe in treating the patient, not just the symptoms we look at other hormones, the thyroid, possible insulin resistance and prediabetes. And we consider lifestyle, exercise, nutrition, and supplements.

Conventional Approach

• GPs and menopause clinics are now prescribing body/bio-identical oestrogen and progesterone which are available on the NHS, but many women do not tolerate this combination.

• Testosterone is not commonly prescribed by GPs even though many women need it.

• Acupuncture, cognitive behavioural therapy, which is a talking therapy, or antidepressants are often suggested. Whilst they have been shown to help alleviate hot flushes and mood symptoms they often aren’t the answer.

Common Symptoms

Anxiety / Bladder problems / Depression / Difficulty sleeping / Dry eyes / Fatigue / Hot flushes / Irritability / Joint pains / Lethargy / Low libido / Low mood / Migraines / Muscle loss / Night sweats / Pain on intercourse / Poor memory and concentration / Thin skin and hair / Vaginal Dryness / Weight gain

Perimenopause

Perimenopause is the transitional time before the menopause. Every woman’s experience of it is different.  Some do not even notice this phase, but for others the perimenopause is an unpredictable and distressing time when hormones fluctuate drastically causing irregular periods, heavy bleeding, night sweats, and hot flushes. 

The underlying cause is huge changes in oestrogen level - from very high to very low with a background of low progesterone.  It is often misdiagnosed as menopause, but is very different.

“Typically GPs and menopause clinics struggle to deal with perimenopausal patients.  Every day we see women who have been put on high doses of oestrogen which worsens anxiety and depression, and can cause even heavier bleeding.”

Our Approach

• From the age of 35 onwards, a woman’s levels of progesterone starts to decline.  We replace this and in doing so, stop the main symptoms of perimenopause - anxiety, night sweats, brain fog, headaches, and heavy periods.

• If a woman’s periods are regular, or nearly regular, then they don’t need additional oestrogen and we don’t prescribe it.

Conventional Approach

• The perimenopause is often misdiagnosed, with GPs prescribing antidepressants and sleeping tablets.

• Often oestrogen is given, which can worsen symptoms.

Common Symptoms

Anxiety / Brain fog / Depression / Headaches / Heavy periods / Lack of sexual desire / Trouble concentrating / Trouble sleeping / Vaginal dryness

Premenstrual Syndrome (PMS)

Premenstrual syndrome or PMS as it is commonly known, can affect women at any age and is experienced by most women at some stage in their reproductive lives.  PMS is the name given to symptoms experienced before a period, which can be both physical and psychological. 

PMS is caused by an imbalance between oestrogen and progesterone in the luteal phase of the menstrual cycle, when, between day 15 and 28, the uterine lining thickens. 

“Often women with PMS are sent away with the contraceptive pill, or antidepressants, which may work for some, but often don’t.  We know this is not the answer and that’s why we prescribe progesterone instead.”

Our Approach

• We use body/bio-identical progesterone to control symptoms, and supplements to help the body restore balance naturally.

• We help to relieve symptoms by encouraging a good diet and exercise routine.

Conventional Approach

• The oral contraceptive pill is usually prescribed to ‘turn off’ the ovaries.  The pill replaces the hormones the ovaries naturally produce with oestrogen and synthetic progesterone.

• Cognitive behavioural therapy to help with depression and anxiety.

• Antidepressants to help with low mood.

Common Symptoms

Acne / Bloating / Bowel symptoms / Breast tenderness / Fatigue / Headaches / Irritability / Joint pains / Low mood / Migraines / Muscle aches / Night sweats / Palpitations / Poor sleep / Sugar cravings / Tearfulness / Weight gain

Premenstrual Dysmorphic Syndrome / PMDD

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS).  It is often misunderstood and misdiagnosed. PMDD, much like PMS, causes distressing symptoms in the week or two before a woman’s period starts.  Whilst the symptoms of PMS are largely physical, PMDD is diagnosed by its severe mental health implications, with women becoming extremely distressed and volatile.

Our Approach

• We recognise the importance of diagnosing and treating PMDD and work with many patients who have struggled to access help in other settings.

• We take a detailed medical history and carry out blood tests when the symptoms are most acute.

• When a hormone deficiency is diagnosed we prescribe body/bio-identical hormones to restore balance.

Conventional Approach

• GPs usually start by prescribing antidepressants and the contraceptive pill.

• When this is no longer useful, hormones are given to suppress the ovaries, causing the woman to go into menopause, sometimes permanently.

• An extreme, but common treatment is a total hysterectomy.

• In most cases these solutions don’t work and hormone replacement is required. 

Symptoms

Anxiety / Fatigue / Feelings of despair or even suicidal thoughts / Insomnia / Joint or muscle pain / Lack of concentration / Panic attacks / Severe mood swings

Endometriosis & Adenomyosis

Endometriosis is a condition where tissue similar to the uterus lining is found outside of the womb. Common areas include the ovaries and fallopian tubes, bowel, bladder, pelvis, and sometimes even in the gastro-intestinal tract.

It is a complex condition which varies in severity from stage 1 (mild) to stage 4 (severe). Causes include retrograde menstruation, where a period flows upwards into the fallopian tubes instead of through the vagina, genetics, immune-mediated diseases, environmental toxins, and hormone imbalance.

Endometriosis can be diagnosed by symptoms alone.  Often a laparoscopy is carried out to give a definitive diagnosis.

Adenomyosis is a related condition .

Instead of the cells that line the womb appearing outside the womb, they build up in the muscle of the wall of the womb.

The conditions are otherwise the same in terms of symptoms (painful periods) and treatment.

“It is so important to diagnose endometriosis early and this is easy, but women wait an average of 12 years for a diagnosis during which time they experience great suffering and increased risk of infertility. Any young woman with terribly painful periods may have endometriosis and doctors must consider this.”

Our Approach

• Body and bio-identical progesterone treatment is highly effective as this counteracts the effects of oestrogen.

• We use supplements such as Mirena to promote healthy oestrogen metabolism.

Conventional Approach

• Pain relief such as anti-inflammatory medication.

• Conventional hormonal therapies such as the combined pill or mirena coil.

• Laparoscopy and laser surgery which is not helpful if the cause is hormonal.

• In severe cases, surgery to remove the womb.

Common Symptoms

Bleeding between periods / Chronic low back pain / Fatigue / Infertility / Painful and/or heavy periods / Pain during sex / Pain on urination / Pelvic pain

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome is a common condition which affects how a woman’s ovaries work. The condition, which often runs in families and can be brought on by stress, is thought to affect one in every ten women in the UK. More than half of these women do not experience any symptoms. 

The underlying cause is insulin resistance which affects ovarian function. Polycystic ovaries contain a large number of harmless follicles which mean ovulation does not take place. 

Women with PCOS are at increased risk of developing other conditions such as obesity, high cholesterol, and diabetes.  Early diagnosis is important to protect a woman’s fertility, and her mental health.

“PCOS is becoming more common among younger women and understanding their condition is vital to make sure these women aren’t  affected by it as they mature. The underlying cause is nothing to do with ovaries. It is a metabolic issue and that is the key to reversing these symptoms and preserving health.”

Our Approach

• We prescribe body/bio-identical progesterone to help regulate cycles and counteract oestrogen.

• We give advice on nutrition and supplements to optimise hormones.

• We look at lifestyle factors and whether they can alleviate symptoms.

Conventional Approach

• Patients are often advised to lose weight or prescribed the oral contraceptive pill. This often helps by protecting the womb lining, but it is not a complete solution.

• Drugs such as spironolactone can be used to treat symptoms such as acne, hair loss, and weight gain.

Symptoms

Acne / Depression / Excessive hair growth on the face, neck or back / Fertility problems / Greasy skin / Hair loss or thinning hair / Insulin resistance / Irregular or no periods / Obesity / Weight gain

Fibroids

These are benign growths in the uterus, also called myomas or leiomyomas. They are made of muscle and fibroid tissue and vary in size from a pea to a small football. Stimulated to grow by high oestrogen levels or low progesterone, they can be asymptomatic or cause a number of painful symptoms.

Fibroids often grow during pregnancy due to increased levels of oestrogen in the body. They shrink after the menopause.

Our Approach

• We prescribe body/bio-identical progesterone to counteract the effects of oestrogen.

• Supplements, such as DIM, which help to restore hormonal balance.

• Supplements to address deficiencies, such as iron which is caused by heavy bleeding.

• Surgery if fibroids are extremely large.

Conventional Approach

• The oral contraceptive pill is usually prescribed, along with drugs such as tranexamic acid which control heavy or painful periods.

• An intrauterine device (known as an IUS or coil) can be fitted to release progesterone.

• For large fibroids, a temporary and reversible ‘menopause’ can be brought on, but this has many unwanted side effects.

• Surgery, and in severe cases hysterectomy.

Common Symptoms

Abdominal pain / Back pain / Bloating / Bowel problems / Heavy or painful periods / Infertility / Painful periods / Urinary frequency

Abnormal Uterine Bleeding

Abnormal uterine bleeding usually occurs when a woman’s cycle is disrupted due to hormone imbalance. Periods can be very heavy with clots, or light. Not only is the flow affected but the bleeding pattern can vary from being regular to prolonged, or more frequent than normal.

It is important to rule out any pathological cause of heavy or irregular uterine bleeding such as pregnancy, endometrial cancer, thyroid disorders, or fibroids.

Our Approach

• We prescribe body/bio-identical hormones, such as progesterone to restore hormonal balance and regulate cycles.

• We aim to avoid invasive treatments and surgery by prescribing progesterone.

• And because we treat the patient, not the condition, we address lifestyle factors, such as diet and exercise, which may be contributing to symptoms.

Conventional Approach

• Usually, the oral contraceptive pill will be prescribed to regulate the cycle.

• Endometrial ablation (surgery which destroys the lining of the uterus) may be considered to reduce bleeding during periods and avoid a hysterectomy.

• If bleeding cannot be controlled and is disrupting quality of life, a hysterectomy (surgery to remove the womb) may be carried out.

Common Symptoms

Anxiety / Anaemia / Heavy bleeding often with clots / Pain / Tiredness / Uterine leaking

Postnatal Depression (PND)

Postnatal depression affects one in ten women within a year of giving birth, and can also affect fathers and partners. PND is thought to be brought on by extreme fluctuations in hormone levels after childbirth. Other factors include a history of mental health problems, lack of support, and stress.

It is common to feel low in mood and tearful during the first week after the birth of a baby. These symptoms should not last for more than two weeks and if they do it is important to seek help, as it may indicate postnatal depression.   

“Replacing deficient hormones can be an excellent way to treat postnatal depression. If left untreated it can go on for months and even years.” 

Our Approach

• Body/bio-identical hormone therapy to restore hormonal balance.

• Referral for psychological therapies.

• Antidepressants for severe cases.

Conventional Approach

• Cognitive behavioural therapy - a talking therapy.

• Antidepressants - these may be necessary in severe cases.

Symptoms

Anxiety / Difficulty bonding with your baby / Difficulty sleeping / Feeling guilty / Low energy / Low self esteem / Withdrawing from people / Worrying thoughts about harming your baby

Osteoporosis

Osteoporosis affects over three million people in the UK and is often diagnosed after a fall or fracture.  The condition causes people to have weak bones and usually develops in the hips or spine. 

Although losing bone density is a normal part of ageing, it can be prevented and replacing hormones is a vital part of this. During the first few years of the menopause women rapidly lose bone because oestrogen, progesterone, and testosterone are all vital for bone density. Women who have low body mass index, smoke, have inflammatory conditions, or take medications such as steroids are at higher risk. Osteoporosis is also known to run in families.

“No woman should suffer osteoporosis. Not only do the hormones oestrogen, progesterone, and testosterone prevent it, they reverse bone loss too.”  

Our Approach

• Medics currently use a DEXA scan to diagnose osteoporosis, but this is not the most reliable way.  We use a blood test called ‘crosslaps’ to detect whether bone metabolism is occurring.

• We use body/bio-identical hormone replacement therapy to rebuild and prevent further bone loss.

• We offer lifestyle, nutrition, and exercise advice and supplements to optimise vitamin and mineral levels whilst assessing other medications which could be contributing to the condition.

Conventional Approach

• Some doctors prescribe HRT for osteoporosis, and the British Menopause Society has recently recognised the value of oestrogen as a first line treatment.

• Medications such as bisphosphonates are also prescribed which can cause side effects and are much less effective than oestrogen.

Thyroid Disorders

The thyroid gland is located in the neck and produces hormones that are related to metabolic processes in the body. It can become overactive or underactive. An underactive thyroid causes low energy, weight gain, and cognitive decline. It is a common condition as we age, and especially during the menopause, but it is often not picked up in medical settings.

Our Approach

• As we know this is a common condition amongst patients we look out for it, and treat it early, to prevent the issue becoming more serious.

• Because we look at the body as a whole, we are better able to manage the condition and do this well by prescribing T3 hormone, which is not routinely available on the NHS.

• We also assess lifestyle factors and nutrition to see whether these are contributing.

• If we discover an overactive thyroid we refer you back to your GP or an endocrinologist for treatment.

Conventional Approach

• GPs generally don’t test for thyroid disorders or treat them well.

• They often prescribe levothyroxine, but this isn’t usually effective for most patients.

Symptoms

Anxiety / Difficulty sleeping / Heat intolerance / Irritability / Neck swelling / Palpitations / Tremor / Weight loss

Premature Ovarian Failure

This is sometimes known as early menopause and is when the ovaries stop functioning before a woman expects. It can happen naturally, before the age of 45, or be a side effect of some treatments. In almost all cases, it is shocking and traumatic. 

At London Hormone Clinic we are experienced in helping younger women deal with this life changing set of events, whether it happens naturally or not.  We replace and optimise the woman’s hormones to prevent osteoporosis, cardiovascular disease, and Alzheimer's and to keep her feeling ‘like herself’.

We are also able to replace hormones to mimic a normal menstrual cycle. This may provide options for fertility treatment. 

Infertility

84% of couples conceive within a year of trying for a baby, and around 92% conceive within two years. Others may experience infertility when, despite regular intercourse, a woman does not become pregnant. 

Couples are advised to see their GP if they have not conceived after a year of trying, but it is possible to carry out initial tests on both partners after six months, particularly if a woman is over 35.

There are many causes of fertility problems, including polycystic ovarian syndrome, endometriosis, damage from untreated sexually transmitted diseases, diabetes, and premature menopause. 

Our Approach

• After six months of trying to conceive we look at underlying problems and lifestyle factors which may be having an impact, whilst ensuring the correct levels of reproductive hormones are present.

• We investigate both partners, rather than just focusing on the woman. 

Conventional Approach

• Couples are advised to wait at least a year before tests are carried out.

Insulin Resistance

Insulin is a hormone made by the pancreas that helps glucose in blood enter cells in muscle, fat and the liver. The more starch and sugars we eat, the more insulin is needed to regulate our blood sugar levels. Over time, cells can become resistant to insulin until the point that the pancreas can’t keep up. This causes midline weight gain and, in the long-term can lead to Alzheimer’s, diabetes, heart disease and cancer.

Everyone is at risk and many people live with IR without even knowing. If you’re over forty-five, overweight, or have a diet high in sugars or carbohydrate, you are more likely to develop insulin resistance. A family history of type two diabetes, chronic stress and certain medications can worsen IR.

Our Approach

• We recognise the signs of insulin resistance and actively go in search of it in our patients. Insulin resistance can be treated and is completely reversible and we begin with nutritional and lifestyle changes, increasing daily levels of exertion and switching to a low, not a no-carbohydrate diet.

• We prescribe hormones, in particular oral oestrogen which has a direct benefit in reversing insulin resistance, as does correct thyroid replacement and DHEA helps to reduce visceral weight.

• Medication is also used in some cases. Metformin improves the body’s ability to respond to the hormone insulin. It is used to treat insulin resistance in women with PCOS and should be used to treat older patients too.

• GLP-1 agonists, such as Ozempic and Wegovy can also be used - these aid weight loss and the peptide in these medications also seems to have direct benefit for insulin resistance, reversing damage to various tissues such as the pancreas. Patients are given nutritional support whilst on this medication, helping them to transition off it.  

   

Conventional Approach

• Despite its prevalence, many doctors do not know how to diagnose or treat insulin resistance. And because of this, don’t look out for early signs of the condition.

• Patients are usually told to ‘lose weight’ and given outdated nutrition plans, such as eating porridge to help lower cholesterol. This high carbohydrate food actually does the opposite as it raises blood sugar and promotes more insulin resistance, causing cholesterol to rise.

• Patients are currently only prescribed metformin when they become diabetic, missing years of potential prevention.

Symptoms

For many years there are no outward symptoms, usually the only sign is midline weight gain/an increase in visceral fat. On investigation there may be…

High or abnormal cholesterol / High or abnormal blood sugar / High triglycerides / High blood pressure / Fatty liver on an ultrasound

By the time other symptoms start to develop insulin resistance has progressed to prediabetes or diabetes. We try to identify early changes making reversal much easier. This lowers the risk of cancers, strokes and heart disease and other conditions such as autoimmune diseases and Alzheimer’s disease.

Hormonal Hair Loss

More information coming soon.

Men’s Health

From the age of 35 onwards, testosterone levels in men start to decline. Unlike the female menopause when hormone levels plummet, the male andropause happens more slowly, over many years. 

As men have differing levels of testosterone, symptoms are wide ranging and can happen at any time. Testosterone levels are also affected by medications, stress, and lifestyle choices.

Our Approach

• We firstly look at medical issues and lifestyle choices which may be contributing.

• We analyse testosterone and DHEA (adrenal) hormone levels by doing blood tests.

• Careful prostate assessment is also necessary through blood tests and ultrasound.

• We refer to a urologist if necessary, and regularly review treatment.

We are able to offer testosterone replacement and the benefits of this are wide ranging. Muscle mass is increased, sexual performance and libido improved, and the risk of cardiovascular disease reduced.

Conventional Approach 

• GPs generally don’t treat men for low testosterone. They often refer to urologists.

• They also don’t consider other hormones such as DHEA or test for prediabetes.

Symptoms

Anxiety / Decreased bone density / Depression / Erectile dysfunction / Fatigue / Fewer spontaneous erections / Increased body fat / Increased sleepiness / Insomnia / Low mood / Low self esteem / Reduced libido / Testicular shrinkage