I saw a menopause specialist at 46 and wished I’d done it sooner – here’s what happened

Arriving at the Menopause Care clinic, I was met promptly by Dr Elphinstone, who immediately made me feel at ease with her warm and inviting nature. We went into a consultation room. It was modern, comfortable and relaxed, despite the more clinical elements of the room, which included an examination area. Whether this area is needed is entirely dependent on individual needs. In my case, blood tests and physical exams weren’t necessary, but had they been, everything Dr Elphinstone needed was on hand.

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The appointment was called a ‘new patient consultation’. It lasted approximately 45 minutes and cost £295. During this time, Dr Elphinstone asked me why I had decided to see her. She then just let me talk and listened as I explained the uneasiness of not feeling right, and a level of rage that often felt unwarranted for the situation.

The whole time I was talking, she smiled supportively and nodded along. I knew she understood what I was saying, and so I felt comfortable being open and speaking without any judgment. She knew what I was going through and, more importantly, she empathised.

As we continued, Dr Elphinstone would occasionally ask for more details, including any physical symptoms I was having, but what I really noticed – and appreciated – was the clear importance she placed on my mental wellbeing as a result of perimenopause.

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“I don’t know if this reassures you, but what you are saying is really common. I think so many people talk about hot flushes, which is definitely a symptom for some, but actually, the emotional side of things, whether that be mood, anxiety, irritability and rage, is a really big part of it. It’s probably one of the most common symptoms that people don’t talk about.”

“Rage is probably one of the most common symptoms that people don’t talk about”

Dr Eloise Elphinstone

This response, honestly, where she told me everything I was feeling was real and true – and all part of perimenopause – was a huge relief. She helped me join the dots, validated my feelings and told me to stop blaming myself. That alone would have been worth the time and cost of the appointment, but there’s so much more to gain from seeing a specialist.

After a good 30-min chat about my physical and emotional symptoms, Dr Elphinstone was able to reassure me and spend time clearly explaining exactly what happens during menopause. It gave me a newfound understanding of why I had been feeling such confusion and discomfort.

To finally know what was happening in my body, and how that was responsible for a lot of my symptoms, has allowed me to not only worry less, but be so much more patient with and kind to myself.

But why is it so difficult for some women to get this clarity or a diagnosis? Surely this is something a blood test could help with, I asked Dr Elphinstone.

“The guidance is that if you are above 45, it’s a clinical diagnosis. So because in perimenopause your hormones fluctuate, you could do bloods when your oestrogen level looks quite good, and they can look completely normal,” she explained. “Do it at a different point, and it would look completely different.

“The other point is, when we do blood tests to diagnose menopause, we look at hormones called the FSH and the LH as well as the oestrogen. They are what the pituitary gland in the brain produces to get the ovaries to work. So when you are having normal cycles, the brain doesn’t have to work that hard. The ovaries produce the eggs, and the eggs produce the oestrogen. So if you’ve got lots of eggs, you’re producing lots of oestrogen, your brain doesn’t have to do anything.

“As you have fewer eggs as you get older, you have less oestrogen, so the brain thinks you need more, and so the FSH and the LH go up, and your body responds initially. It goes ‘okay, we need more oestrogen’ so the oestrogen goes up. The brain’s done its job. Those hormones come back to normal, and if you do a blood test at that point, it all looks normal.

“It’s only as later down the line that the FHS and the LH go up, but when there are no eggs there to produce more oestrogen, they can’t respond. It just goes up and up and up, so it’s only at that point that you might see something on a blood test. And you can have symptoms of that for quite a long time, and the risk of using bloods, and I’ve seen this a lot, is GP take bloods and everything looks fine, and that’s because of that reason.”

The latter half of my consultation discussed the treatment plan I should start. Dr Elphinstone talked through and showed me various options. Once we had decided which treatment to go for, she advised me to monitor how I feel using a journal or symptom-specific app.

A new patient consultation at Menopause Care costs £295, and 30-min follow-up appointments are from £225. Not every woman can afford private healthcare – and that’s a problem. If seeing a specialist is not within budget, or you are unsure about the support you need, the good news is that there are other avenues you can explore.

During my time at Menopause Care, I also caught up with founder Dr Naomi Potter, who very kindly shared some resources. Below is a summary of Dr Potter’s advice for anyone needing further menopause-related support: