Concierge menopause care · London
Menopause diagnostics, FSH, AMH, oestradiol and personalised HRT planning.
Menopause is usually diagnosed clinically in women over 45. Bloods (FSH, AMH, oestradiol) are helpful in earlier menopause, perimenopause and confirming premature ovarian insufficiency. Modern private pathway includes personalised HRT planning and follow-up.
Why patients choose us
- 01
A menopause specialist, not a generalist
We route you to a British Menopause Society-accredited specialist — the person who plans your HRT is the person who follows you up.
- 02
Body-identical HRT by default
Transdermal oestradiol and micronised progesterone are the modern first-line — we do not default to older, higher-risk oral regimens.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
The six things worth knowing before your appointment.
A short brief on when bloods matter, what body-identical HRT is, and why follow-up is part of the plan — not an optional extra.
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What it is
A structured pathway to diagnose perimenopause, menopause or premature ovarian insufficiency (POI) — and to plan personalised HRT.
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Clinical diagnosis > 45
In women over 45 with typical symptoms, menopause is diagnosed clinically. Blood tests are not routinely needed.
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Bloods for POI or < 45
FSH, oestradiol and AMH are helpful when menopause is suspected under 45, for POI, or for confirming perimenopause with atypical patterns.
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Exclude the mimics
TFTs and prolactin sit alongside the reproductive panel to rule out thyroid disease and prolactinoma.
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Personalised HRT
Body-identical transdermal oestradiol, micronised progesterone, and — where indicated — testosterone, chosen to your risk profile.
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Multi-visit follow-up
A titration review at three months and an annual review afterwards — HRT is a plan, not a single prescription.
The problem
Menopause care is only as good as the specialist behind it.
FSH numbers are easy to order and easy to misread. A body-identical HRT plan takes a menopause specialist — the person who chooses the route and dose is the person who follows you up.
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Symptoms starting in your 40s?
We baseline symptoms, order bloods where they help, and give you a personalised HRT plan — not a formulary default.
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Under 45 or suspected POI?
The full reproductive and endocrine panel, with genetic and autoimmune work-up where indicated.
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Struggling on your current HRT?
A titration review — route, dose, progestogen and testosterone — with the specialist who wrote it.
Diagnosis steps
From consultation to annual review — what happens, in order.
One menopause specialist from first message through titration and annual review.
Phase 1 · Before
Consultation and workup
Phase 2 · On the day
Risk assessment and HRT plan
Phase 3 · After
Titration and annual review
- 01
Before
Menopause specialist consultation
A 45-minute consultation with a British Menopause Society-accredited specialist — history, symptoms, risk factors and priorities.
- 02
Before
Symptom scoring (Greene Climacteric)
A validated symptom score to baseline vasomotor, psychological and somatic symptoms — the number we track against on follow-up.
- 03
Before
Bloods (FSH, oestradiol, AMH, TSH, prolactin)
A reproductive and endocrine panel — needed if you are under 45, for POI work-up, or where the clinical picture is ambiguous.
- 04
On the day
Bone-health and cardiovascular risk assessment
FRAX or DEXA where appropriate, lipids, BP and glycaemic status — the risk picture that shapes the HRT plan.
- 05
On the day
Personalised HRT plan
Body-identical transdermal oestradiol, micronised progesterone, and testosterone where indicated — chosen to your risk profile and priorities.
- 06
After
Follow-up at 3 months for titration
A structured review at three months to titrate dose, review side effects and re-score symptoms.
- 07
After
Annual review
An annual review of symptoms, risk, bloods where indicated, and whether the HRT plan still fits the life you are in.
Typical first cycle: initial consult to titration in 3 months. Annual review thereafter.
What it shows
When menopause diagnostics are the right pathway.
The specific questions this pathway answers — from perimenopause pattern-recognition to confirming POI and excluding thyroid or prolactin-driven mimics.
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Perimenopause pattern
Cycle irregularity, vasomotor and mood symptoms in the 40s with fluctuating hormones — the commonest presentation.
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Menopause (12 months amenorrhoea)
The formal definition — 12 consecutive months without a period in the absence of another cause.
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Premature ovarian insufficiency (< 40)
Menopause under the age of 40 — needs confirmed diagnosis, genetic and autoimmune work-up, and lifelong HRT until at least 51.
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Reduced ovarian reserve (low AMH)
A low AMH quantifies ovarian reserve — relevant to fertility timelines as well as menopause forecasting.
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Thyroid mimics
Hypo- and hyperthyroidism mimic menopausal symptoms — TFTs are part of the routine panel.
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Prolactinoma differential
A raised prolactin explains amenorrhoea, low libido and infertility that would otherwise be attributed to menopause.
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HRT response monitoring
Structured symptom re-scoring at 3 and 12 months — with oestradiol levels for transdermal patients where useful.
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Red flag: postmenopausal bleeding — 2WW gynae pathway
Any bleeding after 12 months of amenorrhoea is a two-week-wait gynaecology referral until endometrial cancer is excluded.
Treatment options
Menopause treatment is a plan, not a prescription.
Body-identical HRT is the modern first-line — but it is one part of a broader plan that spans bone, cardiovascular and psychosexual care.
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Systemic HRT (transdermal / oral)
Body-identical transdermal oestradiol is first-line; oral routes reserved for specific indications and risk profiles.
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Vaginal oestrogen
Low-dose vaginal oestrogen for genitourinary symptoms — safe long-term and compatible with systemic HRT.
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Testosterone (specialist prescribing)
For persistent low libido on adequate oestrogen — specialist-initiated, off-label in the UK, monitored on levels.
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Non-HRT options (CBT, SSRIs, gabapentin)
Evidence-based alternatives where HRT is contraindicated or declined — cognitive behavioural therapy, SSRIs, gabapentin.
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Bone-protection therapy
DEXA, calcium and vitamin D, and — where indicated — bisphosphonates, particularly in POI and early menopause.
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Cardiovascular risk optimisation
Lipids, BP, glycaemic status and lifestyle — the long-view work that HRT alone does not replace.
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Psychosexual support
Referral to psychosexual medicine for the parts of menopause a prescription does not solve.
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Structured menopause-clinic follow-up
Three-month titration and annual review — the difference between a prescription and a plan.
Our vetted London network
A small panel of specialists, we picked them.
British Menopause Society-accredited specialists across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every specialist in our network.
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British Menopause Society-accredited specialists
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Body-identical HRT (transdermal oestradiol, micronised progesterone) as default
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Same clinician for consultation, prescription and follow-up
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Two-week-wait pathway to gynae-oncology for red-flag bleeding
Red flags and safety
The clinical points that change the plan.
Menopause diagnostics is safe. These are the specific findings that change the pathway — from postmenopausal bleeding through to migraine with aura on oral HRT.
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Postmenopausal bleeding
Any bleeding after 12 months of amenorrhoea is a two-week-wait gynaecology referral until endometrial cancer is excluded.
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POI in women < 40
Confirmed menopause under 40 needs genetic, autoimmune and bone-health work-up, and lifelong HRT until at least 51.
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Bilateral oophorectomy without HRT
Surgical menopause without HRT accelerates cardiovascular, bone and cognitive risk — HRT is the default unless contraindicated.
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Family history of premature menopause
A first-degree relative with menopause under 45 shifts the pre-test probability — earlier assessment, earlier planning.
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HRT contraindication (breast cancer)
Current or recent hormone-sensitive breast cancer is a contraindication to systemic HRT — non-hormonal routes are the plan.
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VTE risk on oral HRT
Personal or family history of VTE, thrombophilia or obesity favours transdermal oestradiol, which does not raise VTE risk.
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Migraine with aura on oral HRT
Migraine with aura favours transdermal over oral oestradiol to minimise stroke risk.
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Undiagnosed abnormal bleeding
Any undiagnosed abnormal uterine bleeding must be investigated before HRT is started.
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Osteoporosis at diagnosis
A T-score at or below −2.5 on DEXA changes management — HRT plus bone-protection therapy, not HRT alone.
Reading your report
A menopause report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
History, symptoms and risk factors
Menstrual history, symptom score, personal and family risk factors — the frame around interpretation.
- 02 Bloods
FSH, oestradiol, AMH, TSH, prolactin
The reproductive and endocrine panel, with reference ranges appropriate to age and cycle phase.
- 03 Findings
Diagnosis and differential
Perimenopause, menopause, POI, thyroid or prolactin-driven mimic — the clinical conclusion, in plain English.
- 04 Plan
Personalised HRT and follow-up plan
The prescription, the rationale, the three-month titration slot and the annual review — the plan, not just the diagnosis.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about menopause diagnostics.
Quick answers on bloods, body-identical HRT, safety, testosterone, follow-up and red-flag bleeding.
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Do I need blood tests to diagnose menopause?
If you are over 45 with typical symptoms, no — menopause is diagnosed clinically. Bloods (FSH, oestradiol, AMH) are helpful under 45, for suspected premature ovarian insufficiency, and where the clinical picture is atypical.
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What is body-identical HRT?
Body-identical HRT uses hormones with the same molecular structure as those the ovary produces — transdermal oestradiol and micronised progesterone. It is the modern first-line and is not the same as compounded bioidentical products, which are not recommended.
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Is HRT safe?
For most women starting HRT within 10 years of menopause, benefits outweigh risks. Transdermal oestradiol does not raise VTE or stroke risk. Breast cancer risk with combined HRT is small and needs to be weighed against symptom relief and bone and cardiovascular benefits.
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What about testosterone?
Testosterone is prescribed by menopause specialists for persistent low libido on adequate oestrogen replacement. It is off-label in the UK, initiated by specialists, and monitored on blood levels.
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When is a follow-up needed?
A structured titration review at three months and an annual review afterwards. HRT is a plan, not a single prescription — dose, route and progestogen are all things we adjust.
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What if I have postmenopausal bleeding?
Any bleeding after 12 months of amenorrhoea is a two-week-wait gynaecology referral until endometrial cancer is excluded — private or NHS, that pathway is the same.
Sources
- British Menopause Society. Consensus statements and prescribing tools.
- NICE. Menopause: identification and management (NG23).
- Royal College of Obstetricians and Gynaecologists. Menopause resources.
- International Menopause Society. Global guidance on menopause.
Reviewed by Pulse Atlas Editorial Board (). Published 2026-07-30. Next review 2027-07-30. Reading time ~6 min.
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In practice, in London
Why private menopause diagnostics moves differently in London
With menopause diagnostics, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The NHS route for menopause diagnostics is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
Once you’re in the private system for menopause diagnostics, the pace picks up noticeably. Consultant slots run to time, imaging is usually available in the same building or a short walk away, and the report comes back typed and detailed. It’s the coordination that tends to feel different — one person on the other end of the phone, not a switchboard. For menopause diagnostics specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see menopause diagnostics — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.