Premature Menopause Clinic London

Premature Menopause Clinic London We provide a fully comprehensive clinical service to women with health-related problems and fertilit

We all know about the cognitive symptoms which many women report during menopause - brain fog, lack of concentration, me...
23/06/2026

We all know about the cognitive symptoms which many women report during menopause - brain fog, lack of concentration, memory problems and others.

We also have read about research findings using latest imaging techniques which show alterations to structure and function of brain matter and circuitry during perimenopause and menopause.

It is also important to know that there may be differences in how exogenous and endogenous hormones act on these brain changes/pathways besides individual variations in response based on genetics, ethnicity and medical history.

Here is an article in the New Scientist from Grace Wade in which she describes how the brain undergoes a full renovation during menopause and although these changes are profound, we’re learning that the long-term impact needn’t be all bad.

Watch the space - a lot more to come

https://www.newscientist.com/article/2529751-how-menopause-radically-changes-the-brain-and-what-happens-after/

We discussed about brain and cognition in menopause at one of the Midlife Matters webinars. Catch up here if you are interested -
https://rdp-int.com/index.php?&pgid=20011

There has been a lot recently in the medical literature about impact of different types of exogenous hormones on Meningi...
22/06/2026

There has been a lot recently in the medical literature about impact of different types of exogenous hormones on Meningiomas.
Here is a useful narrative review by Nicola Pluchino and colleagues on the topic.

The authors recommend that women’s health specialists should systematically assess a history of meningioma before prescribing progestins.

In patients with incidental meningiomas, discontinuation of high-risk progestins should be considered, followed by MRI reassessment within 3–6 months.
When hormonal treatment remains necessary, the lowest effective dose and regular neuro-oncologic monitoring are recommended.

Increased awareness and individualised counseling are essential to optimise hormonal management in women at risk of meningioma.
https://pubmed.ncbi.nlm.nih.gov/42323841/

Most of the evidence of risk for meningiomas comes from the use of progestins (synthetic progestogens) used for contraception such as cyproterone acetate or depo Provera and the absolute risks remain low. Little or no evidence is available with use of levonorgestrel intrauterine coil or micronised natural progesterone and some women certainly can cautiously make a choice to use hormones with regular tumour surveillance after a thorough individualised discussion of benefits and risks depending on the site, size and nature of the tumour they have had.

We discuss this more in details at one of our Menopause Research Education Fund videos.
https://www.youtube.com/live/zAie2vyR5is?is=gSJQEtOj5VUJyjK3

Haematology and female hormone health intersect at multiple levels. As the authors of this review point out - Haematolog...
21/06/2026

Haematology and female hormone health intersect at multiple levels. As the authors of this review point out - Haematologists have a unique privilege of providing lifetime care, often in multidisciplinary clinics such as sickle cell disease or haemophilia treatment centres.
This is a useful and comprehensive review that covers discussions on hormone changes of menarche, pregnancy, menopause and how these life transitions impact people with underlying haematological disorders, including an increased risk of iron deficiency with or without anaemia.

The review focusses specifically on the impacts of anticoagulation on menstrual bleeding, thrombosis risk on gender-affirming care, and pregnancy on those with sickle cell disease and inherited bleeding disorders.

The authors note that most haematologists have little or no exposure to training on haematology-related, women’s health-specific outcomes. However, many outcomes are impacted by, or are even early signs of, haematological diseases. The review provides a basis for overlap between hormones and haematology conditions and aims to support haematologists in the care of their patients.
https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(26)00110-9/abstract

Friday 19 June was World Sickle Cell Day, a United Nations-recognised day to raise awareness of sickle cell disorder across the world.
https://www.sicklecellsociety.org

Hormone health, fertility problems and menopause transition remain under-researched in sickle cell and thalassaemia patients. This can cause delays in diagnosis, treatment and missed opportunities for optimal fertility and long-term health outcomes. We need to continue working hard to spread more awareness and deliver better outcomes.

Haematology and female hormone health intersect at multiple levels. As the authors of this review point out - Haematolog...
21/06/2026

Haematology and female hormone health intersect at multiple levels. As the authors of this review point out - Haematologists have a unique privilege of providing lifetime care, often in multidisciplinary clinics such as sickle cell disease or haemophilia treatment centres.
This is a useful and comprehensive review that covers discussions on hormone changes of menarche, pregnancy, menopause and how these life transitions impact people with underlying haematological disorders, including an increased risk of iron deficiency with or without anaemia.

The review focusses specifically on the impacts of anticoagulation on menstrual bleeding, thrombosis risk on gender-affirming care, and pregnancy on those with sickle cell disease and inherited bleeding disorders.

The authors note that most haematologists have little or no exposure to training on haematology-related, women's health-specific outcomes. However, many outcomes are impacted by, or are even early signs of, haematological diseases. The review provides a basis for overlap between hormones and haematology conditions and aims to support haematologists in the care of their patients.
https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(26)00110-9/abstract

Friday 19 June was World Sickle Cell Day, a United Nations-recognised day to raise awareness of sickle cell disorder across the world.
https://www.sicklecellsociety.org

Hormone health, fertility problems and menopause transition remain under-researched in sickle cell and thalassaemia patients. This can cause delays in diagnosis, treatment and missed opportunities for optimal fertility and long-term health outcomes. We need to continue working hard to spread more awareness and deliver better outcomes.

It was wonderful to talk to everyone at the ‘National Highways’ staff event in Birmingham today. We covered Menopause, H...
18/06/2026

It was wonderful to talk to everyone at the ‘National Highways’ staff event in Birmingham today. We covered Menopause, HRT and what is new in this field.
Thank you all who shared your personal stories and experiences.
A big thank you to Clare Ball and her menopause warriors team who are providing an exceptional support to colleagues and making the workplace/organisation menopause friendly. Amazing work!
Together, we can keep making progress.

From the pioneering research work of German virologist Dr. Harald zur Hausen who first detected and proved that the Huma...
18/06/2026

From the pioneering research work of German virologist Dr. Harald zur Hausen who first detected and proved that the Human Papillomavirus (HPV) causes cervical cancer in the early 1980s to the US Food and Drug Administration (FDA) approval for Gardasil, the first quadrivalent HPV vaccine to today’s research headlines - what a journey this has been and what a scientific achievement! Forever grateful to the research teams who made this possible 🙏🏻

https://www.bbc.co.uk/news/articles/c621z28z138o

Here is a recent useful study from Simko et al. using the TriNetX database which was used to identify women 18 and older...
17/06/2026

Here is a recent useful study from Simko et al. using the TriNetX database which was used to identify women 18 and older with surgically diagnosed endometriosis. The study showed that patients with endometriosis had a 3.7x the risk of primary ovarian insufficiency and 12.4x the risk of surgical menopause (p < 0.0001), with an overall risk of 1.4% and 0.7%, respectively. Rates of menopause in patients with endometriosis aged 18–39 were 4.7x that of the general population. Reported prevalence proportions of premature and surgical menopause among patients with a diagnosis of endometriosis increased over the past decade, alongside rates of oophorectomy and hysterectomy.

Rates of premature and surgical menopause are higher among patients with endometriosis. With higher rates of oophorectomy and hysterectomy at younger ages, adequate counseling on the risks of premature menopause are essential. Further studies are required to guide management of hormone replacement therapy for patients with premature menopause while minimising endometriosis recurrence. A focus on early diagnosis and preventative strategies (especially peri-operative planning about the use of hormones) is essential to improve the long-term health outcomes for these patients.

https://www.sciencedirect.com/science/article/pii/S2468784726001157

Here is a useful paper from Javier Mejia-Gomez and colleagues on borderline ovarian tumours (BOTs) and use of hormone re...
16/06/2026

Here is a useful paper from Javier Mejia-Gomez and colleagues on borderline ovarian tumours (BOTs) and use of hormone replacement therapy (HRT).
These tumours account for approximately 15% of primary ovarian neoplasms.
This systematic review evaluated the association between HRT use and BOT outcomes and 11 studies met the inclusion criteria (four cohort, seven case–control). Six reported a statistically significant association between HRT and increased odds of BOTs; five did not. Combined oestrogen–progestogen therapy showed a stronger, more consistent positive association (odds ratio 1.426, 95% confidence interval 1.083–1.877), whereas oestrogen-only therapy showed a nonsignificant association. The findings possibly hint at differential actions of two hormones on the ovarian epithelium. No study addressed BOT recurrence, and only one observational study evaluated BOT survival, finding no adverse association.

The authors concluded that evidence on HRT–BOT association is heterogeneous and inconsistent. Although a statistical association was observed between combined HRT use and increased odds of BOTs, postsurgical safety data are limited and overall certainty of evidence is very low so findings warrant considerable caution. Current literature is insufficient to confirm or exclude an association between HRT and BOT recurrence or survival. Indications for HRT after BOT surgery require individualised, multidisciplinary discussion involving oncology and menopause specialists, balancing quality-of-life benefits against unquantified theoretical risks.

There are significant limitations of the study -
studies included were heterogenous, there was inability to assess any impact of HRT on recurrence and survival by formulation type, dosage or differences in route of administration, possibility of publication bias and there were limited number of studies contributing to subgroups. There was heterogeneity in MHT exposure definitions across studies and potential confounding by indication cannot be excluded.

The BGCS BMS menopause and cancer guidelines currently support use of HRT after BOT depending on the nature and extent of disease.

https://www.bgcs.org.uk/wp-content/uploads/2024/08/BGCS-BMS-Guidelines-on-Management-of-Menopausal-Symptoms-after-Gynaecological-Cancer.pdf

This paper again demonstrates some of the uncertainties that may be associated with decision making about HRT following some forms of tumours or cancers. Individualisation is key and informed patient choice should be respected. More research is the need of the hour……..
Future prospective research, ideally randomised controlled trials, are required to establish the evidence base for the safe management of surgical menopause in this population.

https://www.tandfonline.com/doi/full/10.1080/13697137.2026.2675561

Last week was the ‘Diabetes Week’ (8th to 14th June 2026 - to raise public awareness, promote early diagnosis, improve d...
15/06/2026

Last week was the ‘Diabetes Week’ (8th to 14th June 2026 - to raise public awareness, promote early diagnosis, improve daily management, and eradicate the stigma faced by people living with it). On 3rd June on Harley street at Home, we talked about how diabetes, PMOS and other endocrine conditions intersect with menopause, and how this impacts everyday clinical decision-making. To catch up -
https://www.harleystathome.com/ -premium
A useful resource from Diabetes UK -
https://www.diabetes.org.uk/living-with-diabetes/life-with-diabetes/menopause

The day after on Midlife Matters webinar we discussed Surgical menopause and why it’s different from natural menopause. Still a long way to go to achieve ideal peri-operative care for all but awareness is improving and healthcare professionals are increasingly discussing hormones after surgical menopause now. We need to keep going!
Catch up here if you are interested -
https://rdp-int.com/index.php?&pgid=20011
A useful resource from Menopause Support -
https://menopausesupport.co.uk/?page_id=18181

What is the impact of clinic waiting times on patient’s symptoms and quality of life?An interesting study from Alexa Gru...
14/06/2026

What is the impact of clinic waiting times on patient’s symptoms and quality of life?

An interesting study from Alexa Gruber and team from Canada assessed the impact of clinic wait times (6 months) on quality of life (QOL) among patients awaiting consultation for menopause or vulvar dermatologic concerns in a tertiary academic hospital.

Of 363 participants who completed their survey, 285 were included in the analysis. The median wait from referral to survey completion was 246 days for menopause patients (n=149) and 161 days for vulvar dermatology patients (n=135). The median overall wait from referral to appointment was 390 days for menopause patients and 450 days for vulvar dermatology patients. The most represented age group was 45-54 years (33%).

Study findings suggested that prolonged waits for specialised gynecology care were associated with increased symptom burden and impaired QOL, particularly among patients awaiting menopause care and that generic QOL instruments may fail to capture wait-time dependent symptoms.
Patients frustrated with their wait time, and those experiencing highly disabling symptoms were also less interested in participating.
The authors recommended improved resource allocation and healthcare provider education as essential steps to improving care for these patients.

As demands for menopause care increase and more complex patients such as cancer survivors and women with medical co-morbidities seek treatment options for menopause management, we certainly need more resources and investment in provision of clinical care not just for the initial consultation but also ongoing support and follow-up care for patients across primary, secondary and tertiary settings.

https://pubmed.ncbi.nlm.nih.gov/42285504/

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