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Conditions Treated

We offer expert treatment and care for all aspects of menopause and perimenopause.

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Perimenopause

Perimenopause describes the phase in a woman’s life when her ovarian function begins to decline. Periods may begin to get irregular, and the hormones levels start fluctuating. The duration of perimenopause varies a lot among women and may last from a few months to even a few years.

Menopause

Menopause is described when a woman’s period stops completely, and they have not had a period for 1 year. All female hormones, like estrogen, progesterone and testosterone can drop to a very low level.

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During perimenopause and menopause women may experience various symptoms like hot flushes, sweats, fatigue, insomnia, mood swings, vaginal dryness etc. Many women may have mild symptoms which can improve after couple of years, but some women have significant menopausal symptoms which can sometimes last even 7 years or more and may require treatment.

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Premature Ovarian Insufficiency and Early Menopause

If a woman goes through menopause between the age of 40-45 years, it’s called Early Menopause.

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If menopause happens before the age of 40 years, it’s called Premature Ovarian Insufficiency or POI or Premature Menopause.

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Both conditions have special significance as they may have a huge impact on a woman’s physical, emotional and mental health. Early menopause puts a woman at higher risk of cardiovascular disease, dementia, and osteoporosis. They require special investigations, HRT treatment and proper care for optimal long-term health.

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Surgical Menopause

Some women may need to have their ovaries removed due to various reasons. This leads to sudden loss of their ovarian hormones, estrogen, progesterone and partly testosterone. This is called Surgical Menopause. Women may start having menopausal symptoms very suddenly and it is noted that often their symptoms are much worse than natural menopause. If appropriate, women need to start HRT as soon as possible, especially if they are young.

Genito-urinary Syndrome of Menopause (GSM)

Also known as VVA or vulvovaginal atrophy.

 

The tissues in vagina, labia, urethra, and lower bladder are dependent on estrogen for their health. With menopause, women may experience vaginal dryness, soreness, painful intercourse, itching, urinary urgency and may be prone to recurrent urine infections. 

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This may appear even 10 years after menopause and may continue to get worse without proper treatment. However, there are lots of treatment options and it can be managed very effectively.

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Postmenopausal Hypoactive Sexual Desire Disorder (HSDD)

HSDD is defined as lack of sexual desire which causes personal distress and relationship difficulties, and there are no other underlying physical or psychological causes.

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During menopause transition, some women may notice a reduction in libido (desire for sex), difficulty in getting aroused or unsatisfactory orgasm. This can be distressing. 

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This can be treated by optimisation of HRT, transdermal testosterone and DHEA replacement.

© 2025 Dr Shashi Prasad

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