Menopause Clinic London

Here are the latest Clinical Guidelines from the American College of Physicians for Pharmacologic Treatments for Females With Menopausal Vasomotor Symptoms.

The guidelines provide recommendations and evidence base for following treatments
* Alpha agonist: clonidine
* Anticholinergic: oxybutynin
* Estrogen monotherapy
* Estrogen in combination with bazedoxifene
* Estrogen in combination with progestogen
* Gabapentinoid: gabapentin
* Neurokinin receptor antagonists (NKRAs): elinzanetant and fezolinetant
* Progestogen monotherapy
* Selective serotonin reuptake inhibitors (SSRIs): citalopram, escitalopram, and paroxetine
* Serotonin-norepinephrine reuptake inhibitors (SNRIs): desvenlafaxine and venlafaxine

https://www.acpjournals.org/doi/10.7326/ANNALS-26-01205

The guidelines provide useful summary of current treatments both hormonal and non-hormonal as we know ‘one size does not fit all’.
The one point that needs highlighting though is that initiation and duration of treatment with HRT as well as combinations of hormones used should be individualised and not be based on arbitrary age or time limits.

There is so much new research being published about menopause, hormone changes, lifestyle, HRT, cognitive health and risk of dementia. Every few weeks, new study results are reported which add a little bit to our existing knowledge. Are these significant enough to change clinical practice? What do they mean when we counsel patients?

What is certain at present and what is uncertain? We will try to address there topics in our upcoming RCGP event on 14th October 2026.

Please join us on the day by clicking the link or search menopause events on the RCGP website to register -
https://engage.rcgp.org.uk/event/a2kWS000000eYPZ/ev07209?recordId=a2kWS000000eYPZ

Healthcare professionals can join even if you are not a RCGP member.

Thank you Prof Aimee Spector and Dr Alba Soares Pereira for putting this together 🙏🏻.

Social media (SM) has become one of the commonest routes for obtaining health-related information and advice.

Not all content on SM is accurate and restrictions imposed by various platforms can limit what is discussed or presented on various channels.

Here is an interesting study from Hariharan et al. which evaluated how menopause-related sexual dysfunction is represented in content from top menopause creators on TikTok, including symptom frequency, content framing, and creator characteristics.

They performed a cross-sectional content analysis in October 2025 using the keyword “menopause.” The 100 most-viewed TikTok videos posted between April and October 2025 were identified, and the 10 most influential content creators were selected based on follower count and engagement metrics.

Sexual symptoms were infrequently mentioned: vaginal dryness (3.5%), libido changes (7.9%), arousal difficulties (1.3%), dyspareunia (2.0%), and or****ic challenges (0.1%). Broader menopause-related symptoms were discussed more frequently, including mood changes (31.2%), hot flashes (13.5%), and bone or joint pain (12.9%). Most videos focused on symptom validation or empowerment (51.6%), followed by management strategies (19.3%) and product endorsements (13.2%). Among the 10 most influential content creators, one was a medical professional.

The authors concluded that menopause-related sexual dysfunction is underrepresented in content from top menopause creators despite its high prevalence.
This study has several limitations - restricted to English-language content, relatively short study period, limitations on generalisability of findings and no assessment of accuracy/quality of information.
But it identifies some important possible themes - persistent stigma surrounding sexual dysfunction, impact of content moderation policies and algorithmic preferences from SM platforms, more validation-focused content with limited discussion of management strategies, need for greater transparency regarding commercial relationships and sponsorships and the prominence of nonmedical voices which could reflect a gap in clinician communication around menopause and sexual health.

It’s time for yet another webinar!

Join us in the evening today at 6:30 pm for a free webinar on - ‘Hormone Replacement Therapy - what are the different options and what do the current guidelines recommend?’.
We will also discuss about how do we balance the oestrogen and progestogen doses in HRT.
Everyone and all questions welcome!

Thank you Roger Prentis and Katie Day at Midlife Matters for this opportunity as always.

To join us - search for Midlife Matters Menopause Meetings on tickettailor.com website or click
https://www.tickettailor.com/events/rdpi/1033447

Do take part in or share this research 🙏🏻 from My Menopause Brain (UCL). Every experience of menopause is unique and each bit of research adds valuable data to advance our understanding of the transition!
Thank you 🙏🏻 Ruth Wood and team.
Just visit the website at UCL brain 🧠 sciences or click -
https://www.ucl.ac.uk/brain-sciences/icn/research/research-groups/metacognition-executive-functions/my-menopause-brain/take-part

This Royal College of Obstetricians and Gynaecologists (RCOG) online event focuses on crucial topics in female reproductive endocrinology across the life course including:

* Female reproductive physiology and pathophysiology
* Diagnosis and management of menstrual, ovulatory and endocrine disorders
* The safe use of contraceptive and hormone replacement therapies 
Do join on coming Friday 2nd October.
Register on the RCOG website or
https://rcog.eventsair.com/female-reproductive-endocrinology-oct-2026

Here is a paper on a unique menopause economics 💰 model developed by Dr Gayathri Delanerolle and colleagues.

Traditional behavioural finance (which examines how cognitive biases, emotions, and context shape economic decision-making) often assumes cognitive stability, rationality, and consistent risk evaluation, based largely on male-dominated samples.

Emerging evidence from the Menopause and Ageing Research in International Environments (MARIE) WP2a program, encompassing over 6,300 women across thirteen countries, suggests that the menopause transition brings about significant neurocognitive, emotional, and sociostructural changes that may influence financial decision-making processes. These influences remain under-theorised within current behavioural economics models.

This study proposes a new conceptual framework - the Behavioral Finance-Menopausal Cognition (BF-MC) Model - a first of its kind, that integrates menopause-related cognitive, psychological, and sociostructural dynamics with behavioural finance theory.

The BF-MC Model identifies four interrelated domains: (1) neurocognitive regulation, (2) affective-behavioral regulation, (3) sociostructural mediation, and (4) economic adaptation and resilience. The model reframes midlife women’s financial behaviour as a dynamic biopsychosocial process rather than a deficit, highlighting adaptive responses to fluctuating cognitive and emotional resources and provides a conceptual framework to understand how menopausal cognitive and psychosocial changes may shape financial decision-making.

As a clinician, this paper has been a whole new learning for me and has introduced me to the world of menopause and 💵 economics. The next step will be to build up on the work of these amazing researchers from across the world 🌍 from Asia and Africa to Europe and the Americas.

https://journals.lww.com/menopausejournal/abstract/10.1097/gme.0000000000002881~integrating-menopausal-neurocognitive-and-psychosocial?redirectionsource=fulltextview

This is a very useful review from Blanca Gil-Ibáñez et al. which summarises current evidence and international guideline recommendations to provide a practical framework for menopause management in gynaecological cancer survivors, including treatment eligibility, hormone replacement therapy initiation, regimen selection, duration of therapy, drug-drug interactions, and long-term follow-up.

It details when and how long hormone replacement therapy should be initiated/continued after induced menopause and how ovarian recovery should be assessed following chemotherapy before confirming permanent ovarian insufficiency. Individualisation of treatment according to symptom burden using validated assessment tools and various systemic formulations of HRT are discussed.
Potential interactions with contemporary anti-cancer therapies, cumulative thrombotic risks of medications and relevant pharmacokinetic interactions with poly(adenosine diphosphate-ribose) polymerase inhibitors are discussed. With immune checkpoint inhibitors, the principal challenge is distinguishing menopausal symptoms from immune-related endocrinopathies rather than avoiding hormone replacement therapy.
https://pubmed.ncbi.nlm.nih.gov/42660774/

The review emphasises comprehensive menopause care for cancer survivors. It echos the themes on 18th September this year (World Menopause and Cancer Awareness Day) when Menopause and Cancer CIC organised the first global menopause and cancer conference for health professionals and are calling for change.

What needs to happen?
* Menopause support must be embedded into pre-cancer treatment discussions and long-term cancer care planning.
 
* Improved training for healthcare professionals.
 
* Better access to therapies and specialist care.

https://menopauseandcancer.org/events/