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Introduction

The majority of women will have some menopausal symptoms in midlife, lasting a variable length of time, the average being 7 years. These can be physical and/or psychological symptoms and can have a severe impact on quality of life for some women. One in ten women who have worked during the menopause have left a job due to their symptoms. This is also a peak time for relationship breakdowns and even suicide in women.

There has been a lot more discussion about the effects of the menopause recently, but we know that some women struggle to get access to timely and evidence-based menopause care. GPs are coping with unprecedented workloads and short appointment times and not every GP can be expected to be up to date on all the current and evolving evidence. However, we need to encourage at least one health care professional in each practice to keep up to date and act as a resource for the rest of the team.

There are still many myths about who can and can’t have HRT, based on flawed research from 20 years ago. Some women are still being denied HRT unnecessarily. Others may suffer many different symptoms over years before someone joins the dots and realises that lack of oestrogen is the root cause. Some women resort to expensive private clinics for treatment, but most women couldn’t possibly afford this. We need to improve access to evidence – based and individualised advice on menopause care, including the prescribing of body identical HRT and vaginal oestrogen.

After being successful in accessing funding from the Primary Care budget, we started a one year pilot for the Somerset NHS Menopause Service. This provides specialist menopause advice to Somerset GPs and assesses complex patients in face-to-face appointments. The first patients were seen at Glastonbury Surgery in April.

Our aim is to improve the quality of life and long-term health of midlife women in Somerset.


Dr Juliet Balfour

Dr Juliet Balfour set up and now runs the Somerset NHS Menopause Service. She has been a GP for over 30 years but is now concentrating on her work as a British Menopause Society recognised Menopause Specialist with the Advanced Certificate in Menopause Care. 

The Somerset NHS Menopause Service is made up of three elements. The main focus for the service is on the Menopause Clinic. This work is complemented by two other services: training for GPs and public advice and information webinars around the Menopause. Follow Juliet on Instagram at @menopausehealth


Somerset NHS Menopause Service

We are running the specialist menopause clinic to advise GPs and women:
• if they have a complicated medical history and the GP is not sure if HRT is suitable for them
• if they are not getting on well with their current HRT
• if they need advice on lifestyle and non-hormonal prescribed options if they don’t want to or are unable to take HRT

The service can also provide advice on testosterone replacement which can be very important for younger women who have had their ovaries removed or affected by cancer treatments or those with an early menopause for other reasons. Testosterone can also benefit some midlife women who are suffering from low libido.

This service has already proved to be highly popular, so we are already booking appointments into the autumn. Find out more.


How can women in Somerset experiencing symptoms associated with menopause access help?

Most women with menopausal symptoms can be managed by their GP. If you are having difficulty accessing HRT and meet the referral criteria listed here, you can ask your GP to write to Dr Balfour for advice or, if indicated, an appointment at the clinic.

Improved access to menopause services will help remove the stigma that surrounds menopause, help women access the care they need and encourage more women to come forward. For more information on how you can access help via your GP and for useful resources around the menopause click here.


Webinars for patients

Local menopause webinars have proved popular as they help provide advice on a range of topics and can help correct misinformation around the menopause. It also gives us an opportunity to address lifestyle issues.

We are currently developing a programme of topics to roll out later this year and will update this page as we have information on them.


Educating Healthcare Professionals

As part of the service we will also be providing in-person and virtual training training for GPs, nurse practitioners and nurses working in primary care around the many menopausal and perimenopausal symptoms to look out for and the safe prescribing of HRT. Increased education and training will help raise awareness amongst healthcare professionals in Somerset of the huge and long-lasting impact of the menopause on women’s health.


For more information on how you can access help via your GP and for useful resources around the menopause visit: