Guides

What the evidence says, in plain words

Every guide cites its sources, from the UK, the US and Europe: NICE and the NHS, The Menopause Society and the FDA, and the European Menopause and Andropause Society. Each one ends with questions you can take to your appointment.

• HRT & hormonesHRT patches, gel or tablets: what the route actually changesOestrogen can be swallowed or absorbed through the skin. The guidelines say the route matters most for blood clots and stroke, and much less for everything else. Here is what NICE and the NHS say.6 min read · 8 sources
• HRT & hormonesWhy HRT includes a progestogen if you have a wombOestrogen on its own thickens the womb lining. A progestogen protects it. Here is what NICE and the British Menopause Society say about the options, the patterns, and the numbers.7 min read · 8 sources
• HRT & hormonesTestosterone for women in menopause: what the guidelines actually supportTestosterone is widely discussed for energy, mood and focus. The guidelines support one use: low sexual desire. Here is what NICE and the international consensus say, and how it is monitored.6 min read · 4 sources
• SymptomsNon-hormonal treatments for hot flushes: what the evidence supportsHRT is the main treatment for hot flushes, but it does not suit everyone. Here is what NICE, the MHRA and The Menopause Society say about fezolinetant, CBT, antidepressants and herbal remedies.8 min read · 8 sources
• Midlife healthHRT and breast cancer risk: the numbers, not the headlinesHeadlines about HRT and breast cancer usually give a percentage. NICE gives counts per 1,000 women. Here is what they show, how they depend on the type of HRT and how long you take it.7 min read · 6 sources
• HRT & hormonesHow long does HRT take to work? What the guidelines say about timingGuidelines do not give a week-by-week schedule. They give a review point, a window for side effects and a window for bleeding. Here is what NICE and the NHS say about each.6 min read · 6 sources
• AppointmentsWhat to track before your visit: a notebook method that worksClinical decisions about menopause treatment turn on frequency, severity, function and dates. Here is a two-minute daily method that captures all four, using a notebook and nothing else.7 min read · 10 sources
• SymptomsSex, pain and vaginal dryness: the symptom most people never mentionGenitourinary symptoms of menopause affect a large minority to a majority of postmenopausal women, are among the most treatable things in this field, and are the least likely to be raised. Here is what guidelines say.10 min read · 11 sources
• Midlife healthBones and heart: the midlife risks that do not announce themselvesHot flushes get attention because you can feel them. Bone loss and shifting cardiovascular risk get less, because you cannot. Here is what changes around menopause and what the prevention conversation involves.10 min read · 11 sources
• AppointmentsPreparing for a menopause appointment: what to bring and what to askYou get ten minutes, and half of it disappears into establishing basic facts you could have written down. Here is a preparation method that puts the appointment to work, on paper, in under an hour.8 min read · 11 sources
• HRT & hormonesHormone therapy: what the guidelines say, and where they stopHRT has been oversold and overfeared in roughly equal measure. Here is what NICE and The Menopause Society actually state about benefits, risks, timing and route, and what they admit they do not know.11 min read · 12 sources
• Bleeding & cyclesIrregular bleeding in midlife: what is expected and what needs checkingPerimenopausal bleeding is supposed to be erratic, which makes it hard to know what counts as a problem. Here are the specific thresholds that mean book an appointment, including the one absolute rule after menopause.8 min read · 9 sources
• Mind & moodBrain fog, mood and memory in midlife: what the evidence actually showsTwo thirds of women report memory problems during the transition, and the research broadly agrees with them. Here is what is measurable, what is temporary, and when low mood needs urgent help.8 min read · 11 sources
• SleepSleep in perimenopause: night sweats, insomnia, and the apnoea nobody mentionsWaking at three every morning is one of the most common complaints of the transition, and it has at least three different causes that need different answers. Here is how to tell them apart.8 min read · 10 sources
• SymptomsHot flushes and night sweats: how long they last and what the guidelines sayThe honest answer on duration is longer than most women are told. Here is what the largest cohort study found, and what UK and US guidelines actually recommend, including where they disagree.7 min read · 13 sources
• SymptomsPerimenopause vs menopause: what the stages actually meanMenopause is a single day you can only identify in hindsight. Perimenopause is the years of unpredictability before it. Here is how researchers stage the difference, and why a blood test often will not settle it.8 min read · 9 sources