Ask the doctor: Dr Anshumen Bhagat answers our reader’s question on Perimenopause

The London Mums messaging receives questions for experts all the time. One of the topics that has often come up is Perimenopause so we asked a top doctor to she some insights on this hot topic, the creator behind the new doctor-on-demand app GPDQ, Dr Anshumen Bhagat, who is a health and wellbeing expert, as well as a GP with 15 years’ experience straddling the NHS and private healthcare sectors simultaneously. Dr Bhagat responds to a London Mums’ reader regarding pre-menopause based on his medical expertise.ask the doctor Anshu - portrait 1


Cecilia from Chelsea: I am 45 years old and I have started having irregular periods, hot flushes, sweaty night time and mood swings. I took blood tests and all looks fine.

Does it mean I am already on pre-menopause? I am not ready for it as I still feel too young for it and I don’t know what to do…



The age when the symptoms of perimenopause occur can vary, however most women notice perimenopausal symptoms between the ages of 45 and 55, with age 51 being the average age for a woman to have her final menstrual period.

Interestingly, the signs and symptoms of perimenopause can begin from 2 to 10 years before actual menopause, which is the moment in time when your menstrual cycle stops. This is when the ovaries gradually produce less estrogen and usually occurs in a women’s 40s. You’re “officially” in the menopause phase once you haven’t had a period for a year, which then goes on to the postmenopausal stage. Your symptoms may continue for a while once you’re postmenopausal, but they typically become weaker and less frequent over time.

Menopause, when it occurs between the ages of 45 and 55, is considered “natural” and is a normal part of aging. But, some women can experience menopause early, either as a result of a surgical intervention (such as hysterectomy) or damage to the ovaries (such as from chemotherapy). Menopause that occurs before the age of 45, regardless of the cause, is called early menopause. Menopause that occurs at 40 or younger is considered premature menopause.

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If you are experiencing signs of perimenopause, there is no need to worry – it is a natural process of aging and the women’s bodily function. These are the common physical and mental symptoms of perimenopause, some of which you may be familiar with:

  • Period changes. Changes in your period are likely one of the first signs that will signal you that perimenopause is at hand. Your periods may be shorter, or they may be longer. You can experience either heavy or light bleeding during your periods. You’ll probably even miss a few periods.
  • Hot flushes and/or night sweats are common signs of perimenopause.
  • Mood changes including depression, anxiety, irritability, and mood swings are experienced by a significant number of perimenopausal women.
  • Vaginal dryness often occurs during perimenopause due to decreased production of estrogen. If vaginal dryness is a problem for you try using one of the OTC vaginal lubricants that are available, or talk to your health care provider for prescription relief.
  • Many women suffer from sleep problems during perimenopause. You may find it difficult to fall asleep, or to stay asleep. Sleep difficulties during perimenopause are often caused by night sweats, as well as hormonal fluctuations.
  • An increase in fat around the waist is often seen in perimenopausal women. Following a healthy, low carb diet and getting adequate exercise may help to prevent or reduce increased fat associated with perimenopause.
  • Painful sex. Sexual intercourse may be painful during perimenopause due to vaginal dryness.
  • The incidence of urinary problems increases as perimenopause occurs. These urinary conditions include both an increase in the number of urinary tract infections (UTI) and a higher incidence of loss of bladder control or urinary incontinence.
  • Less sex drive. Hormonal fluctuations that occur during perimenopause are often the culprit behind the loss of interest in sex that is experienced by many perimenopausal women.


Treatment During Perimenopause

If your symptoms are annoying but don’t stop you from getting through your daily routine, you may not need treatment. On the other hand, if your perimenopausal symptoms are making you uncomfortable, your doctor can provide treatment that may help you feel better. Or, he or she may suggest treatment with both medication and lifestyle changes.


Medication for Perimenopause Symptoms

If your doctor recommends medication to relieve your perimenopausal symptoms, he or she will likely suggest 1) hormone therapy (estrogen or a combination of estrogen with progestin, the synthetic form of the hormone progesterone) and/or 2) an antidepressant to help stabilize your mood.


Lifestyle Changes That May Help

Many women choose this “natural” route for perimenopausal symptom relief or simply decide to try it first to see if they can get relief without medication (and avoid the risk of side-effects). But whether you use medication or not, you can still benefit from making the following lifestyle changes:

  • Eat a health and balanced diet that includes a variety of fruit, vegetables, and whole grains.
  • Get at least 1,000 to 1,200 mg of calcium per day; if you aren’t getting enough calcium in your food, take a daily calcium supplement if your doctor says you should.
  • Exercise regularly.



Dr Anshumen Bhagat is the doctor behind the GPDQ’s doctor-on-demand app that has recently launched in London.

As the average waiting time to see a GP increases to 7-10 working days, GPDQ, the UK’s first on-demand app that delivers a doctor to your door within 60 minutes, has just launched in London. GPDQ enables patients to arrange an appointment with a private GP at a location of their choice. Appointments can be booked 7 days a week, from 8am to 11pm. GPDQ helps busy people get on with their lives, rather than worrying about taking time off work to go to a doctor’s appointment or having to take their children to the surgery. A selection of the features are listed below:

·     Patients can request a GP and track their progress from their smartphone

·     Patients have a full 25 minute consultation with a GMC registered doctor that has undergone GPDQ’s intensive patient care training programme

·     GPs can issue private prescriptions which can be delivered within 2 hours in Central London

·     Payments are made simply and safely via the app

·     Users can book and pay for an appointment on behalf of someone else (e.g. child)

GPDQ is offering a very competitive price and currently there is no other organisation in the private sector offering patient home visits at this price. Whilst the price point is obviously higher than a free NHS visit, GPDQ is offering speed and the convenience of a doctor coming to you at your home, workplace or any location that suits you.

·     £20 discount is available for first visit

·     WEEKDAY: £120

·     WEEKEND: £150

·     BANK HOLIDAY: £200

The GPDQ app is now available to download for iOS and Android.

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