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Complementary and Integrative Healthcare for Dorking and Reigate

The Menopause & Women's Health Clinic. Menopause Women


The Menopause & Women's Health Clinic

To book online, please click one of the links below:

Initial consultation
(45 mins)
Please note that Dr Peers' diary is booked ahead for several months. Consultations are available sooner with Dr McHugh and Dr Vohra, both of whom are trained to treat menopause symptoms.

Follow up consultation (30mins)
For patients who have seen one of our menopause doctors within the past year.
If you have not been seen at Tillow Barn previously, please bring copies of any correspondence/blood results with you.


Clinics take place on:
Monday PM - Dr Radhika Vohra
Tuesday AM - Dr Tina Peers
Wednesday PM - Dr Tina Peers
Thursday AM - Dr Roisin McHugh
Saturday AM - Dr Karen McGorry

Fees

Meet the Team


Doctor Testimonials



Queries: If you have any questions after your consultation, in the first instance please do take a look at the Frequently Asked Questions section on our website as you may well find an answer to your query there.


The Menopause & Women's Health Clinic. Clinic entrance


About the clinic

The Menopause & Women’s Health Clinic at Tillow Barn was started and is led by Dr Tina Peers. Dr Peers has over 30 years of experience working with and treating menopause and is a global key opinion leader in the fields of menopause and contraception. She lectures internationally and has published several papers in medical journals. She was Clinical Director and lead clinician for contraception services in Surrey for 24 years.

Dr Peers says: "We are extremely fortunate to be able to offer the Menopause & Women's Health Clinic in such a beautiful, calm, and peaceful location as Tillow Barn. All our patients feel relaxed when they arrive at our quiet and exclusive clinic, where we have time to listen to you and not only fully understand your symptoms and worries, but also have time to carefully explain all your options, answer all your questions and put together a treatment plan personalised for you. We are all individuals and each woman will have a different story to tell. The hormone therapy must be individualised and tailored to your needs."

Dr Peers works with a carefully selected team of doctors, all of whom are specially trained in menopause treatment. Whichever doctor you see, your care will be ultimately overseen by Dr Peers.

Making an appointment
You can book online by clicking on the links at the top of this page. Once you have booked, you will receive a confirmation email with some details about the clinic, along with a link to our new patient questionnaire. This will give us a clear picture of your health history and save time at your appointment, ensuring that we can spend the time that we need to on discussing your treatment.

We do accept referrals from GPs, but a referral is not necessary as you can also self-refer to the clinic.

At your consultation
If you would like to bring your partner or a friend to the consultation please do - sometimes its difficult to remember everything that is discussed. Also, if you have a disability and require wheelchair access, please do let us know at the time of booking and we will accommodate your needs.

At the consultation we will discuss the blood tests which may be helpful, and when these should be taken (also see FAQ's below). If your GP is unable to organise these we can refer you to a local laboratory for the tests at a reasonable price (you pay the lab directly).

A prescription will be supplied for the agreed hormone therapy and you can either take this to your local pharmacy, or we can arrange for it to be sent to you by post with free delivery from the online pharmacy service that we use. This can be helpful as the supply of stocks are sometimes unreliable in local pharmacies.

With your permission we will send either a letter to your GP copied to you, or to you directly and copied to the GP. Please let us know which you prefer. These are usually sent within 7-10 working days of your consultation.

Follow up consultations
You may be asked to schedule a follow up consultation for a few months after your first appointment. You can book this online or by telephone. It's advisable to book this as soon as you can, as slots can get booked up far in advance.

Contact details:
Tel: 01737 844659
Email: [email protected]



NEWS

There are currently many stock issues with HRT products in the UK.
See the latest news about HRT supply shortages from the British Menopause Society.

The following online pharmacies can dispense private and NHS prescriptions:
www.pharmacierge.com
www.theindependentpharmacy.co.uk
www.oxfordonlinepharmacy.co.uk



Group Talks

We are able to offer talks to groups about Menopause. Please contact the clinic for more details.


The Menopause & Women's Health Clinic. ButterflyGreen2


Menopause & Women's Health Clinic Fees

Initial Consultation - £240.00 (£250 from April 2020)

Follow-up Consultation (including by telephone) - £180.00 (£200 from April 2020)
For patients who have had an appointment in the last 12 months.
(Patients who have not been seen within the last 12 months: please book an initial consultation in order to allow sufficient time to take a full history and to fully understand your current needs.)

Please note that in the month following your consultation up to two follow up emails will not be charged for. Subsequent emails are charged at £40 each.


Other fees:
Private prescription - £30.00 (£40 from April 2020)
Additional email correspondence - £40.00
Letter fee - £50
Payments should preferably be made by debit or credit card.

Private Medical Insurance
We are not able to administer claims through private medical insurance - the fees must be paid by the patient at the time of the consultation. We can provide a receipt on request, which you may be able to use to claim the fees through your insurance policy if you are covered - please check with your health insurance provider.

Please note that if we have not seen you for a review for over 12 months, then unfortunately we will be unable to comment on blood results or give email advice without a full initial consultation.

Link to our New Patient questionnaire


The Menopause & Women's Health Clinic. Blue butterfly tall


Frequently Asked Questions

1. If my dose of oestrogen is changed, do I change the dose of progesterone (Utrogestan)?
The dose of the Utrogestan may stay the same. The standard doses are either:
2 x 100mg Utrogestan at night for 12 nights per month in cyclical HRT
or
100mg Utrogestan at night, every night, for continuous combined HRT.
If your oestradiol dose is over 1.5mg daily we may ask you to take 2 x 100mg Utrogestan every night.

2. If I get breast tenderness what should I do?
Many women can experience some breast tenderness when they initially start HRT. This usually lasts 2-4 weeks. If it is severe, or lasts longer, please take Super Starflower oil (Solgar make an excellent one) 300iu per day for 3-4 weeks. Evening Primrose oil 2000mg a day may also help.

If you know that you are particularly prone to breast tenderness when taking oestrogen, you could take the Super Starflower oil for 3-4 weeks prior to starting HRT to prime the breasts and reduce this reaction. If the breast tenderness does not respond to this and persists, please book in for further advice. We may change your dose or the preparation you are on.

3. What blood tests should I have before coming to my first consultation?
If you are not on HRT and are over 45 years old, there is no need to have any bloods prior to your first appointment. If you are under 45 years old please ask your GP for:
Oestradiol, progesterone, FSH, LH, testosterone, SHBG, TFTs (thyroid function tests)
Please then bring the results with you.

If you are on HRT already it is useful for us if you have an oestradiol, testosterone and SHBG blood test. (Do not have the blood test on day 4 of a patch if you are using patches - the levels can drop on Day 4. )
Please bring the results with you.

You can either ask your GP to arrange the tests, or you can arrange them privately at The County Pathology Laboratory in Guildford Research Park:
County Pathology Ltd.
31 Frederick Sanger Road
The Surrey Research Park
Guildford
Surrey
GU2 7YD
T: 01483 450388
Website: www.countypathology.co.uk
Email: [email protected]


4. What should I do if I start bleeding heavily on continuous combined HRT and haven’t had a period for over a year?
This is classed as postmenopausal bleeding and should be investigated as soon as possible. Please see your GP who will organise a trans-vaginal ultrasound scan to check the thickness of the lining of your womb and to see if there are any polyps or other causes of bleeding.

5. What if I start getting some ‘old blood’, or light spotting for a couple of days initially after starting the HRT?
Keep a note of it and inform us at your 3 month follow-up. This may happen initially and usually settles after 3-5 months.

6. What shall I do if the Vagifem pessaries irritate my vaginal or vulval skin?
Stop using them and try again once you have started to settle on the transdermal HRT. If it still irritates then please contact us for another appointment, as we may need to examine you and prescribe a different preparation.

7. If I have a Mirena should I have it removed before starting HRT?
No. Many peri-menopausal women need contraception as well as HRT. Contraception is recommended to the age of 55 years if you are still having periods or had them until you were 54 years old. The Mirena may have stopped all your bleeds and it may not be obvious to you that you are postmenopausal, so its best to keep it if you are uncertain.

The Mirena can also be used in HRT for the endometrial protection. We can discuss this with you at your consultation.

8. Testosterone preparations:
From 2018 some testosterone gels are no longer being manufactured. Testogel metered dispensers are NOT recommended for female use. The recommended alternative is Tostran gel 2%. 1 metered dose = 10mg and the usual daily female dose is 5mg per day, therefore Tostran can be used up to one metered dose on alternate days. Follow the instructions given to you at your consultation - the letter will remind you what these were. Another alternative is Testogel 50/5ml - each sachet being used sparing over 7-14 days according to individual need and side effects.

If you are on testosterone replacement, the International Menopause Society Guidelines recommend an annual blood test as a minimum, to monitor the levels. Do not apply the gel the day before or the day of the blood test.

For further information please see the excellent website for the Menopause Clinic at Chelsea and Westminster Hospital in London, where we have put together information leaflets for women on all aspects of HRT and Menopause Management: www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/special-notices

If your question is not answered here
If you have any questions that are not answered above please email us. Your consultation fee includes two follow up emails within one month of your consultation. For any additional questions you may have, further email advice will be charged at £40 per email.

Please also note that repeat prescriptions between appointments will be charged at £40 per prescription and additional letters written between appointments will be charged at £50 per letter.

If you have not been seen for over 12 months
We are only able to comment on your treatment or blood results via email if you have been seen within the last 12 months. Please therefore book an appointment to be seen, in line with the GMC Good Medical Practice Guidelines. If you have not been seen for over 12 months your consultation will be charged as a new patient's consultation to allow sufficient time to take a full history and fully understand your current needs.



Complaints Policy for The Menopause Clinic at Tillow Barn

If you are unhappy with our facilities or service we want to know about it as soon as possible. We will then investigate the situation so that we can explain, apologise and take positive action where necessary and as swiftly as possible. If you tell us as soon as the problem arises, it can often be sorted out straightaway. In many cases, the person looking after you may be able to solve a day-to-day query. Otherwise, the Clinical Lead or other senior member of staff is able to help and is very happy to discuss your complaint in the first instance.

If you are not completely satisfied you can put your comments in writing. We take all comments and complaints seriously.

We always:

  • handle complaints in complete confidence
  • investigate impartially
  • offer a clear and complete explanation

    Please complete the Complaints form, return it to Tillow Barn for the attention of the clinic Manager, and include the following details to help us deal with your complaint:

  • the date on which you had reason to complain
  • names of the consultant(s), or other staff who were caring for you, if known
  • the type of treatment you received
  • details of your complaint
  • any further comments that you want to bring to our attention

    Period within which complaints can be made:

    The period for making a complaint is normally:
    (a) 12 months from the date on which the event which is the subject of the complaint occurred;
    or
    (b) 12 months from the date on which the event, which is the subject of the complaint, comes to the complainant's notice.

    Complaints should normally be resolved within 6 months.

    The Menopause and Women’s Health Clinic standard will be 10 working days for a response. Acknowledgements will be sent within three working days of receiving the complaint. We will then reply in full as promptly as we can - usually within 10 working days.

    If the investigation is still going on after 10 days we will write to explain the delay. In very complex cases, which may take more time, we will send you regular progress reports. We may suggest meeting you to talk through your issues and attempt to resolve them.
    Updated September 2019


    If you wish to make a complaint, please click here to complete our complaint form.


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