Our specialist clinics

Chelsea and Westminster Hospital

Menopause service for women over 40

This is a joint consultant service led by My Nick Panay and Ms Claudine Domoney. Both have recognised national and international reputations as experts in their field.

The clinic provides a holistic approach to the management of the menopause including Bio-identical hormone replacement therapy (HRT), alternative and complimentary therapies.

Advice is aimed at relieving short-term symptoms and promoting long-term health (eg prevention of osteoporosis). Treatment and advice incorporates the best evidence outline in NICE Menopause: Diagnosis and Management, and is individualised according to personal health risks and benefits. This includes symptomatic women with complex or high risk conditions seeking HRT—for example:

  • breast cancer, familial breast cancer, cardiovascular disease or osteoporosis.
  • fibromyalgia, chronic fatigue syndrome or multiple sclerosis
  • hormonal headache, mirgaine or asthma
  • hormonal depression or anxiety

We may refer to other services if required:

  • Women on hormone implants are followed up in the specialist nurse clinic
  • Specialist care—dieticians, specialist counsellor, psychosexual counsellor, physiotherapy, urogynaecology, fertility.

Find out more

Premature ovarian insufficiency service (POI) for woman under 40

Led by Mr Panay (Consultant Gynaecologist)

This clinic specifically benefits younger women to meet their unique needs. Bio-identical hormone therapy is offered as well as advice on alternative and compliment therapies.

It is important to note that risks associated with post menopausal women over the age of 51 on HRT are not applied to women under the age of 51. HRT should be taken up to the average age of the menopause to avoid premature cardiovascular disease or osteoporosis.

  • Close links have been established with the fertility service for women also seeking fertility treatment
  • We can refer women to our specialist counsellor who has expertise in POI

POI Support Group

Led by Claire Bellone (Clinical Nurse Specialist) and Dani Singer (specialist counsellor)
A once a month support forum for all young women with POI. To find out more

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Premenstrual syndrome & premenstrual dysphoric disorder (PMS/PMDD)

Led by Mr Panay (Consultant Gynaecologist)

For some women PMS/PMDD can seriously affect the quality of their life both socially, professionally and personally. Symptoms typically include depression, mood swings, anxiety, irrational behaviour as well as food cravings and physical symptoms. Less typically PMS may be associated with pre menstrual migraine, CFS/ME and fibromyalgia. We see women as young as 15 up to 50.

Treatment may involve the use of the lifestyle and alternative interventions, the oral contraceptive pill, HRT or down-regulation of the ovarian cycle. Down-regulation is with GnRH analogues used either diagnostically or as long-term intervention with add back HRT.

For women on GnRHa injections, treatment is initiated in the clinic but, where possible, continued and prescribed with their GP. Ongoing supervision is always provided from the clinic. This is accordance with PCT tariff guidance. GnRHa are used off licence, but with effective add back the risk for osteoporosis is avoided—all women will have a baseline bone density scan and repeated yearly thereafter.

  • Specialist care—dieticians, specialist counsellor, physiotherapy, urogynaecology, fertility

 Find out more

Kobler menopause clinic

Led by Ms Nneka Nwokolo (Consultant Physician)

This clinic is a specialist menopause clinic for women with HIV. It is recognised that you may have unique needs relating to your HIV status and menopause and we aim to provide a supporting and understanding service. We welcome referrals from HIV physicians and GPs.

Implant clinic

Led by Claire Bellone (Clinical Nurse Specialist)

Implant appointments are every 6–8 months or dependent upon recent blood levels.  Our guideline states the normal range for estrogen implant as 200-600pmol/l. You will need an estrogen blood tests before every appointment and unless previously agreed, blood tests must be done at the hospital: no appointment is required.

  • Estrogen blood tests must be done 1 week before your appointment

If you live outside of London:

  • Blood tests can be done at your GP but results must be brought personally as we or emailed to caw-tr.menopause@nhs.net (GP only email)

If your estrogen levels are above normal range your appointment may be deferred until they return to normal. 

Telephone clinic

Led by Clinical Nurse Specialists

This is a booked appointment to discuss your results and adjust your treatment accordingly. The aim is to provide a convenient and efficient service that avoids unnecessary trips to hospital. There is no call back facility for this appointment so please ensure you are available at the agreed time and date.

If you cannot make the appointment please schedule with the appointment office. If you miss the appointment the next available appointment at the hospital will be sent to you.

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