Qualified Practitioner
Dr Ros Debenham MBChB MRCGP

BHRT Providing a hormone solution specific to each woman’s changing menopause.

The Premenstrual time, the Perimenopause (the time leading up to the menopause) & the Menopause
“I think I’m losing my mind”, “I’ve lost my confidence & get up & go”, “my husband says he is going to kill me if I don’t get some help”, “I’d rather curl up & watch TV than have sex’.
These are common pleas for help from women approaching, or at the menopause.
But our fluctuating hormones can cause problems even from the beginning; at puberty, after or postnatally. Some younger women say “I lose several days every month when I just become irrational, stressed, weepy & unable to think clearly”
Standard NHS treatment does not take into account the oestrogen:progesterone ratio which is the cause. Progesterone, exactly the same molecule as a woman’s own can have dramatic results without the synthetic drug Progesterone replacement side effects.
Standard Hormone Replacement Drug Therapy (HRT) using just 2 hormones sadly may make symptoms worse for women in later life as side effects of the drugs or may subject a woman to other health risks.
Bio-identical hormones (BHRT) selected from a range of 6 hormones that are identical to a woman’s hormones however are safe & are titrated to her body’s needs.


This is the time when our hormones are changing & the imbalance & fluctuation of the various hormones causes symptoms that may be very distressing. It ends with the cessation of menstruation. It usually starts around 40-45 years of age but can start earlier. Some women have no symptoms or may not be aware of the gradual increase in changes in their body that they put down to ‘just getting older’. The perimenopause can last 10 years or longer.
Common symptoms during this phase of hormonal fluctuation can include:

  • Fatigue
  • Mood swings
  • Sleep disturbance
  • Anger and irritability
  • Anxiety
  • Memory loss
  • Poor concentration
  • Irregular periods
  • Periods that are heavier or lighter than usual
  • Premenstrual tension
  • Hot flushes
  • Low libido
  • Vaginal dryness
  • Night Sweats
  • Heavy prolonged periods
  • More frequent periods
  • Anaemia
  • Weight gain
  • Bloating
  • Fluid retention
  • Breast tenderness
  • Aches and painful joints
  • Frequent headaches
  • Urinary incontinence
  • Dry skin


The Menopause

The date of a woman’s menopause is 1 year after her periods finally stop but symptoms may have been going on for 10 years or more. A woman’s reproductive hormone levels continue to drop and fluctuate for some time into the time after the menopause, with symptoms that may take several years to disappear. Symptoms are similar to those leading up to menopause, but with more consistency in:

  • Hot flushes and night sweats.
  • Difficulty sleeping (insomnia).
  • Mood, such as feeling tired, irritable, depressed or anxious.
  • Poor concentration or poor memory.
  • Changes to the vagina, such as dryness, discomfort, itching or decrease in size making intercourse painful.
  • Loss of interest in sex (loss of libido).
  • Urinary problems – such as recurrent urinary tract infections, loss of bladder control (urinary incontinence).
  • Joint aches and pains.

    Treatment of the stages of the menopause

    In each stage of the menopause, hormone levels can fluctuate significantly, however, these vital hormones, such as estrogen, progesterone, testosterone & DHEA remain important for bones, vaginal and urethral health, skin, brain function and cardiovascular health. Balancing and replenishing these hormones helps a woman’s health, energy, mood and brain function.

    Why do we use Bio-identical hormones?

    One size does not fit all as women do not all have fluctuations in all their hormones & to the same degree. A consultation, together with appropriate tests, when symptoms are recognised enables us to provide a hormone solution specific to each woman’s changing hormones.
    Standard NHS Hormone Replacement Therapy (HRT) uses only 2 hormones; ‘an Oestradiol’ & ‘a Progesterone’ & in fixed amounts that may cause side effects & increase heart disease & cancer. These are very often manufactured drugs & so have side effects.
    The 6 Bio-identical hormones are exactly the same molecules as our own hormones hence no side effects & many other heart, cancer, skin, brain & bone health advantages. Testosterone & DHEA can have a profound effect on the body when their levels are restored but are not in NHS HRT.


    We will email/ post in depth questionnaire to you that must be completed & brought to your initial consultation. This will go into medical & medication history, periods, contraception, sexual history, symptoms such as hot flushes, memory loss, poor concentration, loss of libido, loss of confidence, fatigue, anxiety, urinary incontinence, vaginal dryness & many other symptoms associated with your hormones. £50
    Initial consultation 45 mins with Dr Ros or Nurse Helen. This is to go through your questionnaire & clarify symptoms, decide on which blood tests need to be done, & if a scan is required. £240
    Follow up appointment 2 weeks: 15-30 mins with Dr Ros/ Nurse Helen to discuss treatment options & provide you with your individual hormone prescription. £75-120 / or telephone consultation £45.
    Follow up appointment at 6 weeks 15-30 mins with Dr Ros/ Nurse Helen. Review of progress with individualised medicine. Evaluate & adjust doses if required. Consider additional hormones. £80-120 / or telephone consultation £45.
    Follow up appointment at further 6 weeks or 3 months 15-30 mins with Dr Ros/ Nurse Helen. Review of progress with individualised medicine. £75-120 / or telephone consultation £45.
    6 monthly review £80 15 mins with bloods being taken every 12 months along with Pelvic scan if required (2 weeks prior to appointment) £120 30 mins.

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