Holistic Hormonal Healthcare in the East of England

 

Specialist in Menopause & Premenstrual Disorders

About Hannah

 

Hannah is a General Practitioner and accredited Specialist in Menopause & Premenstrual Disorders, recognised by The British Menopause Society (BMS), The International Association for Premenstrual Disorders (IAPMD) and The National Association for Premenstrual Syndrome (NAPS). 

After obtaining her undergraduate degree in Human Sciences from the University of Oxford, she completed her medical training at the University of Cambridge and qualified in 2009. She achieved Membership of The Royal College of General Practitioners (MRCGP) in 2016, and is a diplomate of The Royal College of Obstetricians and Gynaecologists (DRCOG) and The Faculty of Sexual and Reproductive Healthcare (DFSRH).

In December 2018 Hannah was awarded the BMS/FSRH Advanced Certificate in Menopause Care. This enables her to receive external referrals and to lead a menopause service, both within the National Health Service (NHS) and the private sector. 

Former Associate Editor for the BMS journal Post Reproductive Health, she is currently on the Executive Committee for The Primary Care Women’s Health Forum (PCWHF), a member of the IAPMD Surgical Menopause Advisory Committee and provides voluntary medical support for The Daisy Network

Hannah has a keen interest in the role of plant-based nutrition in health and disease, in particular, the association between the gut microbiome and oestrogen metabolism. She is a member of Plant-Based Health Professionals UK and The British Society of Lifestyle Medicine.

She lectures widely, providing education and information for both fellow healthcare professionals and the public.

 

Areas of Expertise

Menopause

Menopause refers to a woman’s final menstrual period; this happens when the ovaries stop releasing eggs and levels of hormones (oestrogen, progesterone and testosterone) fall.

For the vast majority of women, menopause is a natural process. However, it can also occur as the result of a disease process or medical/surgical treatment e.g. for cancer, benign gynaecological disorders or PMDD.

The average age of menopause in the UK is 51 years of age. Menopause below the age of 45 is called early menopause. If it occurs below the age of 40 it is termed premature menopause or Premature Ovarian Insufficiency (POI).

Most women will experience some menopausal symptoms, but the severity of these can vary hugely. Symptoms can start several years before a woman’s final period (during the perimenopause) and may continue for months to years after her menopause. The average length of time for women to experience symptoms is 7 years.

Hannah is qualified to advise on all aspects of menopausal health, and has particular interests in:

  • surgical menopause (including those affected by a BRCA mutation)
  • menopause following cancer treatment (including treatment for breast cancer)
  • menopause and chronic conditions (e.g. endometriosis, autoimmune disease, inflammatory bowel disease, osteoporosis, migraine, diabetes)
Premature Ovarian Insufficiency (POI)

Premature Ovarian Insufficiency (POI), frequently referred to as premature menopause, occurs below the age of 40 and affects around 1 in 100 girls and women in the UK.

POI can occur as a result of surgical or medical treatment for other conditions (e.g. endometriosis, cancer, PMDD), can be associated with autoimmune disease (e.g. hypothyroidism, Addison’s Disease) or genetic abnormalities (e.g. Fragile X Syndrome), or, rarely, may occur following severe infection (e.g. tuberculosis, malaria). However, for the vast majority of women no cause for POI is found. This is then known as spontaneous, or idiopathic, POI.

Specialist management of POI is necessary, not only to help alleviate associated symptoms but also to reduce the risk of chronic disease (in particular heart disease, osteoporosis and dementia) in later life.

Hannah has personal experience of surgical POI, having undergone a total hysterectomy and bilateral salpingo-oophorectomy (removal of the womb, fallopian tubes and both ovaries) at the age of 35. She sees patients from across the POI spectrum. 

Infertility can be a distressing consequence of POI. Please note that Hannah is not a fertility expert. If necessary, onward referral to specialists in this area can be made.

Premenstrual Disorders

For many girls and women mild to moderate premenstrual symptoms, known as PMS, may be uncomfortable but manageable with lifestyle changes/dietary intervention/exercise. Hormonal or herbal treatments may also be helpful.

For others symptoms can be extremely distressing, having such a debilitating impact on quality of life that 15% of those with Premenstrual Dysphoric Disorder (PMDD) (a severe form of premenstrual disorder) attempt to take their own life.

Premenstrual Exacerbation (PME) can be difficult to differentiate from PMS/PMDD. PME occurs when symptoms of an underlying physical or mental health condition worsen in the luteal phase of the menstrual cycle (the time between ovulation and menstruation).

The only way to formally diagnose PMS, PMDD or PME is by tracking symptoms for at least two menstrual cycles. Correct diagnosis is needed in order to receive the most effective treatment.

Hannah offers advice and treatment for all types of premenstrual disorder. If surgery is required for women with treatment-resistant PMDD then an onward referral can be made.

Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT) the most effective medical treatment for menopausal symptoms, and can also be used in the treatment of premenstrual disorders (PMS/PMDD/PME). HRT reduces the risk of chronic disease in women who undergo an early menopause and in those who have a diagnosis of POI.

Hannah is able to advise on all forms of HRT including evidence-based body-identical HRT and testosterone replacement.

In her private clinic, she is currently unable to offer hormone implants (pellets) or insertion of the Mirena IUS (coil). However, arrangements can be made to refer onwards for these should they be necessary.

For women who are unable to take HRT, or who choose not to, Hannah can advise on alternatives to HRT.

Plant Based Nutrition

Hannah has a special interest in the role of plant-based nutrition in female hormonal health, in particular the association between gut health and hormonal balance.

There is evidence that women who follow a whole food plant-based diet suffer fewer menopausal and premenstrual symptoms, and have a lower risk of heart disease, diabetes and certain cancers. Hannah lectures on this topic to both healthcare professionals and the general public, and is also able to advise on concerns relevant to vegan health.  

In April 2018, Hannah completed the eCornell Certificate in Plant-Based Nutritionand has undergone further training in Lifestyle Medicine with the RCGP.

She is a member of Plant-Based Health Professionals UK and The British Society of Lifestyle Medicine.

Location

Suite 3, 35 Fore Hill, Ely, Cambridgeshire 

CB7 4AA

 01353 469 008

Directions and parking

The clinic is located in central Ely, mid-way down Fore Hill, just above Spa Ely and Truly Scrumptious (we share a common entrance).

Please enter the spa/café and head to the reception desk on the right. You will be then be directed to the waiting area and Hannah will collect you at your appointment time.

There is no car park associated with 35 Fore Hill. However, there is free parking available at Fore Hill Car Park (CB74AF), and a direct cut through from the car park, which brings you out opposite the clinic location.

Ely train station is approximately 10-15 minutes’ walk away.