Mid-Life Health and Our Menopause

If you find yourself between the ages of 40 to 60, welcome to your MIDLIFE—a wonderful stage that grants us the opportunity to make real changes! In this article, Dr Elise Dallas, Menopause Specialist, will explore the significance of midlife and its connection to menopause, while delving into the introduction of The London General Practice's new Menopause Service.

This service is dedicated to not only managing menopause but also prioritising screening for chronic conditions that commonly arise during this transformative period of a woman's life.

Midlife: A Period of Reevaluation

Midlife, spanning from 40 to 60 years, presents a golden opportunity to reassess our health and shape our later years. In stark contrast to a century ago when women's lives were often cut short after menopause, we now enjoy a longer average lifespan of 83 years. As we age, our hormones wield significant influence over our lifestyle choices, and in turn, our lifestyle profoundly affects our hormonal balance. The decline of oestrogen during menopause can profoundly impact heart and bone health, making midlife an essential stage for preventive measures.


Silent Changes during Midlife

Midlife brings about age-related changes, some of which are closely tied to menopause. These changes include bone loss, which can lead to conditions like osteoporosis and osteoarthritis, as well as adverse alterations in heart health, such as shifts in lipid profiles and the onset of diabetes or metabolic syndrome. What makes these changes particularly challenging is that they often manifest silently, without overt symptoms, making early screening and detection vital to our long-term well-being.


Introducing LGP's Comprehensive Menopause Service

Their Menopause Service has an innovative approach, encompassing a comprehensive range of health assessments and targeted screenings. This service emphasises the detection of asymptomatic chronic conditions like cardiovascular and bone disease. By adopting an early intervention strategy, they aim to significantly improve long term health outcomes.


Identifying Perimenopause and Menopause Symptoms

When considering perimenopause, they examine factors such as age and menstrual changes. Perimenopause often presents with shorter, heavier cycles that later transition into longer and more spaced-apart periods, but often they can just stop. Menopause is when you have not had a period for a year. It can be challenging to diagnose if you've had a hysterectomy, use contraception, have a Mirena coil, or experience polycystic ovary syndrome (PCOS). In general, if you are 45 years or older and exhibit symptoms, you may be perimenopausal.

Common menopause symptoms include changes in menstrual patterns, hot flushes, night sweats, vaginal dryness, reduced libido, joint pains, difficulty sleeping, and mood swings. However, some symptoms can be atypical, such as ringing in the ears or sensations of crawling on the skin. The Menopause Symptom Checker available on their website which they can personalise to you, can help you assess and manage these symptoms effectively.


Prioritising Heart Health

Heart disease is a significant concern for women, standing as the leading cause of death worldwide. The risk of cardiovascular disease significantly rises after menopause, making women five times more likely to experience a heart attack. The loss of oestrogen during menopause can lead to adverse changes in blood pressure, cholesterol levels, and insulin sensitivity, all of which are silent symptoms requiring screening.

At The London General Practice, they uphold peer-reviewed international guidelines to ensure state-of-the-art screening methods. Our comprehensive cardiovascular screening includes:

  • Blood pressure assessment
  • Further blood tests, including cholesterol, blood sugar, kidney, liver, and more
  • Exercise stress ECG to evaluate coronary artery risk
  • ECG (electrocardiogram) to gauge coronary artery disease risk
  • Echocardiogram to assess heart structure, valves, and function
  • CT coronary angiogram
  • Chest X-rays
  • EBCT Coronary Calcium Score, providing a 3D visualization of coronary arteries
  • Ultrasonic abdominal aortic aneurysm scans
  • Carotid artery Doppler ultrasound


Prioritising Bone Health

Osteoporosis, arising from bone mineral loss, poses a significant risk during menopause. Weak bones may fracture with minor injuries, significantly impacting quality of life. Bone loss commences during the menopausal transition and accelerates around menopause. Half of women over 50 years are likely to experience a fragility fracture, and a hip fracture increases mortality risk by four times, with 80% of women losing their independence.

Early screening and detection are paramount to optimise bone strength preservation. For osteoporosis screening, we offer, bone density scans (DEXA scans) of your hip and spine which is the ‘gold standard’ to diagnose osteoporosis and to predict your risk of breaking a bone and tailored assessments based on individual health backgrounds.


Empowering Midlife Health

In their Menopause Service, they take a comprehensive approach to managing midlife health, offering evidence-based Hormone Replacement Therapy (HRT) options. HRT has proven to effectively alleviate menopausal symptoms and reduce associated health risks. Notably, it can reduce heart disease by 50% and significantly mitigate the impact of osteoporosis. As part of their service, we also offer Mirena coil fittings and testosterone options for evidence-based HRT choices tailored to individual needs.


Addressing Lifestyle Factors: Nutrition, Movement, Well-being, and Sleep


The London General Practice believes in going beyond medical interventions to encompass a holistic approach to women's health during midlife. They address crucial lifestyle factors like nutrition, movement, well-being, and sleep. They help midlife women take charge of their overall health, ensuring that they receive the guidance and support they need to thrive.

This comprehensive approach enhances long-term well-being, reduces the risk of chronic diseases, and improves women’s quality of life.



Midlife represents a significant and transformative period for women. Through LGP's Menopause Service, they are committed to providing individualised and comprehensive care, empowering women to navigate their health and overall well-being during this crucial stage of life. By proactively detecting and managing chronic conditions, they aim to support women in thriving not only during midlife but also throughout their future, promoting vitality and happiness for years to come.



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