Frequently Asked Questions

Helping women navigate through the menopause is not just about prescribing hormone replacement therapy (HRT). Consideration of physical, sexual and psychological factors is important to ensure any intervention is right for you. Therefore, when choosing to receive medical advice and treatment for the symptoms of the menopause, look for practitioners with specific accredited training from the British Menopause Society (BMS). The BMS are the foremost professional society in the UK who advise health professionals and provide basic and advanced training on the menopause. Both doctors at Spiced Pear Health are BMS trained Advanced Menopause Specialists.

Sexual health issues are often experienced by those going through the menopause. The Contemporary Institute of Clinical Sexology provide Pink Therapy endorsed Gender, Sexuality and Relationship Diversity training that is accredited by the College of Sexual and Relationship Therapists. Both doctors at Spiced Pear Health have successfully completed this training.

Psychological health can be significantly impacted by the menopause. Cognitive behavioural therapy (CBT) is a talking therapy that can help manage problems by changing the way a person thinks and behaves. It is an evidenced-based therapy that improves physical and psychological symptoms of menopause and may be helpful for some women who choose not to use HRT. Both doctors at Spiced Pear Health are trained to provide CBT as an additional or optional intervention.

Our service offers you access to our patient portal, whether you decide to stay with us or not. After your initial consultation we will prepare your treatment plan and make this available for you to share with your GP, if you wish. If you decide to continue your care with Spiced Pear Health, the portal is where you can access your treatment plan and leaflets on the advice we provide.

We are committed to generally raising access to advice on the menopause. We have embedded within our business model our ability to deliver free advice to women who currently don’t have access to the support they need to tackle the impact of their menopause via our charity work. We are proud of our work with charities like Maggies and are committed to expanding this part of our work.

Spiced Pear Health was conceived in a chilly square in Prague, when we were both attending the annual congress of the European Society for Sexual Medicine. We had met previously at a testosterone conference and struck up an instant friendship. We sat huddled under blankets, sipping cups of hot spiced pear drink and sharing our frustrations at the way menopause and sexual dysfunction were treated.

As doctors (and women in our forties ourselves) we felt the one-size fits all, cookie-cutter approach that we saw being used to treat women like us was falling a long way short of what we both knew was possible. Our training in menopause and sexology has equipped us with skills to focus on the nuance in the individual and offer the kind of personalised approach to care we knew was sorely needed in this area. And so the concept of Spiced Pear Health was born!

The concept came first, and the name later. We felt that although it was good that more attention generally was being paid to menopause, we wanted to set ourselves apart from the existing clinics from the very start by not putting only treatment of the menopause in our name. We know that you can’t hope to sort sex and menopause issues without placing the woman in the context of her life and relationship. We know that our biopsychosocial approach means we can really understand the many factors at play in a problem, and therefore that we can really hope to properly bring about results.

We wanted a name that would always remind us of our founding aims and make it clear to everyone that we weren’t just about the menopause: we were about the whole woman. Spiced Pear reminds us that we are different, and also of that very first chat: of the power of sitting woman to woman, and being heard and understood.

You can read more about us here. Dr Angela Wright & Dr Angela Sharma are both highly experienced General Practitioners with advanced training in menopause care – the highest level offered by the British Menopause Society. We are proud that we are GPs and believe it leaves us uniquely placed to understand your issues in the context of the rest of your health.

We treat women going through the menopause, irrespective of age. We can help with:

• Symptoms of the perimenopause, menopause, and post menopause

• Menopause following pelvic surgery or cancer treatment induced symptoms

• Premature menopause (premature ovarian insufficiency – POI)

• Vaginal/bladder and pelvic floor problems during menopause

• Women experiencing sexual dysfunction due to the menopause

• Women with progesterone sensitivity

• Women already on HRT who need a review of their treatment or experiencing complications with their medication

• Women with complex medical histories such as polycystic ovarian syndrome (PCOS) endometriosis, previous history of cancer including breast cancer, chronic diseases and women with co-morbidities.

• Women who choose not to have HRT

• Women with a history of trauma and provide trauma informed care

• We welcome GSRD patients and any non-binary identity

You do not require a referral letter from your GP to see a Spiced Pear Health doctor. We think it is important you inform your doctor of the advice we give, and to help with this, we will provide you with a copy of your treatment plan, which you may share with your GP.

Simply click the option on the top of our main web page to book a consultation. You will need to register first and then verify your registration via the email you’ll receive. You can then login onto the portal and select the time and date for your appointment. We take payment for our appointments via a secure online payment gateway provided by Stripe. Spiced Pear Health does not keep any card details. You will then receive a welcome email with the link for the video appointment, which you can click on at the time of your appointment. We will need to see your photo ID at the start of the consultation to verify your identity.

Please read our article on “How to prepare for your consultation with Spiced Pear Health.” Click here.

Please bring one form of photo ID from the following list for your doctor to verify your identity at the start of the appointment:

• Passport

• Driving licence/Provisional driving licence

This information helps us confirm your identity and your appointment cannot proceed without showing this proof.

Aside from your health and wellbeing, your security and privacy are our next highest priorities. Every connection to Spiced Pear Health is secured, whether that be on our patient portal, making a payment or joining a video/telephone consultation with our doctors.

We use Microsoft Teams to conduct video consultations, a platform that is used extensively across the NHS. Our patient portal is hosted on Amazon Web Services, a platform used by the many organisations for their cloud services.

The industry in which we operate is regulated by the Care Quality Commission. Spiced Pear Health has been and will continue to be assessed and certified by the regulators to ensure the service we provide meets their requirements.

We’ll use the telephone instead for the consultation. We’ve carried out many telephone consultations, and the advice we give will be exactly the same so don’t feel you’ll be missing out.

Our website and patient portal have been designed towards WCAG standards for content and accessibility for all users regardless of disability. Patients with a physical disability will benefit from the fact that they can access our expertise from their own homes rather than needing to travel to a clinic. All patients including those who are visually or hearing impaired or who do not feel comfortable with video consultations, can contact us at [email protected] prior to their appointment to discuss adaptations to facilitate their access. Options available include having a telephone consultation, a telephone consultation using your hearing loop enabled technology, using the video consultation with closed captions or having a 3rd party present for translation/ or using sign language.

After your initial appointment, you will receive a treatment plan via the patient portal, which you may share with your GP. We may also share via the patient portal, relevant leaflets and videos depending on your requirements. If blood tests have been requested through our clinic the results will also be in your patient portal.

After your initial appointment, you may, after this, decide to continue your care with your own GP. Your treatment plan, which we will make available to you in the patient portal, can be used to advise your GP on the advice we have given.

If you decide to continue your care with Spiced Pear Health and inform us during the initial or follow-up consultation, we will advise you on when to book your review appointment.

You can also choose to book an appointment for a review at any time you wish. We generally advise conducting a review consultation at intervals of 3, 6 and 12 months after the initial consultation.

If you wish for Spiced Pear Health to continue prescribing your medication after the first 12 months from your initial prescription, in line with NICE guidelines for best prescribing practice, we require you to book a 30-minute annual review. We will thereafter be happy to prescribe your medication for a further year.

Log in to your patient portal to reschedule your appointment. You will be able to reschedule up to 48hrs before the appointment. After this time, we reserve the right to regard this as a last-minute cancellation and retain the consultation fee.

For cancellations, any request received at least 48 hours before the appointment will receive a full refund. If the cancellation is received after this time, we are unable to refund your fee.

In the event of the doctor being unable to provide an appointment, we will do our best to honour the original booking if at all possible. Where the other Dr Angela is not able to run the consultation, we will work with you to be as flexible as we are able to be to provide another appointment as soon as possible, or to refund your fee if this is not suitable for you.

Both doctors provide an equally expert menopause consultation. You will know which doctor will be conducting the consultation when you receive an email from us to confirm your appointment.

Either doctor will be able to continue your care with Spiced Pear Health. Your treatment plan and information in the patient portal will be sufficient to continue your care with either doctor.

Unfortunately, private medical insurance does not cover the menopause.

Unfortunately, new patients who live outside the UK cannot be seen by us because our medical indemnity insurance only covers residents of the UK.

Patients who lived in the UK, the Channel Islands or the Isle of Man at the time of their initial treatment but who have now moved overseas can continue to be seen at our clinic.

We thought long and hard about whether to launch online, or to have premises from the start. In the end, we felt the lack of access to the kind of care we hope to give was a problem that affected women all over the UK. Our priority was bringing our approach to as many women as we could: we have invested heavily in designing a bespoke consulting suite that will allow us to offer a truly unique experience when you use the online clinic.

If you still prefer a face-to-face appointment, then we suggest you find an alternative provider with a clinic via the British Menopause Society’s list of accredited menopause specialists.

Blood tests are not generally useful for diagnosing menopause due to fluctuating hormone levels that can sometimes give an inaccurate picture. However, we are aware that women may use this opportunity to have a general health check. We may decide together that a blood test may be needed for general health and lifestyle management.

If you have started HRT, we may arrange a blood test if needed to monitor your treatment or if your symptoms are not well controlled. We will discuss this with you during the consultation.

Please read the relevant section in Additional Information. If after speaking to Clynxx you still have questions, please email us with your query at [email protected].

Results take 3-5 days to be processed. Once we have reviewed them, we will put a copy of the results in the patient portal, along with our advice.

We only prescribe regulated HRT as recommended by the British Menopause Society. We do not prescribe bioidentical hormones.

The safest types of HRT are “body identical hormones” which means that they are the same structure as the hormones you naturally produce in your body. These hormones are also sometimes referred to as “regulated bioidentical HRT”.

There are some types of hormones given in private clinics called “compounded bioidentical hormones”. These are completely different to body identical hormones – they are not regulated and are not subject to any quality control. They are custom-made hormones in combination doses or preparations that are not routinely available on a standard prescription.

There is no good quality evidence to support the use of these hormones and they are not recommended by the British Menopause Society. In addition, they have not been subjected to the same tests of safety, efficacy, or dosing consistency as the type of HRT that requires a prescription, including body identical hormones. We do not prescribe women compounded bioidentical HRT at Spiced Pear Health.

Testosterone is an important hormone for many women. Many women find that using testosterone can improve their libido as well as their mood, energy and concentration. We would normally wait till your oestrogen levels have stabilised before considering this. There is not currently a licensed preparation of testosterone available for women in the UK.

In our clinic, we usually prescribe testosterone in the form of a gel sachet or a gel pump. There is a female testosterone product called Androfemme cream, but this is unlicensed in the UK. It is only available privately and is expensive for patients, so we prefer using the gels.

This depends on the medication but typically ranges from £10-£40/month per medication. The pharmacy may include a fee for dispensing the medication.

Please email us at [email protected]. We will check your records to confirm the prescription and issue it via Clynxx.

Medication we prescribe for you can be picked up at a local pharmacy or delivered to your home.

If you decide to pick up your medication at a local pharmacy, you will receive a FreeRx token via a text message from Clynxx. Show the message to the pharmacist at your local pharmacy. You will be required to pay for the medicines at your collection pharmacy. Should there be any problems, ask the pharmacist to contact Clynxx on 0330 113 7894.

If you choose to get your medicines delivered directly to you via a partner pharmacy, an invoice will be sent to you electronically via SMS or email. Once the invoice has been paid, you will receive confirmation instantly and the pharmacy will process and deliver the medicines to you within 48hrs.

Yes. We charge £35 per prescription. We will prescribe 3 months of medication and so you will require 4 prescriptions in a year, if you decide to remain under the care of Spiced Pear Health. After 12 months of medication via Spiced Pear Health, we will require you to attend an annual review appointment as recommended by NICE.

Please read the relevant section in Menopause Consultations. Please email us if you have a query at [email protected].

Please read the relevant section in Additional Information.