Menopause Isn’t Always Simple
Understanding Complex Menopause and Comprehensive Care
Dr Elise Dallas, Advanced British Menopause Society (BMS) Menopause Specialist at The London General Practice, believes that menopause care should be about far more than symptom management alone.
“One of the most common things I hear from women is: ‘I just don’t feel like me anymore.’ Menopause can affect every aspect of a woman’s life, and it’s important that care reflects that.”
Dr Elise Dallas
General Practitioner | Specialist in Women’s Health and Menopause Care
Every Menopause Journey Is Different
No two women experience menopause in the same way.
Some women transition through menopause with relatively few symptoms, while others find significant impacts on their physical health, emotional wellbeing, work, relationships and quality of life. Hormonal changes can affect mood, sleep, cognition, energy levels, metabolism, sexual wellbeing and overall confidence.
For some women, the picture is even more complex.
Menopause may coincide with a history of breast or gynaecological cancer, premature ovarian insufficiency (early menopause), surgical menopause, osteoporosis, cardiovascular risk factors, neurodiversity, mental health concerns, weight gain or other medical conditions. Others may have already tried HRT or other treatments but still feel that their symptoms are not adequately controlled.
Looking Beyond Symptoms
Dr Dallas has developed and leads a comprehensive menopause and midlife health service at The London General Practice, recognising that women often need support that extends beyond prescribing hormones.
Her approach focuses not only on improving symptoms but also on protecting long-term health and helping women age well. Consultations are designed to explore the wider factors that influence wellbeing during midlife, including:
- Hormonal health
- Sleep and fatigue
- Mental wellbeing and stress
- Weight management and metabolic health
- Sexual health and relationships
- Bone health and osteoporosis prevention
- Cardiovascular health
- Nutrition and lifestyle factors
- Long-term healthy ageing
Rather than offering a one-size-fits-all solution, each treatment plan is tailored to the individual woman’s symptoms, medical history, priorities and health goals.
Supporting Women With More Complex Needs
While many women need routine menopause care, some require a more specialised approach.
Dr Dallas has particular expertise in managing complex menopause presentations and supporting women whose needs extend beyond standard treatment pathways. This includes women experiencing persistent symptoms despite treatment, those with premature ovarian insufficiency (POI) or surgical menopause, a history of breast or gynaecological cancer, osteoporosis, cardiovascular risk factors, weight and metabolic health concerns, neurodiversity, mental health challenges or multiple co-existing medical conditions. She also developed the specialist Complex Menopause Service at the HCA Women’s Health Centre to support women facing challenging symptoms, significant medical histories and complex treatment decisions that often fall outside standard menopause pathways.
Working within a multidisciplinary network that includes oncologists, breast surgeons, rheumatologists, psychologists, physiotherapists, bone health specialists and weight management clinicians, she understands the importance of coordinating care when menopause intersects with other medical conditions.
For patients, this means access to a service that recognises the complexity of real life rather than viewing menopause in isolation. It means having access to care that considers the whole person, not just their hormone levels.
Menopause and Weight Gain: Understanding the Bigger Picture
Weight gain is one of the most common concerns women raise during perimenopause and menopause.
Many women feel frustrated when lifestyle habits have not changed, yet weight becomes harder to lose or seems to accumulate around the abdomen. While hormones are not the only factor, changing oestrogen levels can influence body composition, appetite regulation, sleep quality and metabolic health.
Dr Dallas has a particular interest in the relationship between menopause, weight management and metabolic health. Having helped develop The London General Practice’s weight management service, she takes a holistic approach that considers nutrition, movement, sleep, behaviour change and, where appropriate, medical treatments including weight-loss medication.
The aim is not simply weight loss, but improving long-term health, reducing future health risks and helping women feel stronger, healthier and more confident.
The Importance of Feeling Heard
Perhaps the most important part of menopause care is feeling listened to.
Many women arrive at an appointment after months or even years of struggling. Some have seen multiple healthcare professionals. Others worry that they are overreacting or that their symptoms are simply something they must endure.
Dr Dallas’s consultations are known for being warm, compassionate and thorough. She believes that understanding a woman’s individual experience is essential to providing effective care.
By taking time to explore symptoms, concerns, medical history and personal goals, she helps women feel understood and empowered to make informed decisions about their health.
You Don’t Have to Navigate Menopause Alone
Whether you are experiencing the early stages of perimenopause, considering HRT, concerned about weight gain, struggling with persistent symptoms or managing a more complex medical history, support is available.
The menopause and midlife health service at The London General Practice is designed to provide personalised, evidence-based care for women at every stage of their menopause journey.
With the right support, menopause can be more than something to get through. It can be an opportunity to take control of your health, prioritise your wellbeing and invest in your future.
If you recognise yourself in any part of this story, whether you are seeking routine menopause support or help with more complex concerns, Dr Dallas and the team at The London General Practice would be delighted to help.