March Questions of the Month

I am not sure if I need HRT – I know I can discuss my symptoms with a GP but will my hormone levels also be checked with a blood test?

In most cases, we do not routinely need blood tests to decide whether HRT is appropriate.

For the majority of women in their 40s and 50s, we diagnose perimenopause/menopause based on:

Your age

Your symptoms (e.g. hot flushes, night sweats, irregular periods, mood or sleep changes, vaginal dryness, brain fog)

Your period pattern

NICE guidance is clear that, for women over 45, blood tests are usually not required to diagnose menopause or to decide on HRT. Hormone levels naturally fluctuate a lot at this stage, so a single blood test often doesn’t add much and can even be misleading.

A GP might consider blood tests if:

You are under 45 and we’re unsure if your symptoms are menopausal

Your periods have stopped very early (under 40) and we’re considering premature ovarian insufficiency

There is something unusual about your symptoms or history that needs further investigation

We need to rule out other conditions that can mimic menopausal symptoms (e.g. thyroid problems, anaemia)

From a general practice workload and clinical perspective, we would usually:

Offer you an appointment to discuss your symptoms in detail .

Take a full history , including periods, medical history, family history and any risk factors.

Decide together whether HRT is appropriate and safe for you, following NICE and local guidance.

Only arrange blood tests if there is a clear clinical reason , rather than as a routine step.

So yes, you can absolutely discuss your symptoms with a GP, but you should be aware that a hormone blood test may not be done unless there is a specific indication.

I am keen to lose weight but don’t want to go down the Mounjaro injection route. Can the doctor help me?

Yes, the doctor can absolutely help, and it doesn’t have to involve Mounjaro or any other injection.

From a GP practice perspective, the main ways we can support weight management (without injectable medication) typically include:

Initial assessment in the surgery

Reviewing your weight history, medical conditions, medications, mental health and lifestyle.

Checking for things that might be making weight loss harder (e.g. thyroid issues, sleep problems, some medicines).

Agreeing realistic goals (often focusing on 5–10% weight loss, which can still bring big health benefits).

Referral to NHS weight‑management services

Depending on your BMI and any other health conditions (e.g. pre‑diabetes, diabetes, high blood pressure, fatty liver, joint problems), you may be eligible for:

A local Tier 2 weight‑management programme (diet, activity and behaviour‑change support, often group‑based or digital).

The NHS Digital Weight Management Programme (online/app‑based support for people with certain conditions and a raised BMI, referred by the GP).

These services focus on structured lifestyle change rather than injections.

Lifestyle and behaviour‑change support

The GP or another clinician in the practice (e.g. nurse, health coach, social prescriber) can:

Help you choose an eating pattern that suits you (e.g. Mediterranean‑style, reduced‑calorie, portion control, etc.).

Discuss physical activity options that are realistic for your health and mobility.

Look at sleep, stress, mood and habits (snacking, evening eating, alcohol) which often drive weight gain.

Arrange follow‑up to review progress if capacity allows.

Discussion of non‑injectable options

You’ve said you don’t want to go down the Mounjaro route. There are other approaches (including some tablet options and more intensive programmes), but:

I’m not able to give specific advice on individual medications or treatment plans.

Any decision about medicines has to be made with a trained clinician who knows your full medical history and local prescribing guidance.

What you could do next

Book a routine appointment with your GP or appropriate clinician at your practice and explain that you’d like help with weight loss but do not want injectable medication.

Ask specifically about:

Eligibility for local weight‑management services or the NHS Digital Weight Management Programme .

A review of your current medications and health conditions to see if anything is making weight loss harder.

Ongoing support or signposting (e.g. health coaching, social prescribing, local exercise schemes).

I believe the Greenwood Centre could also potentially help with classes, please check their website.