Menopause and Perimenopause Care in Dubai
Perimenopause is the years of changing hormones before periods stop, and it often begins in the early forties with symptoms that are not recognised for what they are: erratic periods, hot flushes, poor sleep, low mood, anxiety, aches, brain fog and vaginal dryness. Treatment exists and works. At Smart Care Polyclinic in Deira, a female gynaecologist assesses the symptoms, rules out other causes, and discusses hormone therapy and the alternatives honestly.
For: symptoms from the early forties on; periods that have stopped
Takes: a consultation; blood tests where useful
Price: consultation AED 150
What it is
Menopause is diagnosed by the pattern, not usually by a blood test. Twelve months without a period after forty-five, or the typical symptoms with changing cycles in the years before, is enough; hormone levels fluctuate too much in perimenopause to be reliable and are reserved for younger women or unclear cases. The consultation excludes thyroid disease, anaemia and depression, which mimic it, and reviews blood pressure, weight and bone and heart risk.
Hormone therapy is the most effective treatment for flushes, sweats and genitourinary symptoms, and prevents bone loss. The 2022 position statement of The North American Menopause Society is clear that for women under sixty, or within ten years of their last period, without contraindications, the balance of benefit and risk is favourable for treating troublesome symptoms and preventing bone loss; starting more than ten years after the menopause or after sixty is less favourable because of higher absolute risks of heart disease, stroke, clots and dementia.1
The type, dose, route and duration are chosen for you. Oestrogen through the skin rather than by mouth for women with clot or migraine risk; a progestogen wherever there is a womb; vaginal oestrogen alone for dryness and urinary symptoms without other symptoms; and non-hormonal options for women who cannot or prefer not to take hormones.1 Treatment is reviewed regularly rather than stopped at an arbitrary age.
Beyond hormones
Bone health, heart health and the pelvic floor all change at menopause, and the consultation covers them: calcium and vitamin D, exercise that loads the bones, blood pressure and cholesterol, cervical screening if due, and pelvic-floor advice for leakage or prolapse symptoms. Menopause is also a common cause of new hair thinning and dry, itchy skin, which the dermatology and hair guides cover.
Perimenopausal bleeding
Cycles become erratic in perimenopause, but very heavy, prolonged or frequent bleeding, or any bleeding after twelve months without a period, is assessed with ultrasound rather than attributed to the change. It is usually benign, and the scan is done in the consultation.
The consultation, and what follows from it
Gynaecology consultation, with ultrasound
Assessment, examination and a plan with every cost stated before anything further is done.
AED 150 was AED 250
Bookthyroid, iron, sugar and lipids
Questions patients ask
That depends on your symptoms, age, medical history and preferences. The gynaecologist goes through the options with you, including non-hormonal ones, and where HRT is chosen the type, dose and route are decided for you and reviewed regularly.
Usually not over forty-five; the symptoms and cycle pattern are the diagnosis. Tests are used in younger women, after a hysterectomy, or where the picture is unclear.
There are non-hormonal medicines for flushes, vaginal moisturisers and local treatments for dryness, and lifestyle and psychological approaches with evidence. The gynaecologist will set out the options that apply to you.
This guide is general information, not advice about you. Symptoms overlap between conditions, and the gynaecologist's history, examination and ultrasound are what decide your assessment and treatment.
References
- The 2022 Hormone Therapy Position Statement of The North American Menopause Society Advisory Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-794. PMID 35797481. doi:10.1097/GME.0000000000002028Hormone therapy is the most effective treatment for vasomotor and genitourinary symptoms and prevents bone loss; under 60 or within 10 years of menopause without contraindications the benefit-risk ratio is favourable, later initiation less so. Type, dose, route, timing and duration individualised.
Sources are listed for the specific statements they support. They are published research and guidance, not a substitute for a consultation — what applies to you is decided by a doctor who has assessed you.