What to expect from an online menopause clinic

Have you ever wondered how an online menopause clinic works? 

Or whether you get to see an actual doctor in an online appointment? 

And how prescriptions work after the consultation?

We've gone behind the scenes to answer all these questions and more about our new clinic.

Our very first podcast series started with Katie’s own story and the four years she spent going back and forward to all sorts of different doctors and specialists trying to find out what was causing her symptoms. She was misdiagnosed with depression and offered antidepressants for a whole range of different symptoms, from low mood to heart palpitations.

Seven years later, there are still women struggling to get the right diagnosis and treatment options or to access the right information. We are delighted to have partnered with Stella to create The Latte Lounge+, an online menopause clinic which gives you direct access to online doctor’s appointments, prescriptions to your door, a personalised treatment plan, and so much more. 

Katie speaks here to Dr Rachel Hines, a Menopause Specialist, GP and the Clinical Director of Menopause Services at Stella, about exactly how it works.

Listen to the full conversation in The Latte Lounge podcast episode above.

Could you give us a bit of insight into the sort of issues you see in your clinic?

There is so much information available about menopause, but it’s knowing how to access the information, whether it is accurate or relevant and helpful for you. 

There are so many different symptoms of menopause, as we know.

It’s commonly quoted that there are 34 symptoms and probably more, and everyone has a different group of symptoms, so don’t necessarily recognise perimenopause. 

If you don't tell your doctor your symptoms, they may not recognise it either, and in the wake of covid, access to your doctor can be really tricky.

Appointments are short, so being able to get an appointment in the first place and then tell them all the information and the symptoms that you're having can be difficult. 

When is it appropriate to offer a woman who has all sorts of different symptoms, such as low mood and crying spells and depression, something like an antidepressant and when is it perhaps not appropriate?

Often the first symptoms can be changes in mood.

So it can certainly be that you are having anxiety or depression, or often women will experience kind of episodes of rage, just getting really angry out of nowhere.

Sometimes those are the only symptoms. And it's about putting it into context with your age and thinking about what else is going on in life, but if there are no other symptoms at all, that can be appropriate. 

If you were on HRT already, but the mood symptoms aren't settling, then certainly antidepressants can be helpful.

And the other role that antidepressants have are for women who can't take HRT.

We know that medication like venlafaxine can reduce hot flushes, particularly by about 50%.

So there is definitely a role for antidepressants, but it shouldn't be our first port of call if you're having changes in mood.

RELATED: The 34 symptoms of perimenopause and menopause

For women who are already on antidepressants for a long history of depression or anxiety, if they wanted HRT, should they take both?

When women are on long-term treatment, I wouldn't stop it. I would be continuing.

You are essentially making the choice; if your main symptoms are change in mood, you can increase the dose of the antidepressant or look at starting HRT and then if moods still didn't improve, increase the dose.

If you’re starting HRT for other symptoms, I wouldn't stop antidepressants because you need the stability.

I set up this community to ensure that women like myself and thousands of others don't waste valuable years of good quality life. So I'm really delighted that we have set up the Latte Lounge+, which is powered by Stella, giving our community access to an online doctor's appointment and HRT if that is the right treatment option for them.

Could you tell everyone a little bit about how to get started with the Latte Lounge+, what your role is and what Stella can help them with?

I'm the clinical Director of Menopause Services for Stella, an online menopause clinic.

Our values are very much aligned with yours, which is why I think we work so well together.

But essentially, there's a free online assessment which you take online in your own time.

It's really thorough and safe, and easy to fill in. And it goes through all of the symptoms you're experiencing; it looks at your family history and personal history of any other conditions.

Once you've put in all your information, it will assess what stage of menopause you are at, and it then gives you an individualised menopause plan which may include HRT.

RELATED: Access our online menopause clinic - and online appointments with a doctor - from just £45

Does this include an appointment with a menopause specialist or a GP?

Yes. All our doctors are GPs with a special interest in menopause and additional training in women's health. They are obviously all GMC registered, and they're all registered with the British Menopause Society. 

You get an appointment with them, and because you've filled out the assessment, they've got a wealth of information about you, which then they can discuss in more detail and then talk through which treatment options would be best.

RELATED: Struggling to get your menopause symptoms taken seriously?

How long is that appointment, and what does the follow-up care look like?

The appointments are 20 minutes long.

And as you've already provided a history before you start, it gives plenty of time for discussion with the doctor you're speaking to. 

The appointments are every three months.

If you are given HRT, you're given a three-month prescription, and then you'd be reviewed after that.

But you've also got access to the Stella app, which is fantastic and gives such good support alongside.

This looks at all different areas. There are areas that help with sleep, libido, hot flushes and pelvic floor. We're going be looking at brain health soon, so there's lots of ongoing support with the app as well.

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If HRT is prescribed, how does that work?

When you’ve had your consultation, if HRT is prescribed, then it will be issued and delivered to your home within five days.

We know what medication we've got available at the point when it's being prescribed; you won’t be promised something that you then can't get. And we've got a good supply.

So it will be delivered to you, and then you're reviewed.

You do an online assessment before your three-month review, and then the medication will be issued again.

Which is really great news because, unfortunately, we're still suffering with a lot of shortages, especially here in the UK. 

What other follow up support is there?

We have lots of different support within the app to help manage the different symptoms that you're having.

And lots of these will have a four-week program, so it's helping to introduce new habits, back that up and change your behaviour.

We know that lifestyle and behaviour can reduce the severity of symptoms so there are so many different resources available, from different mindfulness exercises and music to help de-stress to weekly exercise classes and recipes to help with nutrition.

You can access the best and most relevant help for you. 

RELATED: My story – Nutrition and Exercise helped my menopause symptoms

Women are going to feel supported and listened to at all stages of their menopause journey, whilst also receiving the treatment options and the care that they need, as they need it.

This really is an affordable option, especially as it includes any prescription. Here’s some feedback from a Latte Lounge member;

“I just wanted to say a huge thank you for recommending the Latte Lounge+.

I had an appointment with a wonderful doctor from Stella yesterday, and just to be listened to and really heard, meant the world to me. Such a fantastic service.”

How much does this menopause support cost?

It’s just £135 for three months, and that includes the initial doctor's appointment and the follow up at three months.

You can contact us in the meantime if you need to.

So if you do have concerns, if you're wanting to speak to a doctor, you can get in touch sooner if you need.

And you have access to the app as well. Your HRT is included as well.

You do get a lot of wraparound support and ongoing monitoring in case you need changes to the dose and the type of HRT that you use.

Obviously, these prescriptions are sent in the post, and this price includes shipping and everything, but they're a three-month prescription.

What happens if you forget, you are running out, or it's not working? What does the follow-up look like?

You can always contact us.

We've got a great customer care team, and we'll remind you when your prescription is due.

So it won't reach the point that you'd be suddenly about to run out of medication.

We'll be in touch after a couple of months anyway for a review questionnaire to see how your symptoms are, how the medication's helping, and then we'll make sure that the appointment is booked in plenty of time so that your medication wouldn't run out.

We take into account the post and timing for that. 

This sounds like such a brilliant service. If anyone has any questions or is interested in getting started with Latte Lounge+, who do they email?

You can email us at hello@onstella.com. It's really easy.

There is a list of frequently asked questions on the website and on the Latte Lounge website as well. You can find the free online assessment here.

So you can just get going with that, have a look through it, and you can edit it in your own time as well or come back to it with further information.

Is there anyone who may not be suitable? If someone has a much more complicated medical history, would you signpost them somewhere else?

Absolutely. The assessment is really thorough and really very safe. It will go through any risk factors.

So, for example, if you've had breast cancer or you are having ongoing treatment, things that are more complex, certainly it will highlight it.

It may direct you to the app, but you'd get the appointment with our doctors, and then you can work out what would be the best options from there.

HRT is made available when it's safe and appropriate to give. But there's so much thought and research, and it's all evidence-based.

You'll be treated in the same way as if you were having a normal face-to-face appointment. 

This is obviously a menopause service, so it's not a private GP plan, is it? 

Not at all. This is tailored menopause care.

If other issues and symptoms of concern were to arise that we felt needed to be looked at, you would be directed to your doctor.

We've always said that we're here to inform and educate and support and signpost and this enables us to signpost some women to see a doctor who I know is very safe and will do everything they can to help.

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