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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Video assessment, with a prescription when appropriate.
- Menopause is usually diagnosed from your symptoms and cycle history; HRT is prescribed after an individual assessment that includes your blood pressure and personal risk factors.
- Bleeding after the menopause, between periods or after sex is never part of normal menopause and needs in-person assessment.
- HRT remains the most effective treatment for hot flushes and night sweats, delivered as a patch, gel, spray or tablet.
- If you develop sudden chest pain, breathlessness, a hot swollen leg (possible blood clot), weakness on one side or difficulty speaking, call 112 immediately.
Bleeding after the menopause, bleeding between periods, or bleeding after sex is never part of normal menopause and needs an in-person gynaecological assessment, because it can be an early sign of a womb or cervical problem. Book prompt face-to-face care for any of these, and see the referral criteria below before booking.
Can an online doctor treat menopause symptoms?
Often, yes. Menopause is usually diagnosed from a woman's age, symptoms and menstrual pattern rather than a blood test, so a video consultation can gather what is needed to plan treatment, including hormone replacement therapy or non-hormonal options.[1] Prescribing HRT still requires a proper risk assessment, and some situations need in-person review. Prescribing rules vary by country.
Mobi Doctor, an online platform with licensed doctors, treats this as a genuine consultation. The point of menopause care is matching the right option to your symptoms and your personal risk, then reviewing it, and that is a conversation that works well by video for most women.
Listen: Menopause Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with menopause
- Symptoms taken seriously: hot flushes are only part of it. The doctor asks about sleep, mood, brain fog, joint aches, low libido and vaginal or urinary symptoms, and treats the picture rather than one headline complaint.
- An honest HRT conversation: the benefits, the risks for your history, the different forms (patch, gel or tablet), and why one route may suit you better than another, so any prescription follows a real discussion, not a sales pitch.
- Non-hormonal options too: if HRT is not right or not wanted, there are evidence-based alternatives, and the doctor sets them out plainly instead of leaving you to guess.
- A plan with a review date: menopause treatment is adjusted over months. You leave with a starting plan, a date to review how it is working, and clarity on what to watch for.
What are the symptoms of menopause?
Menopause symptoms reach well beyond hot flushes. Falling and fluctuating oestrogen affects the whole body, and the most common effects fall into a few groups that the doctor asks about directly:
- Vasomotor: hot flushes and night sweats, the symptoms most people recognise, which can disrupt sleep and daily life.
- Sleep and energy: waking through the night, difficulty falling asleep, and daytime fatigue, sometimes independent of night sweats.
- Mood and thinking: low mood, anxiety, irritability, loss of confidence, and the "brain fog" of poor concentration and word-finding, which many women find more troubling than the flushes.
- Genitourinary: vaginal dryness, discomfort during sex, urinary urgency and more frequent urine infections, grouped together as the genitourinary syndrome of menopause.[1]
- Musculoskeletal: joint and muscle aches and stiffness, which are common and often unexpected.
- Periods and libido: irregular, heavier or lighter periods in the run-up, and a change in sex drive.
Symptoms vary enormously between women in type, severity and how long they last, and there is no single "normal". Treatment is offered when symptoms interfere with daily life, not simply because you have reached a certain age.[1]
What is perimenopause, and how do I recognise it?
Perimenopause is the transition of several years before your periods stop completely, when hormone levels swing and symptoms often begin while you are still menstruating. Recognising it matters, because this is when many women are told, wrongly, that they are "too young" for menopause to explain how they feel.
The classic clue is a change in your periods, becoming irregular, closer together or further apart, heavier or lighter, alongside new hot flushes, sleep disturbance, mood changes or brain fog. It commonly starts in the mid-forties but can begin earlier.[4] Blood tests are not usually needed to diagnose it in women over 45, because levels fluctuate so much that a single result can mislead; the pattern of symptoms is more reliable.[1] Under 45, and especially under 40, the picture is different and the doctor will consider blood tests and early or premature menopause, which is managed differently and often needs specialist input.
Which menopause treatment might the doctor recommend?
Treatment follows your symptoms, your preferences and your personal risk. This is the framework our doctors use, aligned with European and national menopause guidance:[1][2]
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| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Typical perimenopausal symptoms, age 45+ (flushes, sweats, sleep, mood, irregular periods) | Discuss HRT versus non-hormonal options; lifestyle measures | Usually yes | Diagnostic uncertainty, or symptoms not settling on treatment |
| Mainly genitourinary symptoms (vaginal dryness, discomfort, recurrent urinary symptoms) | Vaginal moisturisers and lubricants; local vaginal oestrogen[1] | Usually yes | Any abnormal bleeding, or no improvement with treatment |
| Under 45 with menopausal symptoms (possible early or premature menopause) | Blood tests and structured assessment; HRT usually recommended | Initial assessment, then coordinated care | Premature ovarian insufficiency needs specialist involvement |
| Higher personal risk (previous breast cancer, blood clots, migraine with aura, uncontrolled high blood pressure) | Individualised risk discussion; non-hormonal options often first | Case-dependent | Specialist or in-person review often needed before starting HRT |
| Bleeding after the menopause, or between periods or after sex | Prompt in-person gynaecological assessment | No | Same-week face-to-face assessment (red flag) |
Availability of individual medicines and who may prescribe them vary by country; your doctor confirms what applies where you are.
Not sure which row is you? A doctor can tell you in one consultation.
See available times →HRT online: what an honest assessment involves
Hormone replacement therapy replaces the oestrogen your ovaries no longer make, usually as a skin patch, gel or spray, or a tablet, with a progestogen added if you still have a womb to protect its lining. For most women with troublesome symptoms and no specific contraindication, the benefits of HRT outweigh the risks, and it remains the most effective treatment for hot flushes and night sweats.[1] The point of the consultation is to work out whether that is true for you specifically.
An honest online HRT assessment covers your symptoms and how much they affect you, your menstrual and pregnancy history, and a careful personal and family history: previous breast cancer, blood clots, stroke or heart disease, migraine with aura, liver disease and smoking all change the picture. Your blood pressure matters too, and because it cannot be measured over video, the doctor may ask for a recent reading or arrange one before starting certain treatments. Risk is discussed individually, not as a blanket figure: for example, oestrogen delivered through the skin (patch or gel) carries a lower blood-clot risk than tablets, which can make it the safer route for some women.[1] Who may initiate and monitor HRT depends on local regulations and clinical pathways, and prescribing rules vary by country; your doctor confirms what applies to you.
Non-hormonal options for menopause symptoms
If HRT is not suitable, not wanted, or you prefer to try something else first, there are options with real evidence behind them. Cognitive behavioural therapy (CBT) is recommended for hot flushes, night sweats, sleep problems and low mood linked to menopause, and it helps without any drug.[1] Certain antidepressants used at low dose, such as venlafaxine or an SSRI, can reduce hot flushes for women who cannot take oestrogen, for instance after breast cancer. Fezolinetant, a non-hormonal medicine that acts on the brain's temperature control, is approved in Europe for moderate to severe hot flushes and night sweats and gives women another route when hormones are off the table.[3] For vaginal dryness and discomfort, moisturisers, lubricants and low-dose local vaginal oestrogen work well and, because very little is absorbed, local oestrogen can often be used even by many women who cannot take systemic HRT.[1]
Lifestyle measures are worth doing alongside any treatment: regular physical activity, keeping a healthy weight, cutting back on alcohol and caffeine where they trigger flushes, and protecting sleep. Supplements such as black cohosh or soy isoflavones are popular, but the evidence is inconsistent and their quality and safety vary, so tell the doctor what you are taking rather than relying on them as a treatment.[2][5]
What the doctor checks in an online menopause consultation
The assessment is structured, because the whole value is in matching treatment to you safely. In a menopause consultation, the doctor will typically check:
- Your symptoms and their impact: which symptoms you have, how severe they are, and how much they affect your work, relationships and sleep.
- Your cycle and stage: whether you are still having periods, how they have changed, and your age, to place you in perimenopause or after the menopause.
- Personal risk history: previous breast or womb cancer, blood clots, stroke or heart disease, migraine with aura, liver disease and smoking.
- Blood pressure: a recent reading, or an arrangement to obtain one, before starting certain treatments.
- Bleeding pattern: any bleeding after the menopause or between periods, which is a red flag that changes the plan entirely.
- Current medicines and preferences: what you already take, what you have tried, and whether you lean towards hormonal or non-hormonal treatment.
When we treat menopause online, and when we refer you
We treat online: typical perimenopausal and menopausal symptoms in women over 45; starting, adjusting or reviewing HRT where there is no contraindication; genitourinary symptoms suitable for moisturisers or local vaginal oestrogen; and non-hormonal treatment for women who cannot or prefer not to take HRT. The same assessment can help with overlapping problems such as recurrent urinary tract infections, thrush or changes in vaginal discharge, and with hormone-related headaches.
We refer or redirect you: any bleeding after the menopause, between periods or after sex, which needs an in-person examination; suspected premature menopause under 40, which needs specialist care; a complex risk history, such as previous breast cancer or a strong clotting history, where HRT decisions are made with a specialist; and symptoms that do not settle despite treatment, where a review in person is the honest next step. In those cases the consultation gives you a clear plan and the right referral, not a prescription that papers over the problem.
When to get in-person care
Menopause itself is not an emergency, but a few situations need prompt face-to-face care: bleeding after the menopause or unusual bleeding between periods, a new breast lump or breast changes, or severe low mood with thoughts of self-harm. If you develop sudden chest pain, breathlessness, a hot swollen leg (possible blood clot), weakness on one side or difficulty speaking, call 112 immediately.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm. Most patients speak to a doctor within about 15 minutes of their booked time. no subscription, exact price up front.
- Speak to a licensed doctor about menopause: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Get your treatment plan and review date: if a prescription is right for you, you get a prescription you can use at a local pharmacy, or you get a full refund.
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Frequently asked questions about menopause
Can an online doctor prescribe HRT in Europe?
Yes, after a proper assessment. A prescription is never issued without a consultation: the doctor reviews your symptoms, history and risk factors by video, asks about your blood pressure, and prescribes HRT when it is suitable, which you can use at a pharmacy near you in most EU countries. Higher-risk situations, such as previous breast cancer, are referred for specialist input, and prescribing rules vary by country.
How much does a menopause consultation cost?
The exact price of a video consultation is shown before payment, and there is no subscription. If the doctor can’t help you online, you get a full refund and clear directions to the right care.
How quickly can I speak to a doctor about menopause?
Appointments are available daily from 7am to 11pm, often within about 15 minutes. You choose a slot that suits you, and you can note your main symptoms when booking so the consultation gets straight to the point.
Do I need a blood test to diagnose menopause?
Usually not if you are over 45, because hormone levels fluctuate so much that a single result can mislead, so the diagnosis is made from your symptoms and periods. Under 45, and especially under 40, blood tests are more useful, and the doctor will advise which you need and where to have them.
Is HRT safe?
For most women with troublesome symptoms and no specific contraindication, the benefits of HRT outweigh the risks. Risk depends on your history and the type used, and oestrogen through the skin carries a lower clot risk than tablets. The doctor discusses your individual risk, which is exactly what the consultation is for.
What if I can’t or don’t want to take HRT?
There are effective non-hormonal options, including cognitive behavioural therapy for flushes, sleep and mood, certain low-dose antidepressants, the non-hormonal medicine fezolinetant for hot flushes, and local vaginal treatments for dryness. The doctor sets out what suits you and what the evidence says.
I still have periods but feel awful. Could it be perimenopause?
Very possibly. Perimenopause often begins while you are still menstruating, with irregular periods alongside flushes, poor sleep, mood changes or brain fog, commonly from the mid-forties. You do not have to wait until periods stop to be assessed or treated, and an online doctor can talk this through the same day.
- Menopause: identification and management (NG23), NICE, National Institute for Health and Care Excellence, updated 2024.
- Menopause fact sheet, World Health Organization (WHO), 2024.
- Veoza (fezolinetant): summary of the European public assessment report, EMA, European Medicines Agency, 2023.
- Menopause overview, HSE, Health Service Executive (Ireland), accessed August 2026.
- Black cohosh (Cimicifuga spp.) for menopausal symptoms (Cochrane Review), Cochrane, Cochrane Collaboration, accessed August 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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