This is because it should be simple to diagnose a woman of this age with menopause if she has had no bleed for 12 months and offer HRT. However, symptoms and issues associated with peri menopause are commonly happening many years before periods become irregular or stop altogether, and as women are getting to 45, we are commonly in the most unstable part of our menopause, where we have too much of some hormones and not enough of others. By not testing what is happening with a woman’s hormones, doctors are blindly offering her a full dose of HRT which she may not need or be able to tolerate, which often makes her feel much, much worse. This guideline in our view is stopping millions of women from getting the support they need and deserve.