Tokio Marine Kiln Clinic

Minter et Al is delighted to be partnering with Tokio Marine Kiln. This is a fantastic initiative for Tokio Marine employees, who will be able to book both their Initial Consultation and 3 month follow up with one of our menopause nurse specialists.

Booking your Virtual Consultation

You may have read up about the symptoms of the perimenopause and menopause, decided that you think that this describes how you feel and have decided to explore this further. You may already have tried HRT and some over the counter medications to try to help yourself. You may have some good friends that have shared their experiences with you and learned how they have managed this transition, and gained some helpful hints. 

We are all so individual and respond very differently to hormones. It can take time to find what suits you and you will have the opportunity to explore all the options available to you whilst feeling well supported. 

All our clinicians spend a lot of time updating their clinical practice, studying and attending conferences so we can support you with the most up to date evidence and research in this field.  

Below is a guide to what you can expect on your hormone health journey with Minter et Al Hormone Health Clinic:

This online diary is exclusive to Tokio Marine Kiln employees. 

Please note that appointments are on a first-come-first-serve basis. Your 3 month follow-up appointment will be booked by your clinician during your initial appointment.

For employees with a contraindication to HRT, like breast cancer, we offer a specialist GP appointment. Please use the drop down menu to book the BMS/FSRH specialist appointment. 

If you inadvertently book the incorrect appointment type, please don’t worry. Once we have reviewed the pre-appointment medical history we can move appointments as appropriate. 

Please note that once booked these appointments are not refundable. If you are unable to attend your appointment please give 72 hours notice so we can offer this to other people. If you are unable to attend on the day no further appointment will be offered. When possible any employees on the waiting list will be offered cancelled appointments.  

For employees not resident in the UK we are unable to provide clinical care or prescribe medications due to insurance.  We will however offer an advisory service.

Confirmation of your appointment will come by email. 

You will be offered a video consultation; and your email will contain a link for you to click on at the time of the consultation. You do not need to have access to Microsoft Teams or Zoom.

Video consultation confirmation emails also include links to a medical history form and a symptom survey form for you to complete in advance of your appointment. This helps us to understand a bit more about you and your medical history so that we can think in advance about what might help. This makes best use of the time in the consultation. 

Before your consultation you will receive further emails and SMS messages reminding you of your appointment time.

The Beginning 

On the day, at the appropriate time, simply click on the link in your email, this will take you to a Virtual Waiting Room. Your clinician will enter from her side and there you will meet – no travel, no parking, no stress. 

Please ensure you are in a quiet private place for this consultation with good internet connection.  

The consultation is your opportunity to discuss how you feel, what symptoms have troubled you, what you have tried already and what you hope to gain as a result of your consultation. This is unique to you. 

The Middle 

Your specialist will ask a lot of questions! These are to learn about you, your medical history, what medication you take, your allergies, how you live your life, what’s important to you, your family and social history and also the story of you as a female through the many hormonal challenges of life. This is to ensure that she can advise you on the best treatment for you. 

We will ask what you already know about hormones and menopause, this allows your clinician to build on your own knowledge base. If you do not know much, that’s not a problem – she does and will talk you through it all. We also send some information sheets in advance and provide links after your consultation.   

The End

At the end of the consultation, your specialist will clearly explain what she thinks will work best for you. In keeping with British Menopause Society and International Menopause Society guidelines, she will prescribe Body Identical HRT. This is backed by research and evidence and it can be prescribed on the NHS.

If you agree with the plan, she will write a prescription, and this is sent electronically to an online pharmacy called The Independent Pharmacy or Pharmacierge . There is no additional cost for this prescription but we will provide you with the contact information for the pharmacy so you can make payment for the medication and agree the delivery address. The cost depends on what we decide together but as a rough guide, 3 months of HRT will cost around £60-70.   

We will book your 3 month follow up appointment to assess your response to treatment, check that you have no further questions, and conclude your consultation. 

You will receive a consultation summary with clear instructions as to how you should use your medication when it arrives. This will come as a shared document from our medical records system.

For online consultations, once the pharmacy has taken payment for the medication, your medication will be posted to you First Class and will usually arrive within 24-48 hours, ready for you to start.  

A letter to your GP will be written within 10 days following your appointment. We are aiming to be more environmentally and security conscious and therefore moving forward we will request your GP’s email address.  If you are unable to provide this, we will ask you to print off your copy and hand it into your surgery.  

Blood tests are not always necessary. For women aged 45 or above, no blood test is needed to diagnose the menopause. Sometimes, in women aged 40-45 blood tests are useful to exclude other causes of symptoms and in women aged 40 or under, blood tests are required to make a diagnosis of Premature Ovarian Insufficiency. 

Some women will be advised to have a blood test to exclude anaemia, an under active thyroid gland or Vitamin D deficiency. The symptoms of these conditions are similar to those of the menopause and are common in midlife. They are easily treated. 

If bloods are required, or a woman wants a health check we will request these through our nurse at home service.  Our nurse at home service is the same price as in clinic blood tests and the prices are on our website. We can also politely ask your GP to do blood tests for you although they are under no obligation to honour our request.  

Once we have requested your blood tests for the nurse at home/work service, they will be in touch to arrange a time, date and location that suits you. The cost of the blood test is in addition to the consultation fee. You will be told the cost of the blood test before this is booked.  An invoice will be sent for your blood tests when they are requested.  

The results of blood tests are usually received and processed within 7 days. We will share these results with you and if all is well, we will discuss them in more detail at your next appointment. 

A follow up consultation after 3 months is recommended for everyone. This is the length of time that it takes for the full effects of HRT to be established.

This consultation is a chance to assess your response to HRT and to check for any side effects. Adjustments to the dose or type of HRT are made if required. A discussion about vaginal symptoms, libido, sexual satisfaction etc is often incorporated in this consultation.

The role of testosterone in normal female sexual function is discussed if appropriate. When prescribing testosterone, we will check your baseline testosterone and SHBG blood tests (Profile 3) and check them again at 3 and 6 months.  We prefer prescribing Androfeme the female testosterone as it is easier to accurately dose than the male preparations.    

If no alteration has been made to the HRT, we will make a follow up appointment in 6 months. At this point, if everything is stable, an annual review is all that is required. It may be that you will have had an opportunity to discuss your care with your GP. If your GP is happy to continue with prescribing your HRT, you can be discharged to the care of your GP for annual review. 

If, however, you prefer to be followed up by our team, or your GP has declined to prescribe your HRT, we are very happy to continue to prescribe your medication on an ongoing basis and see you for annual review or at any time as required. Prescription requests between appointments carry an admin fee of £35. 

If a change to the HRT regime has been made at this follow up appointment, you will be recommended to be seen for review again in 3 months to assess your response. 

Even if you are discharged to be followed up by your GP, you can come back anytime. You are always welcome. 

You can sign up to the newsletter to hear more about this https://www.minteretal.com/useful-resources/ 

Initial Consultation Days 

  • 5 January 2024 – 1 first consultations available with our Nurse specialist
  • 19 January 2024 – 5 first consultations available with our Nurse specialist
  • 23 January 2024 – 3 first consultations available with out Nurse specialist
  • 26 January 2024 – 5 first consultations available with our Nurse specialist
  • 30 January 2024 – 2 first consultations available with our GP specialist & 1 with our Nurse specialist
  • 6 February 2024 – 1 first consultation available with our GP specialist & 1 first consultations available with our nurse specialist
  • 20 February 2024 – 1 first consultation available with our GP specialist

 

Follow-Up Consultations

  • 16 April 2024 – 9 follow up appointments available with our Nurse specialist/GP specialist
  • 26 April 2024 – 6 follow up appointments available with our Nurse specialist

All prescriptions will be issued privately. Example pricing is below. We can also write to your GP to ask them to initiate the prescription request.  There is no additional prescription fee when we prescribe as part of the consultation.  

Example Private Prescription Costs
We will initiate your HRT with a private prescription for the first few months and establish the best dose and regime based on your symptoms and medical history. We can set up regular repeat HRT prescriptions or communicate your HRT treatment with your NHS GP to continue prescribing. 

Costs for a month’s supply of HRT will vary depending on the type of medication prescribed, but varies is around £12-£25 per item for oestrogen patches/ gels/ sprays and micronised progesterone (UtrogestanI. Testosterone is more expensive at £95 -£125 for a tube of cream that will last around 3-4 months. Please be aware that Androfeme testosterone is currently only available on a private prescription.  Example pricing from one of our online pharmacies can be found here https://www.theindependentpharmacy.co.uk/minter-et-al

Oestrogen Patches, Gels & Sprays (Body Identical/ Regulated Bioidentical HRT)*

  • Evorel/Estradot/Elleste patches (25/50/75/100) – 8 patches – £14.00
  • Lenzetto 1.53mg spray – 1 pack – £14.00
  • Oestrogel – 64-dose 80g pump pack – £14.00
  • Sandrena Gel (all strengths) – 28 sachets – £14.00
 

Progesterone | Micronised Progesterone (Body Identical/ Regulated Bioidentical HRT)*

  • Utrogestan 100mg Capsules – 30 capsules – £14.00
  • Utrogestan 200mg Vaginal Capsules – 21 vaginal caps – £29.99
 

Vaginal Oestrogen*

  • Vagifem/Estradiol 10mcg Vaginal Tablets – 24 tablets – £25.00
  • Ovestin (Estriol) 0.1% cream – 15 applicators – £14.00

Testosterone*

  • Androfeme 1% Cream – 50ml tube – £92.00 (lasts 100 days)
 

*Please note that prices vary between pharmacies on private prescriptions so please check with the pharmacy first to confirm their prices. These are example prices only.

Blood tests are not usually necessary to diagnose perimenopause and menopause however we think it best practice to exclude any other underlying causes of symptoms and we usually recommend blood tests if it’s your first appointment with us. There is no need to have any tests before your first appointment. We will discuss blood tests with you during the appointment and will tailor each set of tests to your personal needs. We find this approach minimises need for repeat tests and missing out on tests we feel may be helpful.

Please note that costs of blood tests will not be covered by Tokio Marine, however you can choose to pay yourself, should you wish to do so.  

For information on costs and to read more on how the blood tests are conducted, please see our Blood Tests page.  We can also ask your GP to do blood tests, however they are not obligated to say yes.