CONDITIONS
Menopause, incl. hormone replacement therapy (HRT)
Menopause and Hormone Replacement Therapy (HRT): Navigating the Change with Confidence
Menopause is a natural part of a woman’s life — but that doesn’t mean it’s always easy. For many women, the physical and emotional changes that come with fluctuating hormones can feel overwhelming, isolating and sometimes invisible to others.
At Happiher, we believe menopause care should be supportive, personal and empowering. As a private gynaecologist in London, I help women navigate the menopause journey — whether they’re looking at lifestyle changes, symptom relief or hormone replacement therapy (HRT) — with clarity and compassion.
What is Menopause?
Menopause is officially diagnosed in menopausal women when they have gone 12 months without a period, usually between the ages of 45 and 55. However, the journey to menopause — called perimenopause — can start years earlier, with hormonal changes starting as early as your late 30s or early 40s.
Postmenopausal women are those who have gone through menopause and are in the stage following 12 months without a period.
Common Symptoms of Menopause
Symptoms vary for every woman but common experiences include:
Hot flushes and night sweats
Sleep disturbances
Mood swings or low mood
Anxiety or irritability
Brain fog and difficulty concentrating
Vaginal dryness and discomfort during intimacy
Painful intercourse
Vaginal atrophy
Reduced libido
Joint aches and muscle stiffness
Fatigue and low energy
Changes in weight or body composition
Thinning hair or dry skin
Vaginal symptoms, such as dryness and discomfort, are common during menopause and can be managed with the right treatments.
Estrogen therapy can restore vaginal cells, pH levels and blood flow to the vagina, reducing vaginal atrophy.
Menopause is natural but suffering through severe physical symptoms is not. There are options available to help you feel like yourself again.
What causes these symptoms?
Estrogen only therapy is often prescribed for women who have had a hysterectomy as it can alleviate menopause symptoms without the need for additional hormones.
When Does Menopause Start?
Perimenopause: The transitional phase where hormone levels start to fluctuate, often starts in the early 40s
Menopause: Diagnosed after 12 months without a period
Postmenopause: The stage following menopause, where symptoms may continue but the hormonal shifts have stabilised. Some women may continue to experience symptoms even after the hormonal shifts have stabilised.
Some women experience early menopause (before 45) or premature menopause (before 40) and may need special support and fertility advice.
Menopausal hormone therapy can be tailored to the individual needs of women at different stages of menopause.
How is Menopause Diagnosed?
For women over 45 with typical symptoms, menopause is usually a clinical diagnosis based on history.
In some cases, especially if you’re under 45, we may recommend:
Blood tests to check levels of follicle-stimulating hormone (FSH) and oestradiol
Thyroid function tests to rule out other causes of symptoms
Bone density scans (DEXA scans) if there is concern about osteoporosis risk
Unexplained vaginal bleeding is a significant factor that requires careful evaluation when diagnosing menopause.
At Happiher, diagnosis is holistic — taking into account not just your hormones but your whole health and wellbeing.
Randomised controlled trials have given us valuable insights into the effectiveness of different diagnostic methods for menopause.
What is Hormone Replacement Therapy (HRT)?
HRT involves supplementing the body’s natural hormones (oestrogen, progesterone and sometimes testosterone) to relieve menopausal symptoms and long term health. Menopausal hormone therapy reduces hot flashes in treated women compared to placebo. Conjugated equine estrogen (CEE) is a commonly used form of estrogen in HRT, particularly for vasomotor symptoms.
There are different types of HRT:
Oestrogen-only HRT (for women who have had a hysterectomy)
Combined HRT (oestrogen + progesterone for women with a uterus)
Continuous combined HRT involves daily administration of estrogen and progestogens without interruption, simplifying treatment management.
Body-identical HRT (bioidentical hormones that match natural hormones more closely)
Testosterone supplementation can be considered for specific symptoms such as low libido.
Compounded hormones are custom-made alternatives to conventional HRT, though their safety and efficacy are not established. Bioidentical hormones are claimed to mimic natural hormones but there is limited evidence of their safety and efficacy compared to conventional HRT.
HRT is available in many forms:
Tablets
Skin patches
Gels or sprays
Vaginal rings, creams or pessaries
Studies have shown that HRT can reduce the incidence of colorectal cancer in women.
Choosing the right type, dose and method, including systemic therapy depends on your symptoms, health history and personal preferences.
Types of HRT
Hormone replacement therapy (HRT) is available in various forms, oral, transdermal and vaginal therapies each tailored to address specific menopausal symptoms. The most common types of HRT include estrogen-only therapy, combined estrogen and progesterone therapy and bioidentical hormone therapy.
Estrogen-only therapy is prescribed for women who have had a hysterectomy. This form of therapy relieves symptoms such as hot flashes, night sweats and mood swings without the need for additional hormones.
Combined estrogen and progesterone therapy is used for women with an intact uterus to reduce the risk of endometrial cancer. This combination manages systemic menopausal symptoms like hot flashes and night sweats while protecting the uterine lining.Bioidentical hormone therapy uses hormones that are chemically identical to those produced by the body. This option is available in various forms, oral, transdermal and vaginal therapies and is chosen by some women for its natural approach.
Systemic HRT, which can be taken orally or through the skin (transdermally) is for widespread menopausal symptoms like hot flashes, night sweats and mood swings. Vaginal HRT is for localised symptoms like vaginal dryness and painful intercourse.
Choosing the right type of HRT depends on your symptoms, health history and personal preferences. Consult with a healthcare provider to determine the best treatment for your individual needs.
Bioidentical Hormones
Bioidentical hormones are hormones that are chemically identical to those produced by the body, often used in hormone replacement therapy (HRT) to treat menopausal symptoms like hot flashes, night sweats and vaginal dryness. These hormones can be administered in various forms, oral, transdermal and vaginal therapies.
Regulated bioidentical hormones, approved by the FDA, are available in standardized doses and forms, estrogen and progesterone. These regulated options ensure consistency and safety in treatment.
Compounded bioidentical hormones are custom-made by pharmacists to meet individual needs. While they offer personalised dosing, their safety and efficacy are not established as regulated bioidentical hormones.
Women considering bioidentical hormone therapy should consult with their healthcare provider to determine the best treatment for their individual needs. This personalised approach ensures the therapy is both safe and effective for specific menopausal symptoms.
Benefits of HRT
HRT can give you:
Relief from hot flushes and night sweats
Better sleep
Mood regulation and reduced anxiety
Stronger bones (reducing osteoporosis and bone loss risk)
Protection against cardiovascular disease if started early in menopause
Vaginal health and sexual function
Better quality of life
Estrogen replacement can improve quality of life by relieving many menopausal symptoms and long term health.
Long term use of HRT is associated with reduced risk of osteoporosis and hip fractures.For many women HRT can be life changing and help them feel like themselves again.
Are There Risks with HRT?
As with any medical treatment there are potential health risks including a slightly increased risk of breast cancer, blood clots, stroke and breast tenderness headaches depending on the type and duration of HRT. Using HRT for more than 5 years may increase breast cancer risk but this risk decreases after discontinuation. HRT presents a small increased risk of breast cancer especially with long term use. Combined estrogen and progestin therapy has been linked to an increased risk of invasive breast cancer. HRT may also be associated with a slightly increased risk of ovarian cancer but this risk decreases with progestogen use.
At Happiher we take a personalised, evidence based approach:
Carefully assess your individual risk profile
Use the lowest effective dose for the shortest time
Offer ongoing reviews to adjust treatment if needed
For most healthy women starting HRT under 60 the benefits far outweigh the risks. However there is conflicting evidence regarding the cardiovascular benefits of HRT especially when started after 60.
Menopause and Heart Health
Menopause brings an increased risk of cardiovascular disease including coronary heart disease and stroke. This increased risk is largely due to the decline in estrogen levels which can cause changes in blood vessels and increase blood pressure. Hormone replacement therapy (HRT) has been shown to reduce the risk of cardiovascular disease in some women especially those who start HRT early in the menopausal transition. However it’s important to note that some types of HRT, oral estrogen, may increase the risk of blood clots and stroke. Oral estrogen formulations have a higher risk of blood clot formation compared to transdermal methods which bypass the liver and have a lower risk profile. For women at risk of cardiovascular disease transdermal therapy, such as transdermal estradiol, may be a safer option. Consult with a healthcare provider to determine the best treatment options. The Women’s Health Initiative (WHI) study suggests HRT may reduce risks of coronary disease and dementia if started early.
Menopause and Mental HealthMenopause can have a significant impact on mental health with many women experiencing anxiety, depression and mood swings. HRT can be helpful in relieving these symptoms especially for those with severe menopausal symptoms. Testosterone therapy can be helpful for women with hypoactive sexual desire disorder (HSDD) during menopause and enhance sexual desire and overall satisfaction. Cognitive behavioural therapy (CBT) and other forms of talk therapy have been shown to be effective in managing menopausal symptoms and improving mental health. Lifestyle changes such as regular exercise, healthy diet and effective stress management techniques can also reduce the risk of mental health issues during menopause. A holistic approach that includes both medical and lifestyle interventions can help women stay mentally well during this transition.
Menopause and Bone Health
The decline in estrogen levels during menopause increases the risk of osteoporosis and bone fractures. HRT can help reduce this risk especially for women who start HRT early in the menopausal transition. Starting HRT with a low dose of estrogen can help manage bone health while minimising potential risks. In addition to HRT other strategies for bone health include taking calcium and vitamin D supplements, using bisphosphonates and considering selective estrogen receptor modulators (SERMs). Regular weight bearing exercise is also important for maintaining bone density and reducing the risk of fractures. Women should discuss their individual risk factors and treatment options with their healthcare provider to develop a personalised plan for bone health during menopause.
Nutrition and Menopause
A healthy diet can help alleviate menopausal symptoms such as hot flashes, night sweats and vaginal dryness. Incorporating foods rich in essential nutrients can help manage these symptoms and overall health.
Omega-3 fatty acids found in foods like salmon and flaxseeds may help reduce inflammation and improve heart health. Calcium and vitamin D found in dairy products and leafy greens are important for bone health and reducing osteoporosis risk.
A diet low in saturated fats and high in fibre can reduce the risk of heart disease and certain types of cancer. Whole grains, fruits and vegetables are great choices for a heart healthy diet.Women experiencing menopausal symptoms should consult with their healthcare provider or a registered dietitian to develop a personalised diet plan. A personalised approach to nutrition can help manage symptoms and overall well being during menopause.
Physical Health and Menopause
Regular exercise and healthy lifestyle are key to relieving menopausal symptoms such as hot flashes, night sweats and vaginal dryness. Physical activities like brisk walking or swimming can reduce stress, improve mood and maintain a healthy weight.
Maintaining a healthy weight is important to reduce the risk of health problems like heart disease and diabetes. Women should also be aware of the health risks associated with menopause such as osteoporosis and cardiovascular disease.
To reduce these risks women should have regular bone density tests, monitor their blood pressure and cholesterol levels and take prescribed medication as needed. A proactive approach to physical health including regular exercise and balanced diet can make a big difference to quality of life during menopause.
Consulting with a healthcare provider can help women develop a personalised exercise and lifestyle plan. By taking control of their physical health women can navigate menopause with more ease and confidence.
Lifestyle and Non-Hormonal Support for Managing Menopausal Symptoms
Not every woman needs or wants HRT. Taking HRT is a personal decision that should be made in consultation with a healthcare provider considering individual symptoms and health history. Other options include:
Cognitive behavioural therapy (CBT) for hot flushes and mood
Non-hormonal medications for specific symptoms
Nutritional advice for bone, heart and brain health
Exercise programmes for menopause
Supplements like vitamin D, calcium and magnesium
Non-hormonal medications can be effective for managing other symptoms like hot flushes and mood swings.
A holistic approach means every aspect of your wellbeing is addressed and treatments are administered at the lowest dose necessary for effectiveness.
Why Choose Happiher for Menopause Care?
If you’re looking for a private menopause specialist in London, Happiher offers:
Compassionate, thorough consultations
Personalised advice on HRT and non-hormonal options
Expertise in managing complex or early menopause cases
Holistic approach
Care across Chelsea & Westminster, The Lister and The Wellington Hospital
Our approach is guided by the latest recommendations from leading menopause societies.You don’t have to go through menopause alone. Expert care can make this transition a positive, empowering chapter in your life. We follow the North American Menopause Society and Women’s Health Initiative guidelines for the best care.
Conclusion
Menopause is a natural part of life — but you should feel strong, supported and vibrant during this time of change.
Happiher here to help you with personalised advice, latest treatments and genuine care for your long term health and happiness.
Menopause and Hormone Replacement Therapy (HRT): Navigating the Change with Confidence
Menopause is a natural part of a woman’s life — but that doesn’t mean it’s always easy. For many women, the physical and emotional changes that come with fluctuating hormones can feel overwhelming, isolating and sometimes invisible to others.
At Happiher, we believe menopause care should be supportive, personal and empowering. As a private gynaecologist in London, I help women navigate the menopause journey — whether they’re looking at lifestyle changes, symptom relief or hormone replacement therapy (HRT) — with clarity and compassion.
What is Menopause?
Menopause is officially diagnosed in menopausal women when they have gone 12 months without a period, usually between the ages of 45 and 55. However, the journey to menopause — called perimenopause — can start years earlier, with hormonal changes starting as early as your late 30s or early 40s.
Postmenopausal women are those who have gone through menopause and are in the stage following 12 months without a period.
Common Symptoms of Menopause
Symptoms vary for every woman but common experiences include:
Hot flushes and night sweats
Sleep disturbances
Mood swings or low mood
Anxiety or irritability
Brain fog and difficulty concentrating
Vaginal dryness and discomfort during intimacy
Painful intercourse
Vaginal atrophy
Reduced libido
Joint aches and muscle stiffness
Fatigue and low energy
Changes in weight or body composition
Thinning hair or dry skin
Vaginal symptoms, such as dryness and discomfort, are common during menopause and can be managed with the right treatments.
Estrogen therapy can restore vaginal cells, pH levels and blood flow to the vagina, reducing vaginal atrophy.
Menopause is natural but suffering through severe physical symptoms is not. There are options available to help you feel like yourself again.
What causes these symptoms?
Estrogen only therapy is often prescribed for women who have had a hysterectomy as it can alleviate menopause symptoms without the need for additional hormones.
When Does Menopause Start?
Perimenopause: The transitional phase where hormone levels start to fluctuate, often starts in the early 40s
Menopause: Diagnosed after 12 months without a period
Postmenopause: The stage following menopause, where symptoms may continue but the hormonal shifts have stabilised. Some women may continue to experience symptoms even after the hormonal shifts have stabilised.
Some women experience early menopause (before 45) or premature menopause (before 40) and may need special support and fertility advice.
Menopausal hormone therapy can be tailored to the individual needs of women at different stages of menopause.
How is Menopause Diagnosed?
For women over 45 with typical symptoms, menopause is usually a clinical diagnosis based on history.
In some cases, especially if you’re under 45, we may recommend:
Blood tests to check levels of follicle-stimulating hormone (FSH) and oestradiol
Thyroid function tests to rule out other causes of symptoms
Bone density scans (DEXA scans) if there is concern about osteoporosis risk
Unexplained vaginal bleeding is a significant factor that requires careful evaluation when diagnosing menopause.
At Happiher, diagnosis is holistic — taking into account not just your hormones but your whole health and wellbeing.
Randomised controlled trials have given us valuable insights into the effectiveness of different diagnostic methods for menopause.
What is Hormone Replacement Therapy (HRT)?
HRT involves supplementing the body’s natural hormones (oestrogen, progesterone and sometimes testosterone) to relieve menopausal symptoms and long term health. Menopausal hormone therapy reduces hot flashes in treated women compared to placebo. Conjugated equine estrogen (CEE) is a commonly used form of estrogen in HRT, particularly for vasomotor symptoms.
There are different types of HRT:
Oestrogen-only HRT (for women who have had a hysterectomy)
Combined HRT (oestrogen + progesterone for women with a uterus)
Continuous combined HRT involves daily administration of estrogen and progestogens without interruption, simplifying treatment management.
Body-identical HRT (bioidentical hormones that match natural hormones more closely)
Testosterone supplementation can be considered for specific symptoms such as low libido.
Compounded hormones are custom-made alternatives to conventional HRT, though their safety and efficacy are not established. Bioidentical hormones are claimed to mimic natural hormones but there is limited evidence of their safety and efficacy compared to conventional HRT.
HRT is available in many forms:
Tablets
Skin patches
Gels or sprays
Vaginal rings, creams or pessaries
Studies have shown that HRT can reduce the incidence of colorectal cancer in women.
Choosing the right type, dose and method, including systemic therapy depends on your symptoms, health history and personal preferences.
Types of HRT
Hormone replacement therapy (HRT) is available in various forms, oral, transdermal and vaginal therapies each tailored to address specific menopausal symptoms. The most common types of HRT include estrogen-only therapy, combined estrogen and progesterone therapy and bioidentical hormone therapy.
Estrogen-only therapy is prescribed for women who have had a hysterectomy. This form of therapy relieves symptoms such as hot flashes, night sweats and mood swings without the need for additional hormones.
Combined estrogen and progesterone therapy is used for women with an intact uterus to reduce the risk of endometrial cancer. This combination manages systemic menopausal symptoms like hot flashes and night sweats while protecting the uterine lining.Bioidentical hormone therapy uses hormones that are chemically identical to those produced by the body. This option is available in various forms, oral, transdermal and vaginal therapies and is chosen by some women for its natural approach.
Systemic HRT, which can be taken orally or through the skin (transdermally) is for widespread menopausal symptoms like hot flashes, night sweats and mood swings. Vaginal HRT is for localised symptoms like vaginal dryness and painful intercourse.
Choosing the right type of HRT depends on your symptoms, health history and personal preferences. Consult with a healthcare provider to determine the best treatment for your individual needs.
Bioidentical Hormones
Bioidentical hormones are hormones that are chemically identical to those produced by the body, often used in hormone replacement therapy (HRT) to treat menopausal symptoms like hot flashes, night sweats and vaginal dryness. These hormones can be administered in various forms, oral, transdermal and vaginal therapies.
Regulated bioidentical hormones, approved by the FDA, are available in standardized doses and forms, estrogen and progesterone. These regulated options ensure consistency and safety in treatment.
Compounded bioidentical hormones are custom-made by pharmacists to meet individual needs. While they offer personalised dosing, their safety and efficacy are not established as regulated bioidentical hormones.
Women considering bioidentical hormone therapy should consult with their healthcare provider to determine the best treatment for their individual needs. This personalised approach ensures the therapy is both safe and effective for specific menopausal symptoms.
Benefits of HRT
HRT can give you:
Relief from hot flushes and night sweats
Better sleep
Mood regulation and reduced anxiety
Stronger bones (reducing osteoporosis and bone loss risk)
Protection against cardiovascular disease if started early in menopause
Vaginal health and sexual function
Better quality of life
Estrogen replacement can improve quality of life by relieving many menopausal symptoms and long term health.
Long term use of HRT is associated with reduced risk of osteoporosis and hip fractures.For many women HRT can be life changing and help them feel like themselves again.
Are There Risks with HRT?
As with any medical treatment there are potential health risks including a slightly increased risk of breast cancer, blood clots, stroke and breast tenderness headaches depending on the type and duration of HRT. Using HRT for more than 5 years may increase breast cancer risk but this risk decreases after discontinuation. HRT presents a small increased risk of breast cancer especially with long term use. Combined estrogen and progestin therapy has been linked to an increased risk of invasive breast cancer. HRT may also be associated with a slightly increased risk of ovarian cancer but this risk decreases with progestogen use.
At Happiher we take a personalised, evidence based approach:
Carefully assess your individual risk profile
Use the lowest effective dose for the shortest time
Offer ongoing reviews to adjust treatment if needed
For most healthy women starting HRT under 60 the benefits far outweigh the risks. However there is conflicting evidence regarding the cardiovascular benefits of HRT especially when started after 60.
Menopause and Heart Health
Menopause brings an increased risk of cardiovascular disease including coronary heart disease and stroke. This increased risk is largely due to the decline in estrogen levels which can cause changes in blood vessels and increase blood pressure. Hormone replacement therapy (HRT) has been shown to reduce the risk of cardiovascular disease in some women especially those who start HRT early in the menopausal transition. However it’s important to note that some types of HRT, oral estrogen, may increase the risk of blood clots and stroke. Oral estrogen formulations have a higher risk of blood clot formation compared to transdermal methods which bypass the liver and have a lower risk profile. For women at risk of cardiovascular disease transdermal therapy, such as transdermal estradiol, may be a safer option. Consult with a healthcare provider to determine the best treatment options. The Women’s Health Initiative (WHI) study suggests HRT may reduce risks of coronary disease and dementia if started early.
Menopause and Mental HealthMenopause can have a significant impact on mental health with many women experiencing anxiety, depression and mood swings. HRT can be helpful in relieving these symptoms especially for those with severe menopausal symptoms. Testosterone therapy can be helpful for women with hypoactive sexual desire disorder (HSDD) during menopause and enhance sexual desire and overall satisfaction. Cognitive behavioural therapy (CBT) and other forms of talk therapy have been shown to be effective in managing menopausal symptoms and improving mental health. Lifestyle changes such as regular exercise, healthy diet and effective stress management techniques can also reduce the risk of mental health issues during menopause. A holistic approach that includes both medical and lifestyle interventions can help women stay mentally well during this transition.
Menopause and Bone Health
The decline in estrogen levels during menopause increases the risk of osteoporosis and bone fractures. HRT can help reduce this risk especially for women who start HRT early in the menopausal transition. Starting HRT with a low dose of estrogen can help manage bone health while minimising potential risks. In addition to HRT other strategies for bone health include taking calcium and vitamin D supplements, using bisphosphonates and considering selective estrogen receptor modulators (SERMs). Regular weight bearing exercise is also important for maintaining bone density and reducing the risk of fractures. Women should discuss their individual risk factors and treatment options with their healthcare provider to develop a personalised plan for bone health during menopause.
Nutrition and Menopause
A healthy diet can help alleviate menopausal symptoms such as hot flashes, night sweats and vaginal dryness. Incorporating foods rich in essential nutrients can help manage these symptoms and overall health.
Omega-3 fatty acids found in foods like salmon and flaxseeds may help reduce inflammation and improve heart health. Calcium and vitamin D found in dairy products and leafy greens are important for bone health and reducing osteoporosis risk.
A diet low in saturated fats and high in fibre can reduce the risk of heart disease and certain types of cancer. Whole grains, fruits and vegetables are great choices for a heart healthy diet.Women experiencing menopausal symptoms should consult with their healthcare provider or a registered dietitian to develop a personalised diet plan. A personalised approach to nutrition can help manage symptoms and overall well being during menopause.
Physical Health and Menopause
Regular exercise and healthy lifestyle are key to relieving menopausal symptoms such as hot flashes, night sweats and vaginal dryness. Physical activities like brisk walking or swimming can reduce stress, improve mood and maintain a healthy weight.
Maintaining a healthy weight is important to reduce the risk of health problems like heart disease and diabetes. Women should also be aware of the health risks associated with menopause such as osteoporosis and cardiovascular disease.
To reduce these risks women should have regular bone density tests, monitor their blood pressure and cholesterol levels and take prescribed medication as needed. A proactive approach to physical health including regular exercise and balanced diet can make a big difference to quality of life during menopause.
Consulting with a healthcare provider can help women develop a personalised exercise and lifestyle plan. By taking control of their physical health women can navigate menopause with more ease and confidence.
Lifestyle and Non-Hormonal Support for Managing Menopausal Symptoms
Not every woman needs or wants HRT. Taking HRT is a personal decision that should be made in consultation with a healthcare provider considering individual symptoms and health history. Other options include:
Cognitive behavioural therapy (CBT) for hot flushes and mood
Non-hormonal medications for specific symptoms
Nutritional advice for bone, heart and brain health
Exercise programmes for menopause
Supplements like vitamin D, calcium and magnesium
Non-hormonal medications can be effective for managing other symptoms like hot flushes and mood swings.
A holistic approach means every aspect of your wellbeing is addressed and treatments are administered at the lowest dose necessary for effectiveness.
Why Choose Happiher for Menopause Care?
If you’re looking for a private menopause specialist in London, Happiher offers:
Compassionate, thorough consultations
Personalised advice on HRT and non-hormonal options
Expertise in managing complex or early menopause cases
Holistic approach
Care across Chelsea & Westminster, The Lister and The Wellington Hospital
Our approach is guided by the latest recommendations from leading menopause societies.You don’t have to go through menopause alone. Expert care can make this transition a positive, empowering chapter in your life. We follow the North American Menopause Society and Women’s Health Initiative guidelines for the best care.
Conclusion
Menopause is a natural part of life — but you should feel strong, supported and vibrant during this time of change.
Happiher here to help you with personalised advice, latest treatments and genuine care for your long term health and happiness.
Book your appointment today
Book your appointment today
Book your appointment today