Menopause Care & Services

Our team has a particular interest in Menopause Care and you’ll find our menopause services sensitive, understanding and a combination of the latest evidenced-based medical practise combined with a holistic, woman-centred approach here in the Cayman Islands.

One thing we’re sure of is that one size does not fit all when it comes to care during perimenopause, the period or time leading up to menopause, and then menopause itself. Our all-female, senior OBGYN team is located in a dedicated Women’s Health Suite, offering privacy and a sense of calm.

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Why Choose our Team?

All-female team of senior OB/GYN doctors

Dedicated, private & relaxing Women’s Health Suite

Highly experienced, tertiary consultant, multidisciplinary team


What is Menopause Care?

Let’s briefly explain menopause. Menopause is a point in time 12 months after your last period. The years leading up to that point, when you may have changes in your monthly cycle, hot flashes, or one of a myriad of other symptoms, are called the menopausal transition, or perimenopause. Dr Lisa Joels and Dr Madhavi Manoharan provide care throughout this period.

The menopausal transition itself frequently begins between about age 45 and age 55, although it can be both earlier or later. It typically tends to last around 7 years but can last as long as 14 years. Whilst undergoing this menopausal transition, you body’s production of estrogen and progesterone, two hormones made by your ovaries, starts to vary significantly. It’s also a time when bones become less dense, making women more vulnerable to injuries like fractures.

There are other changes during this period too. For instance, the body starts to use energy differently, there are changes in fat cells, and you main find yourself gaining weight more easily. Menopausal care is about addressing the symptoms that cause you problems or distress, as well as ensuring you are informed, so you (and us) are able to differentiate menopause symptoms from other symptoms that may suggest something more sinister.

More info on Menopause from National Institute of Ageing


Our Menopause Care & Services

As we introduced, when it comes to Menopause Care, one size most certainly does not fit all women, given that each person’s experience of perimenopause and menopause is different. We start by really understanding you. You may have comparatively few symptoms and only need to see your OBGYN for fairly infrequent exams and preventive care procedures. Or, you may find that menopause is impacting your life drastically, or daily, causing more severe hot flushes or flashes, mood swings, sleep issues, depression or anxiety difficulties, bone loss and vaginal dryness, affecting your romantic activities.

No matter how you are experiencing it or where you find yourself on the spectrum or symptoms, our two menopause specialists, Dr Lisa Joels and Dr Madhavi Manoharan, our Consultant Obstetrician & Gynaecologists (OBGYNs) are available to guide you through each stage in both a compassionate, holistic manner and by adopting the latest in evidence-based menopause care.

Both of our menopause care specialists stay fully up-to-date with the latest research, including the use of lifestyle adaptions or approaches and the use of safe, effective medications. They will discuss with you about non-pharmaceutical strategies that can potentially help in decreasing menopause symptoms, including stress management & reduction, holistic approaches e.g. yoga, and practical approaches such as exercise, among others.

Treatment of Menopause

We will also discuss hormone replacement therapy, as a possible, shorter-term option for those women with particularly uncomfortable menopausal symptoms. There is also an increasing understanding of other forms of medical treatment that may have benefits for individual women. What you can be assured of is a comprehensive, evidence-based approach, tailored to you, safe in the knowledge that you are being cared for by two senior, experienced, tertiary Cayman Islands OB/GYN doctors with considerable experience in menopause care.

Monitoring your Health

In addition to direct menopause care and attention to symptoms, we also can also advise you on appropriate prevention and any necessary or advisable screening procedures for women going through this stage of life. That may include clinical bone densitometry, for instance, which can help identify bone loss, something that accelerates once a woman has reached menopause.


Common Symptoms of Menopause

In the months and years that constitute perimenopause, leading up to menopause, you might find yourself experiencing a number of these signs and symptoms:

  • Irregular periods
  • Vaginal dryness
  • Hot flushes or flashes
  • Chills
  • Night sweats
  • Sleep problems
  • Mood changes
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

Changes in menstruation can vary considerably from one woman to the next and almost all women experience some irregularity in their periods before they finally cease. Skipping or missing periods during perimenopause is very common and to be expected. Menstrual periods can skip a month and return, or even miss several months, but then recommence again for a few more months. There is no set pattern. Other changes can happen to your cycles. For instance periods can, or even tend to happen on shorter cycles, so they come closer together. Also, it is worth remembering that despite irregular periods, you can still get pregnant. It can be advisable to consider a pregnancy test if you’ve missed a period but aren’t yet sure you’ve started the menopausal transition.


Dr Lisa Joels

Obstetrician & Gynaecologist
Tel: +1 (345) 745 7450 (clinic)
Email: [email protected]

Dr Joels has 36 years’ experience in obstetrics and gynaecology including 19 years as a Consultant working in Swansea (2001-11) and subsequently at the Royal Devon & Exeter NHS Foundations Trust in the UK (2011-20). She was lead clinician for prestigious Fertility Exeter and is passionate about women-centred care.


  • Obstetric Services (Pregnancy)
  • High-Risk Obstetric Service
  • Fertility Services
  • Gynaecology Care & Surgery
  • Paediatric & Adolescent Gynaecology

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Dr Madhavi Manoharan

Obstetrician & Gynaecologist
Tel: +1 (345) 745 7450 (clinic)
Email: [email protected]

Dr Manoharan has 23 years’ experience in obstetrics and gynaecology, including more than a decade at tertiary level, 7 years as consultant at the prestigious Royal Free London NHS Foundation Trust and a number of years as Assistant Professor at the world-renowned Weil Cornell Medicine, located in their Qatar campus, part of Cornell University.


  • Obstetric Services (Pregnancy)
  • High-Risk Obstetric Service
  • Fetal-Maternal Medicine
  • Gynaecology Care & Surgery
  • Coloposcopy (Accredited)

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Clinic Location & Open Times

The Grand Pavilion Commercial Centre, Hibiscus Way, 802 West Bay Road.

  • Monday to Friday: 8.30am first appointment, 4.30pm last appointment
  • Saturday: 8.30am first appointment, 12.30pm last appointment

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