Hormone Replacement Therapy (HRT) Review

Your Practice Name Here Logo


Key Points

- This secure form will allow you to provide the information your GP team needs to review your hormone replacement therapy (HRT).
- You will have the opportunity to submit a blood pressure reading (see below).
- Your answers may not be seen immediately meaning this service is not suitable for seeking urgent or emergency care.
- This form should only be used by someone over the age of 13 (we're aware you're likely over twice this age).
- When you are ready to complete your review, click the "Review my HRT" tab above.

General information

- Oestrogen and progesterone are sex hormones. The levels of these hormones decrease as women go through the menopause.
- Oestrogen HRT alone significantly increases the risk of endometrial cancer (the endometrium is the lining of the womb).
- Progesterone must therefore also be given, either as a tablet or in the coil, to help prevent cancer in women with a womb.
- If you still have periods when starting HRT, you would usually be precribed a cyclical HRT (a preparation that changes during the month).
- Cyclical HRT is normally changed to a continuous preparation (one that is constant throughout each month) after you turn 54 even if you are having periods.

You should seek urgent help if you have:

- Trouble breathing or are coughing up blood.
- A severe unremitting headache or migraines with an aura.
- An unexplained painful swelling of your leg.
- Problems with your speech, sight or moving your arms and legs.
- Significant pains in your chest or tummy (abdomen).
- An episode of losing conciousness (fainting) or collapsing.

Stopping HRT

- There are no fixed rules about duration of HRT
- Generally, women started on HRT for premature menopause should continue until at least age 51 before reviewing
- Generally, most women benefit from HRT for 2-5 years, but sometimes for longer
- Generally, gradually reducing the dose makes a short-term impact on severity of symptoms
- Symptoms may recur after stopping HRT
- HRT risks tend to increase with age

Blood Pressure

- A blood pressure reading is essential to ensure you can use HRT safely.
- A blood pressure reading above 180/110 should be reported urgently by calling the practice (not entered / submitted).
- If you do not have one to hand now, you can still submit this form and supply us with a reading later.
- You can check your blood pressure on your own machine, at your local community pharmacy or at the practice.

Vaginal Atrophy

- Vaginal atrophy refers to vaginal dryness and skin thinning which can make sex uncomfortable and increase the risk of urine infections.
- Vaginal atrophy can be treated with treatments inserted into the vagina at home including oestrogen cream or pessaries.
- Vaginal treatments are safe for most women and can be used alongside other forms of HRT.

Screening programs

- It is strongly advised to attend for cervical screening (HPV self swab or cervical smear) when invited (Age 30-69 every 5 years).
- Cervical screening is available for Māori and Pacific wāhine or whānau at younger ages (age 25 to 69 at least every 5 years).
- It is strongly advised to attend for breast screening when invited (Age 45-69 every 2 years).


Your Details:
DOB:
These questions relate to your general health and lifestyle.
How often do you drink alcohol?
How much / what do you smoke each day (if anything)?
Are you currently vaping / using a vape?
How would you like to enter your height and weight?
Your BMI is one indicator of a healthy weight.

Your BMI: Please provide your height and weight

These questions relate to taking HRT.
Please provide a blood pressure reading if known (see "information" tab above)
/
Has there been any significant change in your health since your last HRT review?
In what form do you take the oestrogen component of your HRT?
In what form do you take the progesterone component of your HRT?
Are you thinking of gradually reducing or stopping your HRT within the next year?
Do you still have any vaginal bleeding with your HRT (choose the option that fits best)?
Does your HRT medication cause any side-effects?
These questions relate to your menopause symptom control.
Which of the following menopausal symptoms do you experience?
Flushing
Problems with mood
Vaginal dryness and skin thinning (atrophy)
Other
These questions relate to the riks of HRT.
Its is important to be aware that using HRT carries risks. Click the button below to find out more.
Have any of your first degree relatives (parents, brothers or sisters, children) had breast cancer?
Have any of your first degree relatives (mother, sisters, daughters) had ovarian cancer?
Do you attend the cervical and breast cancer screening programs?
Are you happy for a clinician to see your responses and complete your review without further discussion (if appropriate)?

Questions, concerns or additional comments: