How often should I review my HRT?

Menopause lasts for life so learn how to monitor your symptoms with your healthcare professional

For many women, getting a diagnosis of perimenopause or menopause, and a prescription for HRT, can feel like an uphill battle. A survey by Newson Health of almost 6,000 women found 30% of respondents attended between two and five appointments or investigations before their symptoms were attributed to changing hormones [1].

But once a diagnosis has been made and a prescription of HRT issued, you may wonder what comes next. Some women worry about the inconvenience of making appointments at their busy local surgery, while others may want reassurance that their healthcare professional will be able to support them and answer any questions about HRT and their symptoms.

So, what does the guidance say about how often you should be seen if you start taking HRT? The National Institute for Health and Care Excellence (NICE) has clear recommendations on this matter – and you can read them for yourself here.

The guidelines state that once the initial prescription is given for oestrogen, and progesterone if needed, there should be a review with your doctor or nurse after around three months, and then yearly follow-ups after that (see 1.9.2 in guidelines).

Testosterone may be discussed and prescribed for you. Usually, women are reviewed 3-4 months after starting testosterone and it is likely your testosterone blood test will be undertaken at this time.

What happens at a HRT review?

Your three-month review appointment should focus on whether the treatment is working well enough for you and how you are feeling, for example whether you are experiencing any side effects. It can be useful to continue to monitor your symptoms – you can do this by using the balance menopause symptom sheet. This can help your healthcare professional determine how well you are responding to treatment.

After you have had your review, you will be usually given another prescription and you are likely to be asked to come in every few months to ensure you are taking the right dose and type of HRT – yearly follow-up appointments are adequate if you continue to be well.

You can of course, ask to see your healthcare professional whenever you wish, if the treatment is not bringing the improvement you had hoped for, you have a return of symptoms, or side effects are becoming a problem.

Menopause specialist and balance founder Dr Louise Newson advises that HRT is beneficial for most women in the long term (e.g. forever), as long as the benefits continue to outweigh the risks. Your future risk of cardiovascular disease and osteoporosis (bone thinning) are reduced when you take HRT, and women who take HRT also have a lower risk of developing type 2 diabetes, bowel cancer and some studies have shown a lower risk of dementia [2].

If your doctor or nurse is unsure of the most suitable treatment for you, or says there are reasons why you can’t take HRT, ask to be referred to a menopause specialist doctor.

Resources

NICE guidance

HRT doses explained

References