Hormone Replacement Therapy (HRT)

Please review information regarding your HRT at www.menopausematters.co.uk.

The form will be reviewed by a doctor or nurse. If additional discussion is needed, you will be contacted for a telephone consultation or review to be arranged.

Hormone Replacement Therapy (HRT)

Current Treatment

Are you using Hormone Replacement Therapy (HRT) at the moment?
Can you tell us who started you on this treatment?
When did you last have a face to face review with your doctor about your treatment?
How long have you been on HRT?
Does this treatment control your symptoms of the menopause?
Do you have any side effects from the HRT treatment you are taking (including new onset migraines, severe headaches or vaginal bleeding)?
Can you tell us when was your last menstrual period?

Health Check

Have you had a blood pressure check in the last 12 months?
Please note – We will be unable to issue the medication without an up to date blood pressure reading. If you do not have access to a blood pressure monitor at home there is one available for use at the surgery.
Do you have a personal or family history of breast or endometrial (womb) cancer?
Have you ever had a blood clot, such as a DVT or pulmonary embolism?
Have you ever had a heart attack, stroke or high cholesterol?
Do you have any of the following conditions: Asthma, Diabetes, High Blood pressure, Liver Problems, Kidney Problems, Migraines, Epilepsy, Fibroids, Porphyria, SLE (lupus), Otosclerosis?
Do you have any other medical conditions not mentioned already?
Do you smoke?
Do you take any other female hormones (such as the contraceptive pill or a Mirena coil)?
Have you noticed any breast lumps?
Was the mammogram normal?
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