HRT Review

Page {{ paginatorProps.current }} of {{ paginatorProps.total }} ({{ paginatorProps.percentage }}% completed)
Personal Details
Please double check you've entered the correct email address
May be used to identify you
HRT Review Questions
Have you had a hysterectomy (operation to remove your womb): *
 
Do you have a coil that releases hormones fitted (eg Mirena): *
Are you happy with your current HRT prescription: *
Can you provide us with a recent blood pressure reading (we accept blood pressure readings taken at home: *
Have you experienced any new bleeding or change in bleeding pattern since your last HRT review: *
Have you or a close family member (parents, siblings or children) ever been diagnosed with a clot in the leg (DVT) or lungs (PE): *
Have you ever been diagnosed with breast or ovarian cancer: *
Have you ever been diagnosed with a stroke or mini-stroke (TIA): *
Have you been diagnosed with liver disease: *

HRT is associated with an increased risk of certain conditions including clots, breast cancer and ovarian cancer. It is important you remain aware of these risks as well as the benefits of HRT.

Learn more about the risks and alternatives

Please remember that HRT is not a form of contraception and you will require additional contraception unless you are:

  • Aged 50 or over AND have not a period in over a year
  • Aged younger than 50 AND have not a period in over two years
  • Aged 55 or over
Do you need to discuss additional contraception: *
Are you currently using a GLP-1 agonist for weight loss or diabetic control(e.g. Mounjaro, Ozempic, Wegovy)?: *

*Please be aware that weight loss injections can affect the safety and efficacy of your HRT and this should be discussed with the prescriber prior to initiation*

Feedback

Please rate your experience of our HRT service.

  • 5 = best
  • 1 = worst

Privacy Consent

Processing

There appears to be a problem loading the form, please refresh the page.
If the error persists please contact us.