HRT Prescribing
26 September 2024
HRT PRESCRIBING
In April 2023 there was a joint safety alert from the British Menopause Society Faculty of Sexual Reproductive Health, Royal Colleges of General Practitioners, and Royal Colleges of Obstetricians and Gynaecologists. This was in relation to the fact that they were becoming aware that there were increasing numbers of women that were being started on high doses of Oestrogen that exceeded product licenses. Oestrogen should not be regularly prescribed in doses higher than the upper limit listed and tested in clinical research. This upper limit is either 4 pumps of Estradiol 0.06% gel, Estradiol 100 mcg patch or 2mg of oral Estradiol tablets.
We are aware that some private providers are happy to prescribe above the recommended limits of oestrogen, as documented above. In such a scenario, our practice policy is that we would no longer be able to prescribe anything that contributes even in part to this overall treatment dose, and we would be complicit in prescribing above recommended limits. This decision was not taken lightly, as there could be a risk to your safety with long term use of doses above recommended guidelines.
We would therefore ask you to source all your medication supply privately or failing this to reduce your prescribed oestrogen dose. If you are feeling unable to reduce your oestrogen dose, and are unable to fund this privately, please speak to us about the option of being referred into the NHS complex menopause clinic for further management as an NHS patient.
If you believe that you may be on a dose higher than this, or a combination of different Oestrogen products (this does not include vaginal oestrogen cream 0.1% or pessary 10mcg) then please do make an appointment with our clinical pharmacist so that we can go through the potential risks with you and help to make your HRT safe. The problem with increased doses of Oestrogen is that they may be putting you at increased risk of cancer of the womb (uterus), and potentially cancer of the breast or ovaries.
We have attached for your convenience a British Menopause Society News update and a link to the full technical statement is available on this website: https://thebms.org.uk/2023/04/joint-bms-fsrh-rcgp-rcog-sfe-and-rcn-womens-health-forum-safety-alert/
Please do book an appointment with our clinical pharmacist so this can be discussed further. To do this please ring 01789 292 895.
