Hormone Replacement Therapy
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Hormone Replacement Therapy key facts
Hormone Replacement Therapy
When menopause occurs in women it can bring about a range of symptoms such as hot flushes and vaginal dryness, due to a decline in the production of oestrogen by the ovaries. Hormone replacement therapy (HRT) is a treatment option used to provide relief from these symptoms, as well as others, to help improve overall quality of life.
Here, we will take a closer look at hormone replacement therapy, its benefits, health risks, and alternatives.
Understanding Hormone Replacement Therapy
HRT is exactly what it says it is. It is the replacement of hormones no longer made by the body. The most common treatment is a combination of estrogen (estradiol, estrone or estriol) and progesterone. Estrogen helps to treat symptoms like hot flashes and vaginal dryness, while progesterone helps to protect against endometrial cancer and osteoporosis. The two main types of HRT are:
- Systemic HRT: Available as tablets, skin patches, sprays, gels, sprays, and injections. These work throughout the body, relieving hot flashes, vaginal dryness and night sweats
- Local HRT: Creams, rings, and vaginal tablets, used to treat vaginal symptoms
What are the benefits of Hormone Replacement Therapy?
According to The North American Menopause Society, systemic HRT is the best treatment available for the treatment of symptoms such as hot flushes, vaginal dryness, night sweats, bone loss and urinary tract infections (UTIs). HRT has been shown to improve:
- Mood changes, insomnia and brain fog
- Heart disease
- Osteoporosis, osteoarthritis, and joint pain in postmenopausal women
- Glucose control in type 2 diabetes
- Sex drive
- Overall quality of life
HRT is used to manage vasomotor symptoms, genitourinary syndrome, and the prevention of osteoporosis during menopause.
Risks and considerations
The Women’s Health Initiative has highlighted health conditions that may cause risks when taking HRTs, these include:
- Heart disease
- Uncontrolled high blood pressure
- Stroke
- Breast cancer
- Thrombosis
- Blood clots
- Liver disease
Risks tend to be higher when HRT treatment is used for longer periods of time. Factors such as age, preferences, and the availability of treatment options should also be considered when choosing treatment.
Administration methods
Oral estrogen is the most common and convenient method of administration. However, patches or gels can bypass the liver avoiding, the risk of blood clotting. Oral progestogens are necessary for use in women with an intact uterus to protect against endometrial cancer. Vaginal treatments, such as creams, rings, or vaginal tablets, can also help to manage localized symptoms.
Side Effects of Hormone Replacement Therapy
Hormone Replacement Therapy may cause certain side effects. The most commonly experienced side effects of HRT may include:
- Breast tenderness
- Bloating
- Mood swings
- Headaches
- Vaginal bleeding or irregular spotting
If any side effects are concerning, speak to a healthcare provider for further medical advice.
Alternatives to Hormone Replacement Therapy
Alternatives to HRT include:
- Avoiding triggers such as caffeine
- Maintaining a comfortable room temperature
- Wearing breathable clothing
- Relaxation techniques such as deep breathing, tai chi, yoga, or meditation
- Antidepressants
- Vaginal lubricants or moisturizers
Hormone Replacement Therapy after Hysterectomy
Women who have had a hysterectomy may be prescribed oestrogen-only HRT as there is no need for progesterone to protect against ovarian cancer.
Women under the age of 60 who have had a hysterectomy and take estrogen HRT within 10 years of menopause show a reduced risk of breast cancer.
Hormonal Supplements for men
Men’s hormone levels also naturally decline with age, but testosterone as an “anti-aging treatment” is not recommended due to a lack of evidence. Testosterone supplements may also increase the risk of cardiovascular disease.
Frequently asked questions
What is Hormone Replacement Therapy?
Hormone Replacement Therapy is used to relieve the symptoms of menopause due to hormonal imbalances by replacing hormones no longer naturally produced. HRT will not replace the full amount of hormones produced by a woman before menopause, but provides a smaller percentage.
Is Hormone Replacement Therapy safe?
Hormone Replacement Therapy has been linked to an increased risk of breast cancer and heart disease. However, more recent research has provided a more clear understanding of the risks and benefits of HRT. There are still misconceptions around the safety of HRT, but treatment based on an individuals symptoms, risk factors, and well-being, will provide benefits.
In addition, if HRT is started within 10 years of the last period, it has been shown to reduce the risk of heart disease and bone loss, as well as reduce the risk of diabetes and weight gain.
What are the risks of HRT?
The combined use of estrogen and progestin HRT may slightly increase the risk of breast cancer. The increased risk is however, very low. Also, the synthetic progestin hormones used in past studies are no longer prescribed today, and studies also show that bioidentical hormones do not produce clear increases in breast cancer risk. Alcohol consumption and being overweight, have more of an impact on the risk of breast cancer than HRT. HRT may also increase the risk of blood clots, hence the importance of evaluating risk factors before prescribing HRT.
Should I take Hormone Replacement Therapy?
Hormone Replacement Therapy may not be suitable for everyone. If you have had a stroke, blood clots, heart attack or liver problems, breast or uterine cancers, or unexplained vaginal bleeding, you may be advised not to take HRTs. Speak to a healthcare professional to decide the best treatment option for you.
When is it best to start Hormone Replacement Therapy?
Hormone Replacement Therapy should be started within 10 years of your last period. However, if you have severe menopausal symptoms, you should start treatment earlier, even during perimenopause, while still having regular monthly cycles.
How long can I use Hormone Replacement Therapy?
Guidelines suggest the duration of HRT treatment should be a decision made between you and your healthcare provider. The choice will vary for everyone, but you should have regular checkups, to ensure that your treatment is safe and effective for you.
Conclusion
HRT can significantly improve your quality of life. But you should consider the benefits and risks first. Speak to your doctor to decide what the best treatment is for you. Whether you choose HRT or an alternative method, you will need to be monitored closely to make sure you receive the best ongoing treatment options available.
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What does the Get Treated Privately service do?
The Get Treated Privately service is a private prescribing service which is designed for adults aged 18 years and over, who are experiencing health issues and who would like to receive a fast-track assessment and if applicable, a treatment plan from a qualified prescribing clinician. Treatments are dispensed and delivered to your home or workplace from our regulated online pharmacy.
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Yes. Our formulary of medications prescribed and conditions treated are controlled, governed, and continuously risk-assessed by our Medical Director, Dr. Aseel Hamoud. Unlike other prescribing services which operate using faceless questionnaires, our service is conducted through remote video consultations, also known as synchronous consultations. This builds patient safety and prescribing appropriateness into our service, ensuring our prescribing clinicians can be satisfied with who and what they are treating. There is no guarantee of supply of medications, and any prescriptions supplied are at the sole discretion of our clinician prescriber. There is no charge for the consultation.
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Our prescribing clinicians are board-certified pharmacists, nurses, or doctors who can also prescribe any medicine for any medical condition, subject to accepted accreditation and good clinical practice. They are all registered with their respective regulatory bodies. For example, a pharmacist independent prescriber is registered with the General Pharmaceutical Council (GPhC). Each prescribing clinician undergoes an extensive background check including a disclosure and barring service check (DBS). In addition, they undergo a rigorous license verification process. When you book an appointment with our prescribing clinicians you will see their full name, license number, and any specialized credentials they have.
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Yes. This is a private service. You do not need to pay for the consultation. You only pay for the cost of the medication you are prescribed.
How do I book a consultation?
Once you have logged into your account, you will need to navigate to the Get Treated Privately quick action widget which is located at the bottom of your dashboard. You can then select one of the following actions – ‘Search Treatments’ or ‘Search Conditions’.
Depending on the search type, you will be taken to a consultation booking screen. You will then need to select a date and time that is convenient for you, along with the preferred language of the prescribing clinician you wish to choose. You will then see a list of all available clinicians. From this list, you can filter clinicians by gender and then select the clinician you would like to confirm for your booking.
Once you have approved this, you will see a summary of the appointment including preliminary information about the consultation. At this point, you will also be able to add a reminder to your calendar. Always ensure your account health profile is up to date before any consultation. This ensures that our clinicians have the most up-to-date information about your current health status and anything that may influence their prescribing decisions. You will receive a push notification and email reminding you of your consultation, 30 minutes before it is due to start.
You can ‘star’ the Get Treated Privately quick action widget to have it display in the ‘My Favourite Widgets’ section of your dashboard, for ease of future booking or checking active or past orders.
What happens during the remote video consultation?
During the consultation, the clinician will ask you a series of questions that will allow the clinician to diagnose your health condition and consider possible treatment options. At the end of the consultation, the clinician will decide if a treatment plan is a safe and appropriate option for you.
If it is, the clinician will discuss the various treatment options that may be available, so that you can jointly agree on the option that is most suited to you. Once you have jointly agreed on a treatment plan, the clinician will issue a prescription order which will be available in your ‘shopping cart’ at the end of the consultation.
Also, with your consent, the clinician may wish to inform your GP of the treatment that was prescribed. We recommend that you agree to this since your GP is responsible for your overall care and they should have a record of this consultation and medication prescribed. In addition, our clinician may take the opportunity to advise you on your overall health including advice on healthy living or stop smoking.
What happens at the end of the consultation?
At the end of the consultation, you will receive a notification which will summarise the outcome. It will also advise if any referrals were made to your GP, along with any other advice that was given to you by the clinician.
If a GP referral letter was issued, you will be able to view a copy of this in the ‘My Documents’ section of your dashboard.
If you were prescribed a treatment plan, it will now be available in your shopping cart. When you go to your shopping cart, you will be able to checkout and make payment. Once the checkout is complete, your prescription order will be sent to our regulated online pharmacy for processing.
What if the prescriber does not prescribe what I want?
We operate a safe and effective service. This means that our prescribing clinicians always exercise their clinical judgment when prescribing. Unfortunately, we do not operate a service where you can demand a certain medication. If you are not prescribed anything, then you will not be charged.
Will I get status updates for my order?
Yes. When you place an order with NowPatient, we will keep you fully updated with the status of your order. Every time the status of your order changes, you will be notified immediately. These notifications will appear in your ‘My Notifications’ section on your dashboard. You can click the notification and it will take you to your active orders screen which will give you a timeline overview of the progress of your order. This can also be accessed using the ‘My Orders’ quick action widget which is on your dashboard. Here, you can access active and past orders.
How will my order be delivered?
All orders are shipped in discreet and unmarked packaging. This means it is suitable for delivery wherever you require (home, work, or a neighbour). For thermo-sensitive orders (e.g. Insulin or weight loss injections) we use cold chain-validated packaging. Your parcel will normally receive an estimated delivery window from the courier on the day of delivery.
For your protection and safety, your first order can only be delivered to the address that is registered with NowPatient. Future orders can be delivered to any other address, for example, your workplace.
Do you ship cold-chain or temperature sensitive products?
Yes. We use a specialist courier service for all thermo-sensitive deliveries. This is to ensure that cold chain integrity is always maintained and thus the product quality, safety and efficacy.
Learn more about how we handle the delivery of temperature sensitive products.
Where do you deliver?
We currently deliver to all postcodes/zipcodes worldwide. Some postcodes in rural areas may have a slightly longer delivery time.
When will my order arrive?
- UK – Royal Mail Tracked 24 & Signed for Delivery – Next day delivery
- Europe – Royal Mail Tracked – Typical delivery of 3-5 working days
- Worldwide – Royal Mail – Typical delivery of 5-7 working days. If a tracked option is available for your country via Royal Mail, this service will be applied.
What should I do if my order has not arrived?
Delivery is normally made promptly after your dispatch notification is received. You can check the tracking details of your order in the ‘My Notifications’ section of your dashboard, at any point after dispatch.
Unfortunately, packages can sometimes get lost in the delivery system, if after 10 days you have not received your delivery, please contact us and we will do all we can to resolve the problem.
Can you prescribe GLP-1 weight loss injections?
Yes. However, with GLP-1 weight loss medications, the license requires that there are support resources put in place as part of the plan including coaching for a healthy lifestyle, exercise, and diet. Our clinicians will discuss this with you, if you are prescribed this type of treatment.
You can learn more on our Weight Loss Programs feature page.
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Alternatively, if you need to speak to us, you can reach us on the following numbers:
UK telephone number – 020 388 51 500
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NowPatient is owned and operated by Infohealth Ltd, a licensed online pharmacy with services spanning the UK, US and Rest of the World. Infohealth Ltd is registered in England and Wales under company number 04004930 and our registered office is at Lynwood House, 373 – 375 Station Road, Harrow, England, HA1 2AW.
Our website is www.nowpatient.com. Our App is called “NowPatient” and can be downloaded from the App Store (for Apple devices) or Google Play (for Android devices).
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NowPatient’s Pharmaceutical services in the UK are provided by Infohealth Limited trading as ‘Infohealth Pharmacy’.
Our dispensing pharmacy is regulated and authorized for internet sales by the General Pharmaceutical Council (GPhC), registration number 1036487. You can view our license credentials on the General Pharmaceutical Council website. Our superintendent pharmacist who is responsible for the safe and effective oversight of medicines supplies is Mr Amish Patel (Registration Number 2042705).
Medicines are not ordinary items of commerce. All medicines or healthcare product sales are made under the supervision of a registered pharmacist who is licensed by the GPhC. At all times, we endeavour to provide a professional and transparent service whose primary goal is to ensure that the best interests of the patient are served.
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From time to time, we accept that our service levels may not be up to your expectations. NowPatient welcomes concerns, compliments and complaints as valuable feedback that will help us learn from your experiences and make improvements. Feedback can be provided via our clear and transparent Complaints Procedures.
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You can lower the cost of your prescription medications using our various savings programs which include drug coupons, savings card and manufacturer-sponsored patient assistance programs.
We do not provide any prescribing services or dispensing services in the United States.
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