Special notices (FAQs)

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Manufacturing supply shortages

Testim Gel: From 2018 Testim gel 50 mg / 5 ml is no-longer being manufactured. The next alternative is Tostran gel 2%. 1 metered dose = 10 mg and the usual daily female dose is 5 mg per day. The female replacement dose is 0.5 to 1.0 metered dose two or three times per week. Testosterone information for GP (pdf)

Oestrogel 0.06%: There is a temporary shortage of this product from the manufacturer. Sandrena gel 1.0 mg or 0.5mg sachets are the next alternative. Oestrogel information for GP (pdf)

Estradot Patches:  Manufacturer’s delay may result in difficulty in obtaining repeat prescriptions, in which case any alternative brand of the same dose may be issued. To achieve 37.5mcg, cut 75mcg of the alternative brand in half. 

Off-label use medication

(eg Testosterone gel, Syneral nasal spray, Decapeptyl or Zoladex injections)

Where your GP can not prescribe, we will continue to prescribe treatment and ask that you GP give interim injections where required. We will provide sufficient supply until your next review with the clinic.

Routine repeat prescriptions

Routine repeat prescriptions cannot be provided by the hospital. The first month’s supply is given by the hospital and all further prescriptions must be prescribed by your GP.

Hormone implants

Estrogen (estradiol) and testosterone implants are now unlicensed products. Our service is still providing estrogen implants and we are accepting patients from out of region. Testosterone implants are available for women with significant androgen deficient symptoms.

Possible infected implant

Implants rarely become infected. Tetsosterone implants are an irritant to the body and are sometimes rejected. Signs of rejection are pain, tenderness, oozing and redness at the implant site. Take painkillers and keep the wound area clean. If the implant is rejected, keep it to show to the clinician at your next visit. Antibiotics are not usually required as the wound will heal quickly once the implant has been

Progestogen or progesterone standard regimens 

  • Non-bleed progestogen or progesterone: Suitable for postmenopausal women who have not had a period for 12 months and prescribed a combined HRT with estrogen. The progestogen or progesterone is  taken daily e.g. Norethisterone 5mg every day or Utrogestan 100mg every day at night.
  • Cyclical progestogen or progesterone: Suitable for perimenopausal women having menstrual periods and prescribed estrogen e.g. Norethisterone 10mg, Utrogestan 2x100mg
    • Option 1: With regular monthly cycles, timed from day 16–27 (Day 1 is first day on mensturation)
    • Option 2: With irregular bleeding, timed from 1st–12th of each calendar month

Please see Resources and further information (FAQs) for specific printable patient information.

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