Special notices (FAQs)

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COVID-19

Due to the unprecedented COVID-19 crisis—gynaecology services are currently closed, please do not attend the hospital.

If you are on HRT and have one of the following urgent menopause problems, please complete the request form and wait for someone to contact you. Non-urgent requests will not be responded to at this time.

  • GnRHa 10 weekly injections—If you are currently receiving GnRHa 10 weekly injections you will be changed to Syneral nasal spray at this time and once confirmed, a prescription for 3 month supply will be posted directly to you. Please complete a request form to discuss.
  • Hormone Implants—All women on implants will need to use alternative HRT at this time. Please ask you GP for any alternative, with options listed on our patient information leaflet or available on the British Menopause Society web site. If uncertain, please complete a request form. Your notes will be reviewed and only if required will someone call you to discuss further management.
  • Irregular or unscheduled bleeding—If you experience any unscheduled or irregular bleeding please seek the advice of your GP first. If the problem persists, please complete the request form.

Due to the redeployment of the menopause team, there will be an uncertain delay in replying to your request, but rest assured we will do so at our earliest opportunity.

NB: There is no other point of contact for menopause patients other than the request form

Manufacturing supply shortages

There are frequent temporary shortages of many HRT products from the manufacturers, with some also discontinued. Please see the British Menopause Society web site for alternative prescriptions and comparisons, then discus with your GP to have your prescription altered accordingly. In this time of shortage, if you are using an estrogen only patch, request a generic patch rather than a named brand.

Hormone Implants—Both Estrogen and Testosterone implants are currently in short supply and may not be available at your next appointment. This is due to a lack of supply directly from the Manufacture and Suppliers and NOT due to cutbacks from the hospital or NHS. We do not know if this is a short-term or permanent problem. It is important that you still attend your next appointment as usual as we will need to ensure you have a new HRT prescription to be continuing with.

Testosterone—Testogel metered dispensers are not recommended for female use. The recommended alternative is Testogel 50/5ml sachet each used sparing over 7-14 days according to individual need and side-effects. The female replacement dose is approximately 5mg per day. 

Off-label use medication

(e.g. Testosterone gel, Syneral nasal spray, Decapeptyl or Zoladex injections)

Where your GP can not prescribe, we will continue to prescribe treatment. If you are receiving GnRHa injections, we will ask that your GP administers interim injections where required. Your prescription will be enough to meet your needs until your next review with the clinic. If you appointment is delayed and you need a further prescription, please complete the request form.

Routine repeat prescriptions

Routine repeat prescriptions cannot be provided by the hospital. Your GP will be advised of your initial prescription and any subsequent changes.

Hormone implants

Estrogen (estradiol) and testosterone implants are now unlicensed products.  Testosterone implants are available for women with significant androgen deficient symptoms.

Possible infected implant

Implants rarely become infected. Testosterone 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 menstruation)
    • Option 2: With irregular bleeding, timed from 1st–12th of each calendar month

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

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