Special notices (FAQs)


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Manufacturing supply shortages

There are frequant temporary shortages of many HRT products from the manufacturers, with some also discontuinued. Please see the comparison chart for alternative prescritpions, and discus with your GP. For up-to-date information on HRT products click here.

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 cut backs 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: From 2018 some testosterone gels are no-longer being manufactured. Testogel metered dispensers are NOT recommended for female use. The recommended alternative is Tostran gel 2%. 1 metered dose = 10 mg and the usual daily female dose is 5 mg per day, or 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

(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.  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 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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