“To see whether treatment is helping you should be offered
review appointments every 3 months to start with.
If you are not having any problems you should then…”.1

Umbrella

What may the Hormone Therapy Follow Up Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Hormone Replacement Therapy (HRT) Follow Up/Review
  • Hormone Therapy (HT) Follow Up/Review
  • Menopausal Hormone Therapy (MHT) Follow Up/Review

Frequency

If menopausal women choose to use hormone therapy (HT), how often should they review their use?

The (Australian) Jean Hailes for Women’s Health (JH) explain:


Hormone Therapy Follow Up“It can take around six months to find the right MHT. Once you’ve found an MHT that works for you, it’s important to review it with your doctor each year”.2

In Menopause: Treatment – Follow-Up Appointments according to the (United Kingdom) NHS:

“If you’re having treatment for your symptoms of menopause or perimenopause, you’ll need to return to the doctor or nurse who is prescribing your HRT for a follow-up review after 3 months.

When you and your doctor or nurse agree your treatment is working well for you, you’ll need to see them once a year”.3

The (United Kingdom) Women’s Health Concern note:

“Women on HRT should be re-assessed by their doctor at least annually”.4

In the Hormone Therapy: Is It Right for You: Who Can Benefit From Hormone Therapy? the (United States) Mayo Clinic also note:

  • “Seek regular follow-up care. See your doctor regularly to ensure that the benefits of hormone therapy continue to outweigh the risks, and for screenings such as mammograms and pelvic exams”.5

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Managing Clinical Side Effects of MHT Therapy, published online 30 October 2023, the authors explain:

“Optimally, women using systemic MHT should have a medical review at 3 months to assess symptom relief and side effects. This is also an opportunity to discuss any patient concerns and ensure correct use of the prescribed therapy. Further follow-up will be determined by whether any treatment adjustments are made or investigations initiated. Long-term follow-up should be at least yearly”.6

Follow-Up Format

What may the follow-up include?

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Managing Clinical Side Effects of MHT Therapy, the authors also note:

“Review should include updating medical history and a general medical examination and breast assessment as indicated. Investigations should be individually determined, with mammography frequency according to local recommendations”.7

In Menopause: Treatment – Follow-Up Appointments the NHS explain:

“During your reviews, your doctor or nurse may:

  • Make sure your symptoms are under control
  • Ask about any side effects and vaginal bleeding
  • Check your weight and blood pressure
  • Review the type of HRT you’re taking and make any necessary changes”.8

Unscheduled or Prolonged Bleeding

What may unscheduled or prolonged bleeding require?

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Managing Clinical Side Effects of MHT Therapy, the authors explain:

“Unscheduled or prolonged bleeding 3–6 months after commencing MHT needs investigation (ultrasound and/or biopsy), and where indicated, specialist referral. The need for ongoing MHT, the formulation and dose requirement should be reviewed”.9

Health Care Provider

How long do I need to take HT or menopausal hormone therapy (MHT)?

In Menopause Management Options: Menopausal Hormone Therapy (MHT) – How Long Do You Need To Take MHT? the JH note:

“You can take MHT at low doses for as long as you need. Many women have symptoms for around eight years and one in four women have symptoms into their 60s and 70s. The benefits of MHT far outweigh the risks in healthy women within 10 years of reaching menopause”.10

The NHS explain:

“You can choose to continue taking HRT. The doctor or nurse prescribing your HRT can discuss with you the benefits and risks, so you can decide what’s right for you.

You can take HRT for as long as you need it. You can discuss this with your doctor or nurse at your yearly review”.11

Health Topics A-Z

Where may I find Health Topics A-Z related to Hormone Therapy Follow Up?

In Health Topics A-Z you may find:

Links

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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Menopause: Diagnosis and Management – Information for the Public: Reviewing Your Care. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/NG23/ifp/chapter/Reviewing-your-care Accessed: 06 June 2024
  2. Menopause Management Options: Menopausal Hormone Therapy (MHT) – How Long Do You Need To Take MHT? Last Updated: 08 May 2024 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 06 June 2024
  3. Menopause: Treatment – Follow-Up Appointments. Page Last Reviewed: 17 May 2022. NHS https://www.nhs.uk/conditions/menopause/treatment/ Accessed: 06 June 2024
  4. HRT Benefits and Risks: In Summary. Updated: November 2020. Women’s Health Concern https://www.womens-health-concern.org/help-and-advice/factsheets/hrt-know-benefits-risks/ Accessed: 06 June 2024
  5. Hormone Therapy: Is It Right for You? 06 December 2022. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372 Accessed: 06 June 2024
  6. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Management – – Effectiveness: Managing Clinical Side Effects of MHT Therapy. First Published Online: 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 06 June 2024
  7. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Management – – Effectiveness: Managing Clinical Side Effects of MHT Therapy. First Published Online: 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 06 June 2024
  8. Menopause: Treatment – Follow-Up Appointments. Page Last Reviewed: 17 May 2022. NHS https://www.nhs.uk/conditions/menopause/treatment/ Accessed: 06 June 2024
  9. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Management – – Effectiveness: Managing Clinical Side Effects of MHT Therapy. First Published Online: 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 06 June 2024
  10. Menopause Management Options: Menopausal Hormone Therapy (MHT) – How Long Do You Need To Take MHT? Last Updated: 08 May 2024 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 06 June 2024
  11. Menopause: Treatment – Follow-Up Appointments. Page Last Reviewed: 17 May 2022. NHS https://www.nhs.uk/conditions/menopause/treatment/ Accessed: 06 June 2024
Topic Last Updated: 22 June 2024 – Topic Last Reviewed: 06 June 2024

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