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    03 BMS TFC HRT Practical Prescribing NOV2022 A

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    Anaa Mad
    HRT

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    03 BMS TFC HRT Practical Prescribing NOV2022 A

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    Anaa Mad
    142 views2 pages
    HRT

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    03-BMS-TfC-HRT-Practical-Prescribing-NOV2022-A

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    HRT

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    142 views2 pages

    03 BMS TFC HRT Practical Prescribing NOV2022 A

    Uploaded by

    Anaa Mad
    HRT

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    BRITISH MENOPAUSE SOCIETY Tool for clinicians Information for GPs and other health professionals

    1 of 2

    HRT – Practical prescribing


    Types of HRT
    Estrogen

    Estradiol • 0.5mg (combined only)/ 1mg / 2mg oral


    • 25mcg / 37.5mcg / 40mcg / 50mcg / 75mcg / 80mcg/ 100 mcg patches
    • 0.06% Oestrogel 0.75mg
    • 500mcg / 1mg Sandrena gel
    • 1-3 sprays Lenzetto
    • 10mcg vaginal tablets
    • 7.5mcg vaginal ring
    Estriol • 0.1% / 0.01% vaginal creams, vaginal pessary, 50mcg/g vaginal gel
    Conjugated estrogens • 0.3mg / 0.625mg / 1.25mg

    Non-Estrogens
    Gonadomimetic Tibolone • 2.5mg oral tablet (for systemic symptoms)
    DHEA Prasterone • 6.5mg pessary (for genitourinary symptoms)
    SERM Ospemifene • 60mg oral tablet (for genitourinary symptoms)

    Progestogens
    Micronised progesterone
    Dydrogesterone • Combined only
    Norethisterone • Combined only
    Levonorgestrel • Combined and IUS
    Norgestrel
    Medroxyprogesterone acetate

    Testosterone

    Implants (off licence, limited availability)


    Gel (off licence)

    Routes of therapy
    Oral • Tablets (estrogen only, progestogen only, or combined), SERM (for urogenital atrophy)
    Transdermal • Patches (estrogen only or combined) / gels (estrogen only) / Spray (estrogen only)
    Sub-cutaneous • Implants (estrogen only, testosterone only, off licence, limited availability)
    Vaginal • Ring/tablets/creams/pessary/ gel (all estrogen only), DHEA
    Intrauterine • IUS (progestogen only)

    Copyright © 2022 British Menopause Society. All rights reserved.


    Permission granted to reproduce for personal and educational use only. Commercial copying is prohibited.
    BRITISH MENOPAUSE SOCIETY Tool for clinicians Information for GPs and other health professionals

    2 of 2 HRT – Practical Prescribing

    HRT – Practical prescribing


    Estradiol – equivalent doses*

    Ultra low Low Medium High


    Oral 0.5mg 1mg 2mg 3-4mg
    Patch Half 25 25 50 75-100
    Gel-pump ½ pump 1 pump 2 pumps 3-4 pumps
    Gel-sachet ½ x 0.5mg sachet - 0.25mg 0.5mg 1-1.5mg 2-3mg
    Spray 1 spray 2 sprays 3 sprays —

    * The table has been drawn up as a practical guide based on a combination of pharmacokinetics, clinical trials and clinical experience.
    The dose equivalents are subject to significant individual variations in absorption and metabolism.
    Not all suggested doses are within Summary of Product Characteristics, so if used, are used off licence.

    Regimens
    Estrogen only • Hysterectomised patients
    Estrogen and progestogen • If uterus is present
    • Sequential/cyclical preparations • Perimenopausal women
    • Continuous combined • Post menopausal women
    • 3 monthly bleeds • Perimenopausal women
    Tibolone

    Common side effects Dealing with side effects

    Estrogen Estrogen
    • Fluid retention • Reduce dose
    • Breast tenderness • Change route
    • Bloating • Change type
    • Nausea / Dyspepsia • Which hormone is causing the side effect?
    • Headaches

    Progestogens Progestogens
    • Fluid retention • Change type
    • Breast tenderness • Reduce dose if available
    • Headaches • Change route
    • Mood swings • Alter duration
    • PMT-like symptoms

    Authors: Mrs Elaine Stephens in collaboration with Mrs Kathy Abernethy, Dr Julie Ayres, Dr Heather Currie, Mr Nick Panay
    and the medical advisory council of the British Menopause Society.
    Q1P2223

    PUBLICATION DATE: OCTOBER 2021


    REVIEW DATE: OCTOBER 2023

    For further details – please visit

    www.thebms.org.uk or telephone 01628 890 199


    www.womens-health-concern.org Copyright © 2022 British Menopause Society. All rights reserved. www.thebms.org.uk
    Reg Charity No: 279651 Permission granted to reproduce for personal and educational use only. Commercial copying is prohibited. Reg Charity No: 1015144
    Company Reg No: 1432023 Company Reg No: 02759439

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