Online HRT Review | What to Prepare and When Not to Wait

Written and reviewed by the clinical team at The Wellness

Direct answer

Bring the exact HRT name, dose, route and schedule, plus a record of benefits, side effects and any bleeding. NICE recommends a review at 3 months and then annually, with earlier review when treatment is ineffective or problems arise. An online appointment may help, but examination, testing or specialist advice may be needed.

A review is more than a repeat prescription

An HRT review checks whether the treatment is helping, whether it still fits your health history and whether any new symptom changes the plan. Tell the doctor what has improved and what has not. Sleep, hot flashes, mood, vaginal symptoms and day-to-day functioning may change differently. A request for more medication should still include a clinical review when one is due.

Bring the label, not just the color of the packet

Have the name, strength and instructions for each product, including estrogen and any progestogen. Explain whether it is a tablet, patch, gel, spray or vaginal treatment, and when it was started or changed. Say if doses have been missed or a product has been unavailable. If you are unsure what you take, show the packaging or an up-to-date prescription record rather than guessing.

Make a short symptom and bleeding record

Write down the symptoms you most want to improve, when they occur and how they affect you. Record any vaginal bleeding, including when it started, whether it followed a treatment change and whether it is becoming heavier or more frequent. Tell the doctor about pain or other new symptoms. Bleeding should not be assumed to be a routine HRT effect without assessment; its timing and your circumstances matter.

Update the health information

List all medicines and supplements and any new diagnosis, operation or hospital admission. Mention a history of blood clots, cancer or other relevant health problems, and any change in family history. If you have a recent blood pressure reading, provide the actual measurement and date. The clinician may need a new measurement or additional assessment rather than relying on an old record.

Do you need a hormone blood test?

Not everyone does. NICE recommends identifying perimenopause or menopause without laboratory tests in otherwise healthy people aged 45 or over with the relevant symptoms. Routine hormone panels are not required to “prove” menopause in this group. Tests may be appropriate in other circumstances or to investigate a different cause of symptoms. A clinician should explain the question a test is intended to answer before you pay for it.

When an online review needs another step

Remote prescribing requires enough reliable information. A doctor may recommend a physical examination, investigation or specialist review before starting, changing or renewing treatment. This is particularly important when a new symptom needs assessment rather than a dose adjustment. An online consultation does not guarantee HRT, a specific product or a prescription.

Symptoms that should not wait for an annual review

Seek prompt medical advice about new or persistent unexpected bleeding or a breast lump or change. For pain, redness or swelling in one leg, contact a doctor or NHS 111 urgently. Call 999 for chest pain with breathlessness or stroke symptoms such as a facial droop, difficulty speaking or weakness in an arm. Do not wait for a routine online appointment or drive yourself to hospital with emergency symptoms.

Leave with a review plan

Ask what to continue, what is changing and why, when the next review is due and what to do if symptoms or bleeding change. NICE recommends review at 3 months to assess effectiveness and tolerability, then annually unless an earlier review is needed. Bring questions about alternatives and your own priorities. The aim is a treatment decision you understand, not simply another supply of medication.

Frequently asked questions

How often should HRT be reviewed?

NICE recommends review at 3 months and annually thereafter, with earlier review for ineffective treatment, side effects or other clinical concerns.

Do I need hormone blood tests for an HRT review?

Not routinely to identify menopause in an otherwise healthy person aged 45 or over with typical symptoms. A clinician may recommend tests for another clinical reason.

Can an online doctor change my HRT?

A clinician may change treatment when appropriate and enough information is available. Examination, tests or specialist advice may be needed first.

Sources

NICE NG23 | Menopause recommendations — https://www.nice.org.uk/guidance/NG23/chapter/recommendations

GMC | Remote prescribing principles — https://www.gmc-uk.org/professional-standards/learning-materials/remote-prescribing-high-level-principles

NHS | Continuous combined HRT side effects — https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/continuous-combined-hormone-replacement-therapy-hrt-tablets-capsules-and-patches/side-effects-of-continuous-combined-hrt/

Next step

For nonemergency advice, contact the clinical team. London appointments are at 10 Portman Square, London W1H 6AZ. A consultation does not guarantee a prescription or procedure.

Ask about an HRT review: https://www.theonlinegp.com/contact

Choose a GP appointment format: https://www.theonlinegp.com/services-store

This article provides general information and does not replace individual medical advice.