Healthcare Professional Resources:
Guidance and Resources for Ongoing Management
Oestrogen Equivalent Doses & Progesterone Doses
2024 BMS Guidance on Oestrogen and Progesterone
Genitourinary Syndrome of Menopause (GSM)
Resources for ongoing vulvovaginal symptoms:
Prescription and Review Schedule
HRT can be maintained on an annual repeat prescription, unless there are clinical indications for an earlier review, such as symptom recurrence, adverse effects, or reduced efficacy.
This is supported by the National Institute for Health and Care Excellence (NICE), which advises: “Offer women who are taking HRT a review at 3 months after starting treatment and then annually unless there are clinical indications for an earlier review (for example, treatment ineffectiveness, side effects or adverse events).”
Source: NICE Guideline NG23 – Menopause: Diagnosis and Management, Section 1.4.19 (2019)
Slynd: Progestogen-Only Pill (POP) in HRT and Reproductive Health
Slynd is a progestogen-only pill (POP) containing drospirenone, primarily used for contraception. It also offers benefits for PMS, PMDD, and the progesterone component of HRT in perimenopausal and postmenopausal women.
Slynd in HRT (off-licence):
- May be used as a progestogen in menopausal women requiring endometrial protection.
- Drospirenone is also in Yasmin and Eloine and was in the discontinued HRT product Angelique.
Considerations:
- Does not protect against STIs
- Certain medications (e.g. antibiotics, anticonvulsants, St. John’s wort) may reduce effectiveness
- Avoid potassium supplements due to hyperkalaemia risk
British Menopause Society (BMS) - Resource Overview
- Core Tools for Clinicians
- Principles and Practice of Menopause Care Toolkit
- Specific Tools for Clinical Scenarios:
- PDF Clinical Guidance:
- Unscheduled Bleeding on HRT:
- Menopause After Gynaecological Cancer