Abstract
A 55-year-old woman registers with your surgery. She attends a new patient appointment and asks if your practice would be willing to take over her hormone replacement therapy (HRT) prescription. She has been consulting a private online menopause clinic and for the past 3 years has been using 2 × 100 mg oestrogen patches plus a pump or two of Oestrogel® topically to control her symptoms. She has been prescribed Utrogestan® 100 mg orally at night for endometrial protection but says the specialist said it was OK to use these vaginally as she is sensitive to the side effects when taken orally.
What is the safe licensed dose of HRT? What is off-licence prescribing and when might you prescribe in such a manner? What would you need to discuss with the patient and/or document in your clinical records? When and how would you raise concerns about a private clinic if you thought their practice was unsafe?
