NICE guideline Menopause: Identification and management states: 

“Professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service”. 

“Women have the right to be involved in discussions and make informed decisions about their care”.

Menopause symptoms vary in presentation and severity²

Oestrogen doses and timings should be tailored for each patient^1,3

Guidelines provide useful overall recommendations, however, HRT needs to be tailored, taking into account each woman’s risk vs benefit profile^1,3,4

A careful appraisal of the risks and benefits should be undertaken at least annually, and HRT should only be continued as long as the benefit outweighs the risk.^5,6

Evidence regarding the risks associated with HRT in the treatment of premature menopause is limited. Due to the low level of absolute risk in younger women, however, the balance of benefits and risks for these women may be more favourable than in older women^5,6

Oral HRT is associated with an increased risk of venous thromboembolism (VTE) compared with no HRT exposure (odds ratio [OR]:1.58); transdermal HRT preparations were not associated with increased VTE risk compared with no HRT exposure (OR: 0.93)⁶

NICE recommends transdermal HRT, rather than oral, to be offered to women at high risk of VTE, including those with a body mass index (BMI) >30 kg/m2¹

HRT is contraindicated in women with previous or current thromboembolism or thrombophlebitis, known thrombophilic disorders, active/previous/current thromboembolism or thrombophlebitis, known thrombophilic disorders, active or recent arterial thromboembolic disease or recent arterial thromboembolic disease^5,7

Please refer to individual Summary of Product Characteristics for more information on warnings, precautions and contraindications.

Please use your discretion when assessing a patient's individual benefit vs risk profile when considering prescribing HRT.

Combined HRT use can be associated with an increased risk of developing breast cancer, whereas oestrogen-only HRT is associated with a small increased risk in breast cancer^7,8

An up to 2-fold increased risk of having breast cancer diagnosed is reported in women taking combined oestrogen-progestogen therapy for more than 5 years⁷

The increased risk in users of oestrogen-only therapy is lower than that seen in users of oestrogen-progestogen combinations. The level of risk is dependent on the duration of use⁷

All HRT products are contraindicated in patients with known, past or suspected hormone-dependent malignant tumours. Women should be advised on what changes to look out for in their breasts and told to report these changes to their doctor or nurse^5,7

Please refer to individual Summary of Product Characteristics for more information on warnings, precautions and contraindications.

Please use your discretion when assessing a patients individual benefit vs risk profile when considering prescribing HRT.