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North Yorkshire and York Menopause Guidance HRT (refer to ...

Approved by: NYY APC; October 2021 Review Date: October 2024 North Yorkshire and York Menopause Guidance HRT (refer to table overleaf for formulary choices) Menopausal symptoms Post Hysterectomy Uterus intact Oestrogen ONLY Oral, patch or topical Last Menstrual period < 1 year Last Menstrual period > 1 year >54 years >3 years sequential HRT Oral sequential combined HRT Patch sequential combined HRT Oral/patch/gel single oestrogen with IUS or oral progesterone Oral continuous combined HRT Patch continuous combined HRT Oral/patch/gel single oestrogen with IUS or progesterone Tibolone Vaginal symptoms only OTC lubricants & moisturisers, Vaginal estradiol -Vagif

o Consider HRT to manage menopause symptoms including vasomotor symptoms, psychological symptoms (including low mood that arises as result of menopause) and altered sexual function. Urogenital atrophy alone only requires topical estradiol and can be used before the menopause but can also be used in some women in addition to systemic HRT.

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North Yorkshire and York Menopause Guidance HRT (refer to ...

northyorkshireccg.nhs.uk

Levonorgestrel (Mirena) device In an HRT regime, it has a 4-year license. FSRH state it can be used for 5 years for endometrial protection (note offlabel) 2nd Line Estraderm MX patches. 25, 50, 75, 100mcg estradiol Change TWICE per week FemSeven Sequi 50micrograms estradiol & 10micrograms levonorgestrel Change patch ONCE a week

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