Private menopause clinics prescribing HRT at 'twice the recommended dose'

Private menopause clinics are prescribing HRT at "twice the recommended dose", an investigation has revealed.

The investigation by The Pharmaceutical Journal has revealed that patients attending private menopause clinics are subject to “unorthodox prescribing” by providers. Many are receiving oestrogen at up to double the recommended dose placing them at higher risk of cancer and vaginal bleeding.

Nuttan Tanna, a pharmacist consultant in women’s health at London North West University Healthcare NHS Trust, said she had seen referrals for “bleeding investigations” and then found the patient was on "very large doses [of oestrogen] prescribed previously by private providers”.

Brendon Jiang, a senior clinical pharmacist for North Oxfordshire Rural Alliance Primary Care Network, said that his team were increasingly getting letters from private clinics requesting for patients to be prescribed doses of oestrogen that are off-label or exceed licensed recommendations.

He also raised concerns that patients were not taking enough progesterone alongside increased doses of oestrogen. Taking increased doses of oestrogen alone can increase the risk of womb cancer but progesterone protects against that risk and therefore the two hormones should be taken together.

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Source: The Telegraph, 19 December 2022

Further reading on the hub:

• Surgical menopause: a toolkit for healthcare professionals (British Menopause Society)
• Menopause Support - Getting the most out of your doctor’s appointment
• World Menopause Day 2022: Raising awareness of surgical menopause
• All-Party Parliamentary Group on Menopause: Inquiry to assess the impacts of menopause and the case for policy reform - conclusions