Recommended follow-up

Women having treatment for menopausal symptoms should ideally have a review 3 months after starting treatment, then at least annually thereafter, unless there are clinical indications for an earlier review (such as treatment ineffectiveness, side effects or adverse events).

The objective of the review would be to:

• Reinforce information and lifestyle advice.
• Assess efficacy and tolerability of treatment. If a menopause symptom questionnaire (MSQ) has been used, this can be repeated to track symptoms.
• Review vaginal oestrogen (if being used) and consider placing on repeat.
• Change to dosage or preparation can be considered if required.
• Check for side effects.
• Screen for new red flags.
• Repeat basic health checks, including weight and BP.
• Reinforce advice and information about how to optimise bone health.
• Discuss routine cervical and breast screening in accordance with NHS Screening Programmes.
• Review contraception if needed.

How quickly should the dose of oestrogen be increased?

The dose of HRT should not be changed too quickly, and the 3-month follow up is a good time to review a dose change. This gives HRT adequate time to work and enables enough time for mild side effects to have settled.