Refer to Menopause and HRT guidance for further information, also note NICE guidance NG23 Menopause: diagnosis and management. Oral preparations are usually first-line unless not tolerated.  Where patients have persistent oestrogenic side-effects, reduce dose and change preparation or move to a transdermal preparation. For patients with risk factors for venous thromboembolism or stroke consider transdermal preparations.

MHRA advice: ​Hormone replacement therapy (HRT): further information on the known increased risk of breast cancer with HRT and its persistence after stopping​ (August 2019) (www.gov.uk).

For information on HRT supply shortages see medicines shortage log (intranet access required) and shortages information.