HRT Review (Sequential)

HRT Review (Sequential Combined)

High Blood Pressure readings

Advise review of BP and witholding HRT until checked

Blood Clot

Advise review with clinician and stop HRT

Stroke or Heart Condition

Advise review with clinician and stop HRT

Breast Cancer 

Advise review with clinician and stop HRT

Age >60

Advise review with clinician and stop HRT

Sequential to Continuous

Patient needs switched from sequential to continuous combined HRT. Advise GP review of HRT and form.

Please complete this form to help us review your HRT.

To ensure you are at low risk of problems, we need you to provide your HEIGHT, WEIGHT and BLOOD PRESSURE (unless done recently in the practice). If you are unable to measure these at home please arrange to have these done at the practice. 0131 333 3215

Your Details

Risks of HRT

HRT provides physical and psychological  benefits during the menopause but also comes with risks:

  • Blood clots
  • Stroke
  • Endometrial Cancer
  • Breast Cancer
  • Ovarian Cancer

Starting and continuing HRT is a decision made by you and your GP based on your individual case but a simple rule of thumb is:

  • < 50 years old - we would recommend you continue HRT

  • 50 – 60 years old – we would advise you consider the risks vs benefits and stop HRT if your symptoms allow

  • > 60 years old – the risks are usually greater than the benefits and we would recommend you stop HRT


Please confirm that you have considered the benefits vs risks of HRT
Please confirm that you have considered alternatives to HRT

Blood Pressure and weight (within the past 12 months)



Weight Units

Do you smoke?

Smoking is the most common cause of high BP, heart attacks and stokes. We STRONGLY advise stopping.

There are NHS smoking clinics in Edinburgh and West Lothian to help you stop.

Have you ever had a blood clot?
Have you ever had breast cancer?
Have you had a stroke or heart attack?
If you haven’t had a period in the past year you will require an HRT change.

How would you like to proceed?
This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our privacy policy to discover how we protect and manage your submitted data.

© 2022 Kristian Turnbull