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HRT (Hormone Replacement Therapy) review

HRT Review – Haygarth Medical Centre

Section

BMI

e.g. 1.75
e.g. 60.6
Please note: BMI calculator is only for patients aged 18 and over.

Blood Pressure

If you are unable to provide a blood pressure reading, please request a healthcare assistant appointment. Add in comments box “For my HRT review”.

Alcohol Consumption

One unit of alcohol

Amount of different types of drink representing one unit of alcohol

More than one unit of alcohol

Amount of different types of drink representing more than one unit of alcohol

How often do you have a drink containing alcohol? *
How many units of alcohol do you drink on a typical day when you are drinking? *
How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year? *

Review

Do you smoke? *
Do you find HRT effective? *
Are you experiencing any side effects? (e.g. Migraines) *
Has there been any changes to your health since your last HRT check? *
Has there been any changes to your medications since your last HRT check? *
Do you have any vaginal dryness or discomfort? *
Are you attending the following recommended screening programmes?
Cytology: *
Mammography: *
Breast awareness: *
Do you have any concerns about vaginal bleeding? *
Do you need contraception? *
*