First GP appointment about HRT - any tips?

[harriethoyle]

After a few months of night sweats, broken sleep and increasing anxiety, I’ve bitten the bullet and booked an appointment with a female GP to discuss potentially starting HRT. I’m 47 and pretty confident this is peri rather than life stress!

What do you wish you’d known to ask before your first appointment? Or what research did you do which helped? I want to go in fully informed and not be fobbed off…

You just go in and say you want to try hrt please. Job done. I didn't even get an appointment just a phonecall followed by a prescription. It was very simple.
I suggested what I wanted to take which at your age i think would be a patch and cycling progesterone but don't quote me on that.

Go for it. Wish I’d taken HRT much earlier in the process to preserve bone density. You lose the bulk of it in the first few years.

Note that oestrogen is highly protective of the heart - and far more women die of heart disease than breast cancer.

Have a look at the Menopause Matters website. If you do some research as to what you’d like to try it makes our job much easier.

No need for bloods at 47 with typical symptoms. Just be clear, concise and have an idea of what you’re expecting from the consultation.

Make sure you use the magic words "and it's really affecting my quality of life". Bonus points if you can show a cause/effect link between your symptoms and finding it more difficult to exercise/eat healthily or other important health-improving activities.

Go in with a WRITTEN list of your symptoms in case you have brain fog / forget anything in the moment. Be prepared to say how long you've been experiencing them for and how they are affecting your life

Then TELL the GP (don't ask) that you would like to try HRT. They may want additional blood tests (iron, b12, vitamin D etc) and that's good practice, but no hormonal tests because they're not useful for diagnosing peri. They should also discuss your diet, exercise, sleep and general lifestyle and give you advice as appropriate.

Unless you have a few limited contraindications, they should discuss types of HRT (patch, gel, spray for oestrogen, coil or tablets for progesterone) and prescribe what you ask for. It can take up to 12 weeks for any new medication to fully kick in so don't panic if it takes a while to feel different

Good luck! HRT has made a world of difference to me

Make sure you tell them it is impacting your life and your ability to do your job. Be prepared to be dismissed!!

Thank you all. I’m (naively?) hoping a female GP might be less dismissive than a male but will be prepared to advocate for myself. Menopause matters website is a great shout, thank you.

I requested a female doctor but saw my registered, male, gp. He was fab. Listened, asked questions and then asked if I what I knew and HRT and did I want to try it. The relief was amazing, knowing I’d been listened to. Just to say, don’t rule out male doctors! But be clear with how you are feeling, the effect on your life and what you want. I agree that writing it all down to take with you is a good idea. I’d written all my symptoms in my online request for the appointment, which helped as he already had the info.

Though some women - like myself think they are perimenopausal, at 50ish, but the night sweats and some other symptoms were actually heart issues. (Was not menopausal til 59!)
Make sure you get a heart health check if assuming menopause - blood pressure, list your symptoms etc

I was prepared to fight my corner and they were just like shrug here you go, a bag of stuff

The attached 2 resources should give you enough information to be able to advocate for yourself. The booklet has a symptom checker you can use to tick off all you’re experiencing and it also contains information about HRT. The Nice Menopause guidelines endorse shared decision-making with your doctor.

https://menopausesupport.co.uk/wp-content/uploads/2025/07/Menopause-Support-Booklet-V2.pdf

https://thebms.org.uk/publications/nice-guideline/

I made a mistake and the first time I didn’t book with a specialist. She didn’t got eme HRT! Offered me clonidine and antidepressants- completely against nice guidelines. Fast forward 18 months I asked if there was a specialist. She apoligised Ask to see the menopause specialist gp.

write down the last few cycles you have had.
decided what type of oestrogen - it should be transdermal patch or gel. Research it. I used chat gpt. I was prescribed a patch and it femseven (this was better than the one I found as that need to be change twice a week) and decide why typ of progesterone you think
is be best for you. I wrote the main list of symptoms (sleep/ anxiety/hot sweats/ aching hips/ ) and minor one (tinitus, aching hips) and so on. There is a good list in the menopause matters booklet about preparing for you appointments. Progesterone should be body identical micronised (utrogestan)

menopause matters is great.

edit: menopause support not matters

'Just to say, don’t rule out male doctors!'

Absolutely. It's just pure sexism to expect that male healthcare professionals will be shit and clueless, and female professionals will be clued up and caring. My current GP is female and fantastic - follows the guidance, very caring, treats me like a grown independent adult. My previous GP was also a woman, and was utter shit

Of course, the larger point is that women should be able to expect evidence based care from all HCPs, regardless of sex!

Embrace HRT as your new best friend.its the fountain of youth. The doctor might hum and ha, but the benefits so far outweigh any down side.
I've been on it for 28 years now.....believe me I'm fabulous.

Absolutely the same experience , I’m also 47 and I believe over 45 they just hand it out lol. I did have to have a routine blood test first though .
4 months in, it’s been life changing , my hot flushes went almost immediately

Mine asked me to do a meno scale score, might be worth doing before you go.

https://zoe.com/menoscale?srsltid=AfmBOoqzYbJGNIzNh4FoXcaBuh51UGxLAYYjpLkZpNyYQ2CUGOhXWTgK&lead_id=fbe876d9-2311-4a94-8364-b1d2a15bf05f

Just be very clear. I knew I wanted gel and progesterone tablets and initially they tried to fob me off with Kliovance because it was cheaper. Read up NICE guidelines and don’t agree to blood tests as they’re not at all accurate.

Don’t forget vaginal oestrogen

Can I just say, as an HCP, we’re not here to gatekeep HRT. But we do need a concise summary of your symptoms, how they are affecting you and what your expectations are.

We have limited time to consult, take a history, assess and examine you if needed (eg weight and BP), agree a shared plan of care and explain the pros and cons as well as how to use it. If you’ve done your homework it’s massively helpful. Remember not everything is caused by menopause. Some symptoms are just life and HRT is not a magic bullet. But most of us are open to discussion, trial and review. NICE guidelines are guidelines not mandate, and sometimes SSRIs/SNRIs are more appropriate, or HRT is contraindicated. We are also limited sometimes by our ICBs prescribing formulary, and cannot prescribe certain things.

Thanks all. This has been really useful and some good resources signposted. I’m very grateful!

Just be prepared to be offered hrt on the first appointment ( you are over 45) so just have an idea what type you want.

My older sister and friend both told me to go in and say I am here for HRT and let me tell you why I want it. Then have a printed list of your symptoms plus a copy of the NICE guidelines. Be prepared to advocate for yourself.

I did have to have a blood test but that was to rule out any thyroid issues not hormone tests. I did not have night sweats and my periods were still regular. I had a lot of other symptoms though and I did say X was the reason I pulled the trigger on coming in because of the impact on my day to day life.

My sister was fobbed off with antidepressants. She had a coil so hadn't had a period in 10 years. She was very firm on what I should say going in. Best of luck to you. I have been on HRT for 5 months and feel a million times better.

How do you know which type of HRT you should have?

Just say your symptoms and that you’ve been doing some reading and would like to try HRT.
have a think about what sort would suit you - Paris, gel, coil etc.
its a 10, maybe 15 min appointment if you’re lucky so get to the point and just say what you want and ask the questions you need to ask.

So having done some reading I think a complicating factor is that I am still on microgynon - my DM had her last child at 48 😱 as did her mother! - and I’m really reluctant to come off it BUT you can’t take it with HRT because it’s synthetic estrogen.

So that’s annoying! Although apparently the combined pill can help with peri symptoms so if I wasn’t on it I’d be losing my mind 🙈