How to Get a Second Opinion on Your HRT Without Changing GP

You can get a second opinion on your HRT without changing GP, and you do not need anyone's permission or a referral to do it. A private prescriber can review your HRT in parallel while your own GP stays exactly where she is. Nothing about seeing a private prescriber removes you from your practice list or affects your NHS care. Many women assume otherwise, which is the main reason they never ask.

This matters most for a particular situation: you are on HRT, the worst of the sweats have settled, and the energy, the sleep or the libido have not. You have been told the dose is fine, or that this is just your age. You are not asking to start again. You are asking somebody to look properly at what you are already taking.

Why a review is often the whole answer

HRT is not one prescription. It is a type, a dose, a route into the body and sometimes a second hormone, and the first combination anybody is given is a starting point rather than a conclusion. Several things commonly go unadjusted.

• •The dose was never titrated upward after the first prescription, because nobody reviewed it.
• •The route does not suit you. Absorption through the skin varies between women, and a patch, a gel and a spray are not interchangeable in practice.
• •The progestogen is the part causing the trouble, not the oestrogen, and there is more than one option.
• •Testosterone has never been discussed, which matters if low libido is the symptom that has not shifted.
• •The symptom being blamed on menopause is something else, which is exactly what a proper review is for.

What a parallel private review actually involves

• •A consultation with a prescriber who has time to take a full history: what you take now, at what dose, since when, what improved and what did not.
• •A recommendation you can act on, either as a private prescription or as a written summary to take to your own GP.
• •Blood tests where they are needed, which for HRT is less often than people expect, and more often once testosterone is involved.
• •A follow-up. A review that does not check back is not a review, because the whole point is the adjustment.

You can keep your GP and still do this

Two arrangements are common, and both are ordinary.

• •Private assessment, NHS continuation. A private prescriber assesses you and writes to your GP, who then continues the prescription on the NHS. Whether your GP takes it on is her decision, and it is more likely when the recommendation is clear and written down.
• •Private throughout. The private service prescribes and a registered pharmacy dispenses to you, while your GP continues to look after everything else. You should tell your GP what you are taking, and a good private service will write to her.

What to ask for, in plain words

If you want your own GP to have another look first, which costs nothing and is worth trying, ask for a medication review specifically about your HRT, and say what has not improved rather than that it is not working. Ask whether the dose can be increased, whether a different route would absorb better for you, and whether testosterone has been considered. Ask for the answer to be recorded. Our guide on how to talk to your GP about menopause goes through this in more detail.

How Solene fits

A 45-minute review with a named independent nurse prescriber, by video, with no referral. She goes through what you are already on and what has not changed, adjusts it where it should be adjusted, and keeps reviewing until you feel well. Your GP stays your GP.

We publish our prices in full rather than quoting on enquiry. They are all on our treatment plans page.