Hormone Therapy Management
Guidance on managing side effects and monitoring patients receiving hormone therapy.
Key Recommendations
Side Effects Management (1.4.1)
Offer people having hormone therapy advice on managing these common side effects:
- • Hot flushes
- • Sexual dysfunction
- • Fatigue
- • Osteoporosis
Osteoporosis Risk Assessment (1.4.2)
Follow the recommendations in the NICE guideline on osteoporosis: assessing the risk of fragility fracture when assessing the risk of fragility fracture in people having hormone therapy.
Prescribing Guidance (1.4.3)
Follow the recommendations in NICE's guidance on prescribing medicines when prescribing medicines for the side effects of hormone therapy.
Managing Common Side Effects
Hot Flushes
Sudden episodes of flushing and sweating
Management: Counseling on triggers, consider pharmacological options
Sexual Dysfunction
Erectile dysfunction and reduced libido
Management: Psychosexual support, consider PDE5 inhibitors
Fatigue
Persistent tiredness and reduced energy
Management: Lifestyle modifications, exercise programs
Osteoporosis
Reduced bone density and fracture risk
Management: DEXA scans, calcium/vitamin D, consider bisphosphonates
GP Role in Hormone Therapy Management
As a GP, your role includes:
- • Monitoring: Regular review of side effects and treatment tolerance
- • Support: Provide counseling and reassurance about common side effects
- • Osteoporosis Screening: Arrange DEXA scans as indicated by risk assessment
- • Medication Management: Prescribe supportive medications for side effects (e.g., PDE5 inhibitors, bisphosphonates)
- • Liaison: Maintain communication with specialist services regarding treatment changes
- • Psychosexual Support: Offer or refer for specialized psychosexual counseling when needed
Important: Hormone therapy side effects can significantly impact quality of life. Early identification and management improve patient satisfaction and treatment adherence.
Osteoporosis Prevention
Key Actions for GPs
- • Assess baseline fracture risk using NICE osteoporosis guidance
- • Recommend calcium intake (1000-1200 mg/day) and vitamin D supplementation
- • Encourage weight-bearing exercise and muscle strengthening
- • Consider DEXA scanning for patients at high risk
- • Prescribe bisphosphonates if indicated (e.g., alendronate)
- • Monitor for medication side effects (e.g., GI upset from bisphosphonates)