1Safety screening
ContraindicationsHRT not advised while present0 ticked
✓
Active / recent breast cancer
✓
Undiagnosed vaginal bleeding
✓
Active severe liver disease
✓
Active / recent VTE
✓
Known thrombophilia
✓
Active endometrial cancer
✓
Pregnancy
✓
Uncontrolled hypertension
CautionsHRT possible: adjust route or seek specialist input0 ticked
✓
Personal history of breast cancer
Relative contraindication — specialist input
✓
Previous VTE
Transdermal strongly preferred
✓
BMI >30
Transdermal preferred
✓
Migraine with aura
Transdermal strongly preferred
✓
Cardiovascular disease
Not a contraindication — transdermal preferred
✓
Stroke / TIA history
Transdermal strongly preferred
✓
Uterine fibroids
✓
History of endometriosis
2Clinical context
3Symptoms present
✓
Vasomotor — hot flushes, night sweats
✓
Mood / anxiety / brain fog
✓
Genitourinary — dryness, dyspareunia, UTIs
✓
Low libido / fatigue
See Testosterone tab for TRT guidance
✓
Sleep disturbance
✓
Joint / muscle pain
4Oestrogen
Guideline reference only. NICE NG23 · BMS 2024/2026 · RCOG. All decisions remain with the responsible clinician. © 2026 SynaptAI Limited.
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