1 · Safety screening
Select all that apply — contraindications and cautions
Contraindications
✓
Active / recent breast cancer
✓
Undiagnosed vaginal bleeding
✓
Active severe liver disease
✓
Active / recent VTE
✓
Known thrombophilia
✓
Active endometrial cancer
✓
Pregnancy
✓
Uncontrolled hypertension
Cautions — inform route/product choice
✓
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
2 · Clinical context
3 · Symptoms present
✓
Vasomotor — hot flushes, night sweats
✓
Mood / anxiety / brain fog
✓
Genitourinary — dryness, dyspareunia, UTIs
✓
Low libido / fatigue
May indicate TRT consideration
✓
Sleep disturbance
✓
Joint / muscle pain
4 · Route preference
Guideline reference only. Based on NICE NG23 (April 2026), BMS 2024/2026, RCOG, and FSRH/CoSRH. All clinical decisions remain with the responsible clinician. © 2026 SynaptAI Limited.
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