If no write: NO. If yes, please state the name and dose of these medications.
E.g. change in personal or family history
It is really important to try and get a home reading as this will help speed up the process. If no reading is given you will need to attend the practice to have your blood pressure taken.
Please note those aged 25 to 49 should have a smear test every 3 years. For those aged 50 to 64 it is every 5 years. While those over 65 will only need one if 1 of your last 3 tests was abnormal.
Please note that if your mental health is currently significantly impact and you are concerned for your well-being you must contact the crisis team on 0300 200 0011 and select option 1 or 999.
If you are struggling with your mental health please contact the practice or if out of hours or in an emergency call the CRISIS team: 0300 200 0011 and select option 1.
A total hysterectomy is where your uterus and cervix have been removed
If you are no longer having periods or you have a Mirena coil please indicate this here
This might include unusual bleeding in between regular periods, bleeding after sex or bleeding more than 12 months after your last period
Out of 1,000 women taking HRT between the ages of 50-59, there will be an extra 4 cases of breast cancer diagnosed every 5 years. If you use oestrogen only HRT there are 4 fewer cases diagnosed.
A recent study found that for every 1,000 women taking HRT for 5 years, there will be 1 extra case of ovarian cancer
It is thought that the risk of developing a blood clot is 2 to 4 times higher than normal for women taking HRT tablets. But as the risk of menopausal women developing blood clots is usually very low, the overall risk from taking HRT tablets is still small. It is estimated that for every 1,000 women taking HRT tablets for 7.5 years, fewer than 2 will develop a blood clot. Please note that there is no increased risk of blood clots when using HRT patches or gels
The evidence shows that HRT does not significantly increase the risk of cardiovascular disease (including heart disease and strokes) when started before 60 years of age. Oestrogen-only HRT is associated with no, or reduced, risk of heart disease. Combined HRT is associated with little or no increase in the risk of heart disease. Taking oestrogen tablets is associated with a small increase in the risk of stroke, but the risk of stroke for women under age 60 is generally very low, so the overall risk is still small
Your blood pressure should be checked every 12 months whilst you are taking HRT. Please record it here. Blood pressure machines can be bought from pharmacies, online retailers and most supermarkets. If you are not able to check it yourself please arrange an appointment with one of our health care assistants.
If you drink more than 2 units of alcohol each day, out of 1,000 women aged 50-59 there will be an additional 5 cases of breast cancer diagnosed every 5 years.
If you are a current smoker, out of 1,000 women aged 50-59 there will be an additional 3 cases of breast cancer diagnosed every 5 years.
If you are overweight or obese (your BMI is equal or greater than 30) out of 1,000 women aged 50-59 there will be an additional 24 cases of breast cancer diagnosed every 5 years.
If you do at least 2.5 hours of moderate exercise each week, out of 1,000 women aged 50-59 there will be 7 FEWER cases of breast cancer diagnosed every 5 years.
Whilst a Mirena coil offers contraception other methods of HRT do not.
If you would like to change to a different regime we will call you to discuss this further
If so please let us know the date and the outcome