GP referral before treatment
GP referral before treatment
There are some situations when a patient should be referred to their GP before treatment, in order to help them assess their risk and to confirm suitability. However, if they have been using local oestrogen therapy and their health status hasn’t changed, this risk will have been assessed previously by their GP.
If you do refer them to the GP, explain why and that they can return to the pharmacy for supply, if suitability is confirmed by their GP.
Click on each card to find out more about when to refer.1
Women who have a history of endometriosis, unless they have:
- previously been prescribed a local oestrogen therapy and there have been no changes to their health status since their last prescription, and
- no recent symptoms of endometriosis
Unopposed oestrogen stimulation could lead to a recurrence of endometriosis.
Women who are receiving hormonal therapy, including systemic HRT, unless they have previously been prescribed a local oestrogen therapy for concurrent use and their health status has not changed since their last prescription
Concurrent use of hormonal therapy, including systemic HRT, increases women’s exposure of oestrogen, and therefore its associated risks.
Women who have a history of endometrial hyperplasia, unless they have:
- previously been prescribed a local oestrogen therapy and there have been no changes to their health status since their last prescription, or
- they have had a hysterectomy
In women with an intact uterus, the risk of endometrial hyperplasia is increased when oestrogens are administered alone for prolonged periods.
This is because endometrial hyperplasia is sensitive to oestrogen.
Women who are currently using another local oestrogen therapy, unless they have been using their current local oestrogen therapy for more than 3 months at the recommended dose, and their symptoms are adequately controlled and their health status has not changed since their last prescription
Gina should not be supplied unless women have used their current local oestrogen therapy for at least 3 months and have experienced benefit.
If their symptoms are not adequately controlled by 3 months, these women should be referred to their GP as switching to Gina is unlikely to offer more benefit. They should see their GP to confirm a VA diagnosis.