About Your Health
To help us understand that this treatment is the right option for you, please answer the following questions. If you get stuck or need any help, you can contact us.
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Have you suffered any negative effects as a result of consuming Indivina?
For which duration have you used Livial Tablet?
Who gave you the Livial Tablet first?
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Is Novofem something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Novofem?
For which duration have you used Novofem?
Who gave you the Novofem first?
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Is Oestrogel something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Oestrogel?
For which duration have you used Oestrogel?
Who gave you the Oestrogel first?
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Is Premarin 0.65mg Tablet something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Premarin Tablet ?
Have you suffered any negative effects as a result of consuming Livial Tablet?
Is Livial Tablet something you are using right now?
if so, have you noticed any improvements on your symptoms?
Who gave you the Lenzetto first?
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For which duration have you used Indivina?
Who gave you the Indivina first?
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Have twelve months already lapsed since you experienced your last period?
For which duration have you used Kliofem Tablet?
Who gave you the Kliofem Tablet first?
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Is Kliovance Tablet something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Kliovance Tablet?
For which duration have you used Kliovance Tablet?
Who gave you the KliovanceTablet first?
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Is Lenzetto something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Lenzetto?
For which duration have you used Lenzetto?
For which duration have you used Premarin Tablet ?
Who gave you the Premarin Tablet first?
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Who gave you the Trisequens?
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Are you using any ostrogen at the moment?
If you are, please indicate which one (this may be an oral tablet, a gel, or a patch).
Is Utrogestan something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Utrogestan?
If so, kindly describe the symptoms you have suffered.
For which duration have you used Utrogestan ?
Who gave you the Utrogestan?
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Is Utrogestan your preferred contraceptive?
Have you placed a Mirena coil in right now?
Do you experience any of the following?
You are under medication or receiving supplements
Is Zumenon something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Zumenon?
If so, kindly describe the symptoms you have suffered.
For which duration have you used Zumenon ?
For which duration have you used Trisequens ?
Have you suffered any negative effects as a result of consuming Trisequens?
If so, kindly describe the symptoms you have suffered.
Is Trisequens something you are using right now?
if so, have you noticed any improvements on your symptoms?
Is Premique Low Dose Tablets something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Premique Low Dose Tablets ?
If so, kindly describe the symptoms you have suffered.
For which duration have you used Premique Low Dose Tablets ?
Who gave you the Premique Low Dose Tablets?
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Is Progynova Tablet something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Progynova Tablet ?
If so, kindly describe the symptoms you have suffered.
For which duration have you used Progynova Tablet ?
Who gave you the Progynova Tablet?
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Is Sandrena Gel something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Sandrena Gel ?
If so, kindly describe the symptoms you have suffered.
For which duration have you used Sandrena Gel ?
Who gave you the Sandrena Gel?
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Who gave you the Zumenon?
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Is Indivina something you are using right now?
if so, have you noticed any improvements on your symptoms?
Is menopause something you are experiencing at the moment?
Are you aware of and agree with the following:
Breast cancer risk is enhanced when combined HRT is used.
Did you know that that HRT products for gender transformation are not available from us?
Gender reassignment is a difficult procedure that requires a face-to-face consultation with a doctor and cannot be ordered over the internet.
Are you aware that:
You should use the smallest dose of HRT possible for the shortest duration possible.
Is Elleste Duet 2mg tablet something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Elleste Duet?
For which duration have you used Elleste Duet?
Who gave you the Elleste Duet 2mg tablets first?
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Do you have a history of using any other HRT treatments?
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Have six months already lapsed since you experienced your last period?
Are you on any of the following medication?
Antibiotics.
Did you know that once you suffer any of the following symptoms, you should stop taking HRT and consult a doctor:
Skin discoloration or yellowing of the whites of your eyes (jaundice).
Can you relate to any of the following statements?
You have or have had stomach or duodenal ulcers, as well as stomach or intestinal bleeding in the past.
Do you or anyone in your family have a history of having:
Clots in the blood
Have you been experiencing any of the following symptoms?
Vaginal bleeding that is abnormal.
If you know your blood pressure, do you frequent your doctor to have it checked and monitord?
Do you recall the first time you experienced menopause symptoms?
How long has it been since you had your last period?
Have you had your uterus removed?
If not, do you consume a progestogen (kindly specify)? This could be a Mirena coil or an oral tablet like norethisterone.
Kindly identify the symptoms that you are experiencing or would experience if you did not take HRT:
You can choose more than one option
Do you know of any reason why you shouldn't use HRT, or have you been previously prevented from using it by your doctor?
Do you consent to the following routine checks:
Check your blood pressure and take a blood test.
Do you remember the last time you had a gynecological exam or a cervical smear test?
Do you remember the last time you had a mammogram or a breast examination?
Do you remember the last time your blood pressure was checked by your doctor?
Do you smoke?
If you do, please write how many cigarettes you smoke per day. Or, if you vape, please tell us about this.
Please share your Height (cm) and Weight (Kg)
Height should be above 1 ft 10 inches
Do you know if your blood pressure is Low, Normal or High? Please write LOW, NORMAL or HIGH
Use the following as a guide:Low = Under 90/60Normal = Between 90/60 and 140/90High = Over 140/90
What is your biological gender?
Please select your option
If female or transmale, are you currently pregnant, breastfeeding or planning to do so?
Please select your option
Who gave you the first Evorel patch?
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Have eighteen months already lapsed since you experienced your last period?
Is Evorel Sequi something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Evorel Sequi?
Who gave you the first Evorel Sequi patch?
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Is FemSeven something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming FemSeven ?
For which duration have you used FemSeven ?
Who gave you the first FemSeven ?
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Is Femoston something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Femoston?
For which duration have you used Femoston?
For which duration have you used Evorel?
Have you suffered any negative effects as a result of consuming Evorel?
Is Evorel something you are using right now?
if so, have you noticed any improvements on your symptoms?
Are you currently receiving any treatment or under any medication?
Please provide more information of the medication being used if any.
Can you relate to any of the following?
You have an underlying medical condition
Can we share this information with your General practitioner?
Providing us with your physician's address means that you allow us to share this information with him/her for updated medical records if need be. It also allows our clinician to access your medical records if there is a need for that. We advise you share this treatment with your doctor for him/her to update your medical records.
Is Elleste Solo tablet something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Elleste Solo?
For which duration have you used Elleste Solo?
Who gave you the Elleste Solo tablets first?
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Is Estradot something you are using right now?
if so, have you noticed any improvements on your symptoms?
Have you suffered any negative effects as a result of consuming Estradot?
For which duration have you used Estradot?
Who gave you Estradot first?
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Did you know that:
A healthcare practitioner should assess any acute injuries.
Who gave you the Femoston first?
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