Menopause and HRT in Primary Care: 2026 Guidelines for Effective Clinical Management

Menopause in primary care can feel complex—but the right framework makes diagnosis and HRT prescribing much easier. In this detailed A4Medicine session, we simplify the NICE NG23 approach to menopause identification and management for UK primary care. You will learn: How to diagnose perimenopause and menopause clinically When FSH testing is appropriate How to recognise early menopause and premature ovarian insufficiency The physiology behind hot flushes, sleep disturbance and genitourinary symptoms When to use systemic HRT, vaginal oestrogen and menopause-specific CBT How to choose combined or oestrogen-only HRT Sequential versus continuous combined HRT explained Why transdermal HRT is preferred when VTE risk is increased How to discuss breast, endometrial, ovarian and cardiovascular risks Management of unscheduled bleeding and HRT follow-up When to stop HRT or seek specialist advice This video is designed for GP trainees, GPs, ANPs, pharmacists and other UK primary care clinicians, including those preparing for the RCGP AKT. The session also features the A4Medicine book Metabolic Problems & Endocrinology, an evidence-based revision and everyday primary care guide covering diabetes, thyroid, bone, adrenal and lipid disorders. Key message: Menopause care should be clinical, symptom-led, individualised, safely prescribed and regularly reviewed. This video is for medical education and should be used alongside current NICE guidance, local prescribing pathways and individual clinical assessment. #Menopause #HRT #PrimaryCare #NICEGuidelines #NG23 #GPTraining #GPtrainee #AKTRevision #WomensHealth #A4Medicine #MenopauseManagement