Q & As from Dr Nick Panay, Founder and Director of Hormone Health

Q1: Is it possible to confuse menopause symptoms with Coronavirus symptoms?

A: Hot flushes, sweats, aches and pains and tiredness induced by the menopause could be similar to Coronavirus symptoms, but the menopause does not usually raise body temperature to 38 degree C or above.

Q2: Are women more or less vulnerable to Coronavirus infection?

A: The incidence of infection appears to be similar in women and men. However, there is good evidence that survival rates are much higher in women compared to men.

Q3: Why do more women recover from Coronavirus infection than men?

A: The reason for this appears to be multifactorial. One of the main reasons appears to be that men suffer with more heart and lung disease compared to women. This is partly due to smoking and partly due to the protective effects of estrogen on the female cardiovascular system. This may make men more vulnerable to the effects of the virus. However, there is also increasing evidence that women’s immune systems are enhanced by the presence of estrogen. Even in menopause, without HRT, some estrogen is produced by androgenic hormones from the ovaries and the adrenals.

Q4: Does HRT provide some protection against the Coronavirus?

A: The answer to this question is still unknown, but given the information in Q.3 it would not be surprising if this was the case. It is planned to perform research into this area over the next few months to compare users to non-users of HRT in natural and surgical menopause.

Q5: If I am admitted to hospital with Coronavirus related issues do I have to stop my HRT?

A: As long as your estrogen is being delivered through the skin (patch or gel) there is no need to modify or stop your HRT. Patients on oral estrogen may need to be switched to a patch or gel to avoid the risk of thrombosis in case of long term immobilisation.

Q6: Can I still have a consultation about menopause and other hormone health issues even if I am self-isolating?

A: The Hormone Health Associates are still providing virtual consultations to new and pre-existing patients. Consultations are being conducted using a safe Virtual Private Network (VPN) from home which gives the Associates access to patient’s records. Patient confidentiality, which is of paramount importance, is maintained using this system. It is also planned to introduce Skype or Zoom video consultations once GDPR (General Data Protection Rules) have been assured.

Q7: Is there someone I can talk to if I have a Hormone Health related problem or query?

A: Hormone Health administrators and nursing support are available for immediate discussion either operating from a call centre or on site from 92 Harley Street depending on staff availability . Any medical queries which cannot be immediately answered will be passed on to an Associate for a response, usually on the same day. Please call +44 (0)808 196 1901

Q8: What should I do if I need a new / repeat prescription?

A: The Hormone Health Associates can arrange for medications to be delivered to patients’ chosen address through collaboration with our pharmacy partners Pharmaciege and Madesil. Alternatively, prescriptions can be sent to your chosen address for collection locally.

Q9: What is happening with blood tests and scans?

A: Unless the test is deemed to be urgent by the Hormone Health Associate, these are being deferred until the self-isolation rules have been relaxed and when the risks of Coronavirus infection have significantly reduced. If a blood test is required urgently, this can be performed at The Doctor’s Laboratory. If an ultrasound scan is required urgently, this can be performed by Prof Tom Bourne and his team in London (020 7636 6765.) It is highly unlikely that a bone density scan or a routine smear test can be justified at this time.

Q10: What if I have bleeding problems with my HRT or Contraception?

A: Bleeding problems on HRT or contraception are not an infrequent problem. If this happens the problem can usually be solved by altering the hormonal regimen e.g. by using more progesterone/less estrogen. An ultrasound scan may be required to look for polyps/fibroids and other causes of bleeding but this can usually be deferred by 3-6 months. Your Hormone Health Associate can advise you as to the urgency of the scan and make arrangements for this to be done in the unlikely event of it being urgent. For more information please see BMS statement released on 31st March.

Q11: What can I do to mitigate the risks of Coronavirus?

A: As per Public Health England (https://www.gov.uk/government/organisations/public-health-england ) advice it is of paramount importance to maintain good self-hygiene (frequent hand washing) and social distancing (2 metres). In addition to this, maintaining a well -balanced diet, regular exercise, minimising alcohol and not smoking are the cornerstones to maintaining a healthy immune system. This will not guarantee prevention of the infection, but it will ensure that we are in the best position to fight the infection if it does occur, to try to mitigate the impact.

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