We have compiled a list of frequently asked questions to help you prepare for your Hormone Health consultation or screening, and to provide some initial answers regarding your treatment and medication.

What should I bring to my consultation?

Any pertinent medical records/letters or recent blood test results would be useful along with any symptom diary that you may have been recording. If possible, please download and complete our symptom diary (PDF, 149KB).

What will happen in my consultation?

Mr Panay or one of his Associates will take a detailed medical history and discuss any further management required with you. This may include blood tests or scans. They may not prescribe at the first appointment.

We will also keep informed your GP and any other consultants that you may be under the care of (if you agree to this).

Who are Mr Panay’s Associates?

They are doctors with a special interest in hormone health. Each has a variety of backgrounds including gynaecology, general practice and sexual health. They have all been trained under Mr Panay’s supervision and  have further qualifications in menopause management.

Please see About Us for further information about individual doctors.

Please note, the associates are only able to see self-funding patients as private health insurance policies do not cover.

Will my treatments be covered by my health insurance?

Please note private health insurance provides limited cover. BUPA, BUPA International and AXA do not cover consultations with Nick Panay or the Hormone Health associates. Other companies may cover consultations with Mr Panay only. Please check with your insurer.

What sort of scan might I need?

The commonest scans are ultrasound scans and DEXA Bone Density scans (see Our Services).

Once I start HRT, how long will it be until I see an improvement in my symptoms?

There is no predictable timescale but it can certainly take at least 6 weeks for hormone levels to settle and symptoms to improve, it can take up to 3 months which is why we ask to see you every 3 months until things start to settle down.

We also ask that you have blood tests prior to being seen at follow up consultations, this is so that we can see how your levels are on the medication you have been prescribed as this may need to be adjusted at your consultation.

Where should I apply the various medications?

We ask you to apply the Estrogen patches or gel to the abdomen, buttock or thigh, moving the site of application from one side to the other each time to minimise skin irritation.

Testosterone gel should be applied to the lower abdomen.

Progesterone tablets can either be taken orally or used vaginally as a pessary.

What side effects should I expect?

This depends on what you have been prescribed but the most common side effects are listed below:

Estrogen: bloating, breast tenderness or swelling, nausea, headaches.

Progesterone: weight gain, fluid retention and swelling (oedema), fatigue, acne, drowsiness or insomnia, breast discomfort or enlargement, premenstrual syndrome (PMS)-like symptoms.

Testosterone: Acne or oily skin, Mild fluid retention, increased hair growth at the site of application.

How can I reduce any side effects?

Dr Panay and his team will try and achieve the best hormone balance possible which may mean altering the doses/timings of elements of your treatments. Progesterone seems to be the most common cause of unwanted side effects but for instance, using the tablets as a vaginal pessary instead of taking orally, can reduce the side effects significantly.

Can you explain the difference between Sequential HRT and Continuous Combined?

Sequential HRT mimics the natural cycle with continuous estrogen and sequential progesterone i.e. only for part of the month. The length of time progesterone is used varies between individuals but is usually for anything from one to two weeks of the cycle.

Continuous Combined HRT is just that: both estrogen and progesterone taken together every day of the cycle, continuously.

How much notice is necessary for a repeat prescription?

You should allow 3 working days.