I have been on menopause hormone therapy

Keep taking your HRT exactly as prescribed until the Wednesday review — do not taper it, skip a dose, or stop it on your own in the meantime — and take the list below into that appointment.

This is a preparation guide for a planned review, not a diagnosis, and it changes no medicine.

1. What you have already tried, and the better version

Stopping suddenly on a bad day. That is the one approach worth replacing. NHS (UK) public guidance, checked 21 Oct 2026, says you *can* stop HRT suddenly, but that it is usually recommended to reduce the dose gradually over about 3 to 6 months, and that symptoms coming back for a short time is less likely if the dose is reduced gradually. A bad-day stop also means nobody was watching whether the flare settled.

Better, in three moves:

• Decide with the prescriber, on a planned date, not on a bad day. The same page says there is no fixed limit on how long you can take HRT, that you will usually have a review every year, and that it is best to take it for as long as the benefits outweigh the risks — which depends on your symptoms, your age and your own risk factors. So the Wednesday question is not "is it Wednesday's turn to stop?" It is: *for my own history, do the benefits still outweigh the risks right now?*
• Two weeks of a 5-minute log before Wednesday (see the printable sheet): hot flushes and night sweats, sleep, mood, the bleeding pattern you were told to expect, breast tenderness, headache or dizziness. It turns "it works well" into something a clinician can weigh, and it gives you a baseline to compare against if you do taper later.
• One bag, one trip: every box — HRT, the blood-pressure tablet, the 6:30 thyroid tablet, any antibiotic you were given, plus every supplement, herb or powder already in the house. Supplements count as medicines here.

What tends to change when you stop (same NHS page): symptoms may come back for a while; this is less likely if the dose is reduced gradually; and if symptoms come back and do not settle after about 3 months, speak to the prescriber, who may suggest other treatments or restarting a low dose. Two things to ask about *before* you decide: the type matters (NHS notes vaginal oestrogen does not carry the same risks as other HRT types, and if you are continuing or starting over 60, a prescriber may suggest a low dose and patches or gel rather than tablets), and the same page notes that if your symptoms return when you try stopping and the benefits still outweigh the risks for you, you can keep taking it for longer — that is a legitimate answer, not a failure.

2. Constraints and the avoid list

Do

• Keep every other medicine exactly as prescribed — the blood-pressure tablet, the 6:30 thyroid tablet, any antibiotic course. This one decision changes nothing else.
• Let the prescriber write the taper: how much less, how long between steps, what symptoms mean "pause here", and the date you review it together. Ask for it in writing.
• Choose a start date that is not a bad week — not the week of the school run or a relative staying over.
• Keep the home supports that cost little: a cooler bedroom and layered clothes ready at the bedside (one basket, one minute), a glass of water by the bed for night sweats, the calcium-and-vitamin-D foods you already buy (dairy, tinned oily fish, greens, fortified milk — bone protection matters most if you come off), and 10–15 minutes of walking on most days as your body allows. These are comfort and bone habits, not a treatment for the flushes, and none of them needs a new purchase.

Avoid

• Self-tapering, skipping then doubling doses, or changing the day you take the HRT.
• A herbal or "natural hormone" powder, a menopause supplement, a sleep powder, or a weight-loss product started now — you cannot referee interactions at home, and it will also muddy the Wednesday picture.
• Buying HRT, thyroid tablets or anything prescription-only online, or using a neighbour's, a leftover box, or someone else's patch.
• Any home blood-pressure reading turned into an extra tablet or a skipped one.

Decision tree (screenshot this)

1. Red flags right now? → emergency, below.
2. Do the symptoms still matter to you, and does your own history (blood pressure, thyroid tablet, family history of breast/ovarian/uterine cancer, any clot or stroke, whether you still have a womb) still favour continuing? → Yes: stay on the same prescribed dose, book the next yearly review, and ask when BP, cholesterol, blood sugar and any breast screening should be rechecked. → No, or you want to try coming off: ask for a written gradual plan, a start date, and a 3-month review; keep taking as prescribed until that plan starts.
3. Symptoms come back and do not settle in about 3 months? → back to the prescriber: other treatments, or a low-dose restart, decided together.
4. Which type? → ask whether a patch, gel, tablet or vaginal option suits your risk profile better.

3. Red flags — when to stop the DIY and get help

Call your local emergency number now, or go to the emergency department:

• chest pain or pressure, or pain spreading to your arm, jaw or back
• sudden breathlessness, or one leg that is painful, swollen or hot
• sudden weakness or numbness on one side, or slurred or confused speech
• a sudden worst-ever headache
• heavy bleeding, or fainting

Call the clinic the same day — do not wait for the review:

• any bleeding that is not the bleeding you were told to expect
• a new breast lump, or a change in one breast
• a bad headache that builds over hours, or blurring of vision
• one-sided calf swelling
• low mood or anxiety worse than your usual, or thoughts of harming yourself

And on the home cuff: a high reading on its own is not an extra tablet and not a reason to skip the prescribed one. But a high reading together with severe headache, confusion, chest pain, breathlessness or vision change is the emergency line above.

4. Scripts to screenshot

To her: "Nothing about your tablets changes before Wednesday. We are only taking the list — and if a hot flush ruins a night, there is the cooler bedroom and the water by the bed."

To the prescriber (30 seconds): "She has been on HRT about a year and it works well. Given her blood-pressure tablet, her thyroid tablet and her family history, do the benefits still outweigh the risks for her? And if we taper, what is the written plan and when do we review it?"

To a relative or elder helping this week: "The decision is hers and her doctor's. Our job this week is the school run and Thursday's list. If she mentions chest pain, sudden breathlessness, one-sided weakness or heavy bleeding, that is an emergency — call, do not wait."

5. What success looks like in 24 hours (no cure promised)

• The bag is packed: every box, the one-page log, the questions list.
• Wednesday's appointment is confirmed, and the plan in the meantime is "continue as prescribed".
• Two nights with a cooler bedroom and water within reach.
• The school week and the nearby elder are covered, and the handover was said out loud, not assumed.
• No dose changed, nothing bought online, no new powder started.

I have put the log grid, the questions and the scripts on one printable page you can screenshot or print: hrt-stay-or-taper-review-2026-10-21-bc84fb18.pdf

Which country or city are you in? I can point you to the exact review service and to what local guidance says for your area — the page I used is UK guidance, and your own prescriber may work differently locally.