HealthRX.com · Printable question sheet
Planning HRT alongside a GLP-1: appointment sheet
Note your menopause timing, whether you have a uterus, your symptoms and your clot and cancer history, track the first 12 weeks of both treatments, and take the questions about timing, route and progestogen choice to the appointment.
About you
Date of your last period, or age at menopause
Uterus: yes, or hysterectomy (year)
Main symptoms and how oftenhot flashes, night sweats, sleep, vaginal dryness, mood
Personal or family history of blood clots, breast cancer, heart attack or stroke
GLP-1 medicine and dose, now or planned
Bring to the appointment
- A list of every medicine and supplement, marking any hormone taken by mouth
- Recent blood pressure readings
- Latest lipid panel, HbA1c and liver tests
- Date of your last mammogram
- Bone density result, if you have had one
First 12 weeks on both treatments
Starting one treatment a few weeks before the other makes this log easier to read.
| Week | HRT dose and route | GLP-1 dose | Hot flashes per day | Sleep: good, fair, poor | Nausea | Bleeding or spotting |
|---|---|---|---|---|---|---|
What the trials and the Wegovy label show
- WHI, estrogen plus progestin: 12 more adverse events per 10,000 women a year at ages 50 to 59, rising to 38 more at ages 70 to 79.[1]
- WHI, estrogen alone after hysterectomy: 19 fewer events per 10,000 women a year at ages 50 to 59, but 51 more at ages 70 to 79.[1]
- WHI, estrogen alone: invasive breast cancer was not increased during treatment (hazard ratio 0.79, 95% CI 0.61 to 1.02).[1]
- The WHI authors concluded hormone therapy is not for preventing chronic disease but is appropriate for symptom relief in some women.[1]
- ESTHER: oral estrogen was linked to higher clot odds (odds ratio 4.2); transdermal estrogen was not (0.9).[2]
- Wegovy delays stomach emptying, which may affect how medicines taken by mouth are absorbed; its label says to monitor their effects.[3]
Questions for the prescriber
- Given my age and years since menopause, how does the timing of starting HRT change my risks?
- Would a patch, gel or spray suit me better than a tablet while I take a GLP-1?
- If I have a uterus, which progestogen and schedule do you recommend, and why that one?
- Should I start HRT or the GLP-1 first, and how far apart?
- How will we tell GLP-1 nausea apart from hormone side effects?
- When will we review whether I still need HRT, and at what dose?
Sources for the facts on this sheet
- Manson JE, Chlebowski RT, Stefanick ML, Aragaki AK, Rossouw JE, Prentice RL, Anderson G, Howard BV, Thomson CA, LaCroix AZ, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. JAMA 2013. PMID 24084921. https://pubmed.ncbi.nlm.nih.gov/24084921/
- Canonico M, Oger E, Plu-Bureau G, Conard J, Meyer G, Lévesque H, Trillot N, Barrellier MT, Wahl D, Emmerich J, et al. Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation 2007. PMID 17309934. https://pubmed.ncbi.nlm.nih.gov/17309934/
- Novo Nordisk, via DailyMed. Wegovy (semaglutide) injection, for subcutaneous use, and Wegovy (semaglutide) tablets, for oral use: prescribing information and Medication Guide. Effective 2026-06-18. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.