Dr Caoimhe Hartley

We have a hysteroscopy suite.

It's fantastic.

That's great.

Common sense has to prevail a little.

So I think the way we should practice is we look at what evidence base we have.

And that's where the guidelines come from.

Realistically, you look at the patient in front of you and what they want, what their priorities are, their individual risk and benefit, and then a bit of common sense thrown in.

So what that means is that you have a conversation with somebody and tease out why they want to go on HRT, if that's what they're there for.

So specifically, what are their symptoms?

what's bothering them, what's affecting their quality of life.

Look at their own risk factors for things like breast cancer.

Look at their other risk factors for cardiovascular disease.

Look at their bone health.

And you're taking a sort of holistic all round picture of that.

And then it's my job to give them the information.

It's my job to know the guidelines.

But guidelines are just guidelines.

That's all they are.

So they're broadly generalizing, but they're not supposed to be used on an individual basis.

So we would then explain, you know, look, these are the known risks with HRT and they're not all about breast cancer.