Hormone therapy during the COVID-19 outbreak – patient information

Updated October 2020

In light of the ongoing Coronavirus pandemic, NHS services have adapted and most services are now able to provide a more normal service, including regular injections and blood tests in primary care and at GP practices. Our general advice is that your hormonal therapy is continued and maintained as per our recommendations and clinical guidelines. At this stage, we do not expect for there to be much delay or disruption to your treatment. However, if problems arise, we suggest that you ask your GP to contact us or visit our website at the following link:

Visit the GP advice page on this site.

We have also put the following information together for you and other patients under our care.

Q: Why are my hormones not being changed/increased?

A: In the early stage of the pandemic, NHS services were under immense pressure and at that time we were generally not advising on changes to hormone therapies because monitoring blood tests could not be guaranteed. Now that most NHS services are able to provide a more normal service, including regular injections and blood tests in primary care and at GP practices, we are recommending changes to hormone therapy again. If you have any problems or there are queries or concerns, please ask your GP to contact us.

Q: My GP has paused my prescription as they are unable to organise routine monitoring blood tests at the moment.

A: Please ask your GP to see the GIC website and our Coronavirus advice page (link above) which asks them to continue your prescription and organise monitoring blood tests as soon as is possible.

Q: There were abnormalities on my last blood tests.

A: Ask your GP to contact us about the results so we can provide appropriate advice. If there are safety issues relating to hormone therapy then we would expect urgent action in line with our recommendations, which may include repeat blood tests.

Q: I can’t get appointments for the practice nurse to administer my testosterone (Sustanon or Enantate) injections.

A: Please ask your GP or practice nurse to consider teaching you how to self-inject your Sustanon or Testosterone Enanthate injections or to consider switching you over to testosterone gel (GP to follow advice on GIC website, link above).

Q: I can’t get appointments for the practice nurse to administer my Nebido injections.

A: You can be reassured that Nebido is a long-acting testosterone formulation. Therefore, it is unlikely that testosterone levels will drop out of target range if an injection is delayed by a few weeks. However, we do not recommend that the injections are given early. You cannot self-inject Nebido. It must be given by a trained healthcare professional in a healthcare setting. If there are problems accommodating these injections then it is advisable for your GP to switch you over to testosterone gel (see link to GP advice as above).

Q: I can’t get an appointment for my GP practice to administer my Decapeptyl / Zoladex / Prostap injection.

A: It is fine to delay the injections even by several weeks as the effect is long-lasting. If there are repeated delays, or the delay is longer than a few weeks, then you could ask your GP to consider other alternatives which we have outlined on our website (GP to see website advice at link above).

Q: What if my treatment is paused for a long time?

A: This should not occur because most NHS services and GP practices are now able to provide a more normal service. We are advising GPs to continue and maintain your hormone therapy as per our recommendations and clinical guidelines. This is because we know that delays and disruption to hormone therapy may affect your wellbeing and mental health. However, it is important to note that physical harm is unlikely to occur if your hormone therapy is temporarily reduced or stopped. There may be a slight return of characteristics of birth assigned sex but these should revert when hormone therapy resumes. For people who have had genital reconstructive surgery, physical health complications are unlikely unless you are off hormone therapy for more than two years.

Q: What if there are problems getting my usual medication?

A: There are alternative options for most of the formulations we recommend. Your GP or pharmacist can visit our website where we have information on alternative formulations, at the following link: https://gic.nhs.uk/gp-support/updates-on-physical-interventions/Alternatively, you can ask the pharmacist or GP to get in touch with us by emailing gic.endocrine@nhs.net (for GPs and healthcare professionals only).

Q: What can I do to look after myself and ensure I am taking my hormone treatment safely during this time?

A:

  • Take your hormonal therapies and other medications as prescribed.
  • Look after yourself well – don’t smoke, drink within safe limits, aim to maintain a normal body weight. Follow a healthy diet and keep active. Stay hydrated.
  • Phone your GP rather than going in, to check what the situation is with their capacity at this time – eg to do your injections and blood tests.
  • To help manage worries and anxieties related to the current situation please have a look at the following resources:

GIC website links to support organisations: https://gic.nhs.uk/info-support/support-groups-and-resources/

LGBT Foundation helpline: https://lgbt.foundation/helpline

Contact with the endocrine team

We can only give advice for patients who have been under our care. If you have never been under our care, you should ask your GP or the person who is prescribing your hormone treatment for advice.

If you are a current or previous patient, you can email gic.endo@nhs.net with hormone specific queries. The endocrine team cannot help with general queries. General queries can be emailed to gic.noreply@nhs.net.