FAQs - Stella

Stella FAQs

Our most frequently asked questions about Stella.

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What is Stella?

Stella is an online menopause clinic which offers lifestyle change support and medication to help manage symptoms. Our personalised menopause care is safe, effective and affordable. Our services are available exclusively to our partners.

We help people to:
– Understand their menopause stage and treatment options by answering questions about health and medical history, which takes just 15 minutes
– Talk to clinicians online and get treatment delivered within five working days. This could include hormone replacement therapy (HRT) and testosterone, if right for you
– Get access to long-term support through the Stella app. We offer a personalised lifestyle change plan, articles from clinicians and wellness experts, workouts, mindfulness tracks, virtual events and more!
– Feel motivated with encouragement from app-based coaches trained in psychology and menopause support

What symptoms does Stella support?

Stella supports nearly all of the 34 recognised symptoms of menopause through a combination of lifestyle change support and prescribed treatment. 

You may be eligible for HRT through our clinical services. This is the most effective available treatment for the following menopause symptoms:
– Night sweats
– Hot flushes
– Mood changes (including low mood)
– Sleep issues
– Genitourinary syndrome of menopause (GSM)
– Low libido

HRT isn’t for everyone and the Stella app offers lifestyle change support to help manage difficulties with sleep, mood, sex and relationships, brain fog, weight gain, bladder, hot flushes, night sweats, plus much more.

How much does Stella cost?

Only our partners can use Stella and our costs depend on your specific needs. We’d love to partner with you or you can tell your HR about us! Get in touch at hello@onstella.com.

How do businesses find out more about Stella?

Workplaces can book a demo and find out more about our clinical menopause services and lifestyle change support by emailing us at hello@onstella.com. Find out more on our For Work page.

How do Stella’s doctor’s appointments work?

Our doctor’s appointments are online via a secure video platform where you can see the doctor during the consultation. You do not need any special equipment. You can use a laptop or mobile phone.

You book your appointment and we send you a secure video link that takes one click to join. Our appointments are 20 minutes long.

What do you need for a doctor’s appointment?

You do not need any additional information for your doctor’s appointment. Our doctors will have reviewed your assessment and may ask questions about some of your answers. 

The following may be useful for your appointment if you have them, but are not necessary:
– Any blood test results relating to your hormones, thyroid health or iron levels
– Any recent scan results which may relate to your current symptoms
– A list of the medications you are currently taking

How qualified are Stella’s doctors?

Our doctors are general practitioners (GPs), gynaecologists or doctors with experience and additional training in women’s health.

What is HRT?

HRT has consistently proven to be an effective treatment for some menopause symptoms, including sleep issues, mood changes, hot flushes, night sweats and genitourinary syndrome of menopause (GSM), such as dryness, pain and some bladder issues.

It works by replacing the hormones that are no longer produced by your body after menopause. Since many symptoms of menopause are caused by this dramatic hormone reduction, taking HRT is a logical way to treat them.

Will HRT help my low mood?

It can be difficult to know if mood changes are caused by hormonal changes or other stresses in your life. HRT will help manage anxiety and low mood relating to your hormone levels.

If your mood does not improve after taking HRT, health professionals are there to help. We’d recommend discussing your low mood with a health professional as soon as possible, if you haven’t already. This is particularly important if you have any feelings of harming yourself or other.

Getting help
– Contact your GP or NHS 111
– Samaritans Helpline, available 24/7 – call 116123
– Mind – https://www.mind.org.uk/

Emergency help
If you feel that can’t keep yourself or others safe, call 999 or go to A&E as a place of safety and for emergency help. 

What are systemic HRT and vaginal HRT?

Systemic HRT is taken as tablets, transdermal gels, sprays or patches, or vaginal preparations used for symptoms across your entire body
Vaginal HRT is taken as a vaginal tablet, cream, ring or pessary for vaginal and urinary symptoms

Which forms of HRT can you get through Stella?

– We prescribe body identical forms of oestrogen and progesterone first, including gels (Sandrena, Oestrogel) and patches (Evorel, Estradot, Estraderm)
– We recommend body identical progesterone capsules (Utrogestan)
– We offer vaginal HRT
– We prescribe testosterone, including Testim, Tostran, Testogel and Androfeme. We will explain the different types of testosterone available during your consultation and you can choose what suits you best

All of the HRT we prescribe is regulated. Read more about the difference between body identical and bioidentical HRT.

Your first HRT prescription is for three months in line with UK (NICE) guidelines. It can take up to three months to feel the full benefits. We also check in with you every quarter to see how your medication is working in case it needs adjusting and to check if your symptoms or health history have changed.

Can you get testosterone with Stella?

Yes, our testosterone service costs £200 per quarter. This includes your blood test kit & postage, doctor’s appointment, medication and delivery. 

Testosterone is recommended by UK clinical guidelines to help with low sex drive or libido during menopause. If you are interested in our testosterone service, email hello@onstella.com and we’ll explain more.

You need to be taking HRT and your treatment needs to be stable. Being stable means that your HRT is not causing you side effects and is effectively managing your symptoms – apart from low libido. This is recommended by the British Menopause Society and NICE. Your HRT can be prescribed by Stella at no extra cost, or through the NHS.

Oestrogen treats many different menopause symptoms, all of which can contribute to low libido and sexual difficulties. Testosterone without oestrogen can lead to more side effects, including acne and excess hair growth. If you are currently taking oral HRT you may be recommended to switch to HRT patches, gels and sprays as they do not impact testosterone’s effectiveness in the same way. 

How our service works:
– We ask you to complete an in-depth online assessment and answer health and history questions to confirm if testosterone is right for you
– We send you a finger-prick blood test kit by post to check your testosterone levels. We partner with Thriva for accurate and effective blood test kits
– Our clinicians check your blood test results and schedule an online appointment with you to discuss your treatment options
You will receive your medication by post within five business days if testosterone is right for you

Testosterone isn’t the right treatment for everyone. It won’t be prescribed for you if your blood tests show your testosterone levels are above a certain level, or if there are medical reasons why it is not safe for you.

Which form of oestrogen HRT do you need?

You will need to use some kind of oestrogen as part of your HRT, which you can take as a:
– Tablet
– Patch – you apply to your skin either once or twice per week
– Gel – you apply to your skin every day
– Spray – you apply to your skin every day
– Vaginal cream – you apply inside your vagina
– Vaginal ring – you insert into your vagina
– Vaginal pessary – you insert into your vagina
– Vaginal tablet – you insert into your vagina

Your first HRT prescription is for three months in line with UK (NICE) guidelines. It can take up to three months to feel the full benefits. We also check in with you every quarter to see how your medication is working in case it needs adjusting and to check if your symptoms or health history have changed.

Stella also prescribes testosterone, including Testim, Tostran, Testogel and Androfeme. We will explain the different types of testosterone available during your consultation and you can choose what suits you best. Email us hello@onstella.com for more information about our testosterone service.

Do you need progesterone HRT?

You will also need to take a form of progesterone if you still have your womb and haven’t had a hysterectomy. Progesterone protects the lining of your womb from thickening abnormally and reduces your risk of endometrial cancer compared to using oestrogen HRT on its own. 

You can take progesterone in three ways:
1. Sequential or cyclical progesterone. The medication contains a variable amount of progesterone per cycle so you have a period-like bleed either per month or every three months, depending on your dose. This is recommended for those whose last period was less than one year ago. 

2. Continuous progesterone. You take the same dose of progesterone every day and will not have any periods. If you have a hormonal intrauterine device (IUD), such as a Mirena coil, this may cover your progesterone needs. Continuous progesterone may be recommended if it has been over a year since your last period.

3. Combined oestrogen and progesterone. If you need to take both oestrogen and progesterone for HRT, some products combine the two.

How do you choose between gel, patch or tablet form of HRT?

If you are given a choice of medication, that means they are all safe and appropriate for you to use. We will list the advantages and disadvantages of each option so you can choose which one is right for you. For example, patches can be worn for multiple days and may be more convenient than applying gel daily. They can also be less messy than a gel. On the other hand, gel can be a better option for those with sensitive skin as a patch contains adhesives that may irritate.

Read more about the different types of HRT.

Why do different HRT medications have different doses?

HRT is absorbed differently depending on the type of formulation, such as patches, tablets or gels. For example, a 25mcg oestrogen patch has the equivalent effect as a 0.5mg Sandrena gel sachet.

We will review your medication after the first three months if your symptoms are not improving, and adjust your dose or the type of HRT prescribed as needed.

When should you start your HRT?

The first time you take HRT, take it within five days of starting your period. If you don’t have periods, you can start your HRT at any time.

How long does it take for HRT to work?

It can take a few weeks for your symptoms to start improving so you may need a little patience. Menopause symptoms are caused by hormone changes and everyone has a different experience. Your mental health, lifestyle and other medical conditions can all have an impact, which means HRT can work differently for everyone who takes it.

Your first HRT prescription is for three months in line with UK (NICE) guidelines. It can take up to three months to feel the full benefits. We also check in with you every quarter to see how your medication is working in case it needs adjusting and to check if your symptoms or health history have changed.

What are the risks of HRT?

There are different types of HRT and the type recommended depends on your symptoms, personal medical history and family medical history. You can read more about HRT risks, such as breast cancer, blood clots and strokes, by clicking here.

What are the side effects of HRT

You may notice side effects shortly after starting HRT, which usually wear off within one to three months. HRT side effects can include headaches, vaginal spotting, nausea, breast tenderness, and tummy (abdominal) pain. 

Some may notice mild bloating or ankle swelling due to fluid retention in the first few weeks, but this should settle fairly quickly. HRT that is applied to the skin may cause skin reactions. This is more likely with patches, which contain an adhesive. Read more about HRT and side effects.

Always read the information leaflet that comes with your medication, particularly the section on side effects.

What happens if you forget to take HRT?

If you miss a dose of your HRT, read the information leaflet that came with your medication to find out when to take your next dose.

Contact your doctor if you experience any spotting or breakthrough bleeding after you have missed a dose of your HRT.

How long do you need to take HRT for?

There is no maximum age for taking HRT but the balance between benefits and risks changes as you get older. Some people will choose to stop at age 60 but not all people.

Keep up with regular HRT reviews to check your HRT is working for you. Your HRT should be reviewed at least yearly. You should also be reviewed when you reach the age of 60. Your HRT reviews are included in your plan. Read more about when to stop HRT.

Is HRT a contraceptive?

No, HRT is not a contraceptive. Some people who are still having periods may need to use contraception when taking HRT if they don’t want to get pregnant.

You may have a hormonal intrauterine device (IUD) which can be used as a contraceptive as well as providing the progesterone component of your HRT. You may know them as Mirena, Levosert and Benilexa. While these contain high enough levels of progesterone to be used as part of your HRT, there are other coils on the market which are not suitable for this use. Read more about contraception during menopause.

Some vaginal creams and pessaries can affect how well condoms work and this may change the way we give your medication. Always read the information leaflet that comes with your medication.

Will HRT affect any of your other medications or medical conditions?

HRT might affect your other medications or medical conditions. This is why we need to know about your medical conditions, previous surgeries and medications.

We base our prescription recommendations on the information you share to make sure you are prescribed the safest options. We also encourage you to let your doctor and any healthcare professionals know about your new prescription so they can update your medical records.

Will you lose weight by taking HRT?

There is no evidence that HRT will help you lose weight. Being able to better manage symptoms can mean you find it easier to exercise and improve your nutrition, both of which could help weight management. You can read more here about weight gain during menopause.

The Stella menopause app can help you with the steps you need to manage weight gain during menopause.

What should you do if you notice bleeding or spotting after taking HRT?

A bit of spotting or irregular bleeding is common in the first three months of taking HRT. Make a note of the date, duration and severity and let us know during your three-month review appointment.

Talk to your doctor if you have new heavy bleeding, bleeding after sex, or blood in your urine. Also, talk to your doctor if you experience any unexpected vaginal bleeding when using vaginal creams or pessaries.

What symptoms need urgent medical attention after starting HRT?

Stella is not an emergency service and you need to seek urgent medical attention if you experience the following while taking HRT:
– Sudden severe chest pain (even if not radiating to left arm)
– Sudden breathlessness or cough with blood-stained sputum
– Unexplained swelling or severe pain in the calf of one leg
– Severe abdominal pain
– Severe prolonged headache (particularly if this is your first one), if it’s getting progressively worse, or if you are experiencing loss of vision
– Change in speech or new weakness/numbness affecting one side or part of the body

Your doctor will be able to advise you on further actions and whether you need to stop HRT or not.

Should you tell your doctor about your new medications?

Yes, let your doctor and any healthcare professionals know about your new prescription so they can update your medical records. This is because it may affect other medications or medical conditions. We send you a clinical letter to share with your doctor.

How long will it take for your medication to arrive?

Medication is delivered within five working days. It will arrive in a plain box with no description or information indicating what is inside. It fits through your letterbox and does not need to be signed for it.

How can you contact us about your order, treatment plan, prescription or anything else?

We can answer queries by email hello@onstella.com or by phone 020 801 62064.

How can you change your medication or renew prescriptions?

Medication can be changed by contacting our care team at hello@onstella.com or 020 801 62064. Medication may need changing or the dose adjusting if side effects remain or symptoms haven’t eased.

The first prescription is for three months. We send an email before a prescription runs out and we will book a follow-up consultation. We will renew prescriptions for another three months if treatment is easing symptoms. If there are any issues, our care team will explain the next steps.

Is HRT available over the counter?

Some types of HRT are available over the counter in pharmacies. At the moment this only includes one vaginal tablet, which we offer if you are eligible. You can read more here about over-the-counter HRT.

Can you use an NHS prescription pre-payment certificate?

No, we cannot accept an NHS prescription pre-payment certificate as our prescriptions are private. We have kept costs as low as possible.

What is the Stella app?

The Stella app provides long-term support with lifestyle changes that can help manage symptoms, such as sleep issues, mood changes, weight gain, hot flushes and sweats, brain fog, bladder problems and low libido, plus much more. 

We offer a personalised plan which uses exercises and psychological techniques to get lifestyle change habits to stick, improving health now and in later life. There is also app-based coach support and an extensive library of resources, including articles from our clinicians and wellness experts, workouts, mindfulness tracks, recipes and online Q&As with our experts.

How do Stella’s coaches work?

Our coaches are trained in menopause support and have a background in psychology. They are here to offer motivation by sharing useful resources and tips, and to encourage progress. They do not provide medical advice. 

Stella users who interact with their coach are more likely to complete their plan.

How much time does a plan take on the Stella app?

The Stella app is designed to fit into busy lives, whether that means reading a few articles each day or deep-diving into a plan’s techniques and tips.

How can you track progress in the Stella app?

Stella checks in on symptoms every month to track progress. The questions and scoring are based on the Green Climacteric Score.

How can you join our online events?

We hold regular events online for Stella users, including expert Q&As – invites are shared in our weekly newsletter.