Well my situation was - therapy about 12 years ago, and my therapist actually had sent HRT approval back to my referring GP. Went back 2 years ago, asking for blocker, and next thing I know, he says to me "you need to be on E" and I ended up with an endo referral.
So I've now been on low dose for 2 years. In my case, you could say I jumped the hoops, in another sense, it was a pretty loose informed consent - but there are extenuating circumstances in my case.