SINGAPORE: A doctor with over 40 years of experience and several past convictions inappropriately prescribed hormone replacement therapies (HRT) to 18 patients, despite them having normal hormone levels and not showing symptoms that warranted the therapies.
The Singapore Medical Council (SMC) brought Dr Wong Yoke Meng before a disciplinary tribunal, which found him guilty of professional misconduct. The tribunal censured and suspended him from practising for a period of 36 months – the maximum suspension period.
Dr Wong faced a total of 40 charges of professional misconduct under the Medical Registration Act (MRA), of which 18 were on his inappropriate prescriptions of HRT to 18 patients between 2013 and 2015, and the remaining on his inadequate keeping of medical records of these 18 and four other patients.
Dr Wong was also criticised for not carrying out physical examinations and taking a proper history of each patient. In many instances, he started the HRT even before blood test results were out.
Among these 14 men and four women, aged 39 years to 74 years at the point of their HRT, three men underwent progesterone replacement therapy through application of cream containing progesterone – a primarily female hormone. This is not a therapy supported by scientific evidence for males, an expert report submitted to the tribunal stated.
Four women underwent testosterone replacement therapy, through intramuscular testosterone injections or application of cream containing testosterone – the primary male hormone. This therapy is not usually prescribed to women, except those with hypoactive sexual desire disorder, according to the clinical practice guideline by the international Endocrine Society.
Ten patients, including some mentioned above, were prescribed with more than one hormone each, which was also inappropriate as this subjected them to possible harm.
According to medical experts who provided their views to the tribunal, the interaction between the hormones was uncertain and could cause undesirable side effects detrimental to the patient, and it would be unclear which medication caused the side effects.
Dr Wong caused actual harm to at least three patients – a woman suffered side effects such as hand tremors, while two men saw their blood testosterone levels rise above the normal range.





