If you’re experiencing menopause symptoms, you might want to explore your treatment options, but we understand that it can be a little overwhelming to know where to start.
Hormone replacement therapy (HRT) is a viable, safe and effective option for many individuals, with an estimated 2.3 million women prescribed HRT products in 2022-2023.
In this article, we outline how to get HRT in the UK so that you know what your options are. If you're interested in starting HRT, you can speak to your GP practice or obtain a private prescription through Menopause care.
A brief overview of HRT
HRT is a hormone-based treatment that is used to alleviate menopause symptoms including hot flushes, night sweats, vaginal dryness, and brain fog. It works by replacing hormones (oestrogen and progesterone) that have naturally declined during perimenopause and menopause.
Types of HRT
There are two main types of HRT: combined HRT and oestrogen-only HRT. Combined HRT uses oestrogen and progesterone and is prescribed to women who still have their wombs. Oestrogen-only HRT is prescribed to women who have had a hysterectomy.
Local HRT can be used alone or in addition to systemic HRT and helps to alleviate vaginal, urinary and pelvic symptoms.
There are different ways that HRT can be taken including:
- Tablets – taken orally
- Patches – that are stuck to the skin and release the hormone
- Gel – which is applied to the skin and absorbed into the bloodstream
- Spray – which is applied to the forearm and absorbed into the bloodstream
- Local HRT – which comes as a tablet, pessary, cream, gel or ring that you insert into the vagina
How to get HRT in the UK
In the UK, you can get HRT from your GP or through a private prescription. You can usually begin HRT as soon as you start experiencing symptoms of menopause and you won’t usually need to have any tests first if you’re over 45. If you’re between 40 and 45 years old, a blood test may be recommended to measure your hormone levels.
Is HRT free on prescription?
Unless you’re eligible for free NHS prescriptions, you’ll need to pay for HRT prescribed by your GP. The current NHS prescription charge is £9.90 per item. How much you pay will depend on the number of different medications prescribed.
If you obtain a private prescription, there will also be a charge for your HRT medication, and this will usually be more expensive than NHS prescriptions. The cost will vary according to the type of HRT you are prescribed and who dispenses it.
HRT pre-payment certificates
If you pay for NHS prescriptions, a HRT pre-payment certificate (HRT PPC) could save you money. You can buy an HRT PPC for £19.80, and this will cover an unlimited number of eligible HRT medications for 12 months. Only HRT medications that are licensed to treat menopause in the UK are covered by an HRT PPC.
If your HRT medication is not covered by an HRT PPC, you may still be able to save on the cost of your prescriptions with a standard pre-payment certificate (PPC) that covers all NHS prescriptions.
A PPC costs £32.05 for 3 months or £114.50 for 12 months. A PPC will save you more than an HRT PPC if you a prescribed:
- 4 or more items in a 3-month period and at least 2 are not for eligible HRT medication
- 12 or more items in a 12-month period and at least 10 are not for eligible HRT medication
Can you buy HRT over the counter?
In most instances, you will need a prescription for HRT. However, there is a local oestrogen treatment, called Gina, which is now available as an over-the-counter medication. It was reclassified from a prescription-only medicine to a pharmacy medicine by the Medicines and Healthcare products Regulatory Agency (MHRA) in 2022.
To be able to purchase this HRT, you will need to have a consultation with a pharmacist who will ask you a few questions to make sure it is suitable for you.
Gina is a small vaginal tablet that delivers a low dose of oestrogen directly to the vaginal wall to relieve symptoms of vaginal atrophy such as dryness and inflammation. It doesn’t treat vasomotor symptoms of menopause so if you are experiencing hot flushes or night sweats, it won’t help with these.
GP vs private prescription
Going to the GP is the first port of call for many of us and they routinely prescribe HRT to women in the UK. One of the advantages of seeing your GP is that they have access to your medical history. They are also usually local to you, which is convenient, and if they give you an HRT prescription, you know you will pay the fixed NHS prescription price.
However, the main benefit of a private HRT prescription is time. It can sometimes be difficult to get a GP appointment, especially if you work full-time and need to attend in person during office hours. Private doctor services are becoming increasingly popular as they can offer online appointments outside of the standard operating hours of most GP surgeries.
With a private doctor, you are also likely to get a longer appointment time. Most NHS GP appointments are around ten minutes, but a private appointment can last up to 45 minutes or more. This allows you to discuss your symptoms and talk through treatment options in greater detail so that you can make a fully informed choice about your healthcare.
Additionally, paying for a private consultation gives you the freedom to decide who you see. Rather than a general practitioner, you can see a menopause specialist who is experienced in helping women navigate their menopause symptoms.
Getting HRT with Menopause Care
At Menopause Care, we have a dedicated team of specialists that you can speak to about starting HRT.
Our British Menopause Society accredited doctors offer appointments in person and online. During your 45-minute initial consultation, you will talk through your symptoms and circumstances so your doctor can get the full picture of what’s going on and carry out a thorough medical evaluation.
Depending on your needs and what you’re looking for, you may be recommended HRT, testosterone or non-hormonal medications. You'll also receive tailored lifestyle advice and a personalised treatment plan. Following your appointment, a detailed report will be sent to you and your GP. Private prescriptions are issued via our pharmacy and delivered straight to your home. If you would prefer to obtain your prescription via your NHS GP following your consultation this is also possible.
Typically, after three months, you'll have a follow-up appointment with the same doctor to see how you have adjusted to treatment, discuss any side effects and request additional testing if necessary. After this, our team are here to see you as needed – we offer ongoing support for as long as you need it.
If you’re keen to access private healthcare but worried about the cost, we also offer menopause specialist nurse consultations from the comfort of your own home at a lower price than doctor consultations. You’ll receive personalised support and advice, and our nurses can prescribe you HRT without you needing to see a doctor.
We also offer subscription plans after your initial consultation to reduce and spread the costs of your HRT prescription, coaching, tests and appointments.
Knowing which doctor to consult for menopause can feel like a daunting choice to make but rest assured, when you choose a specialist from the Menopause Care team, you’re in good hands. If you’d like to talk about your HRT options and get your prescription delivered directly to your door, start by booking a consultation with a menopause specialist.
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