21 Sep 2023

HRT in the UK: Essential information you need to know

Are you considering if HRT in the UK is the right choice for you? With numerous treatment options available for the perimenopause and menopause, it can be overwhelming to know where to start.

Keep reading for our guide on Hormone Replacement Therapy (HRT), a treatment that can help to alleviate menopause symptoms and improve your overall quality of life.

What exactly is HRT? Learn more in our guide

HRT has grown in popularity in recent years, and getting a pre-payment prescription certificate in the UK is now easier than ever. However, it is worth noting that there are nationwide shortages, so getting this prescription filled can sometimes be tricky. 

But once you’ve decided it is something you’d like to explore, how do you get hold of it?

This article explains how you can get HRT in the UK – whether that is from your GP or privately.

Patch HRT

Is HRT right for me?

Before looking for treatment, it is worth assessing whether you are a good candidate for hormone replacement therapy.

HRT is typically recommended for women who are experiencing moderate to severe menopausal symptoms such as hot flushes, night sweats, vaginal dryness, and mood swings. 

It may also be prescribed for women who have had a hysterectomy or oophorectomy (removal of ovaries), which can cause abrupt menopause. 

You may also be advised by your healthcare professional to take HRT for protective benefits, such as for your bone health. 

In the UK, the NHS now concludes that the benefits of HRT now outweigh the risks for many women.

However, your GP may not offer you HRT  without you asking, and you may still meet resistance if you ask. (For more about that, take a listen to our podcast episode on navigating the health system.)  

Some reasons why it may not be recommended to you (wrongly or rightly!) are if you have a history of breast cancer, blood clots, or liver disease, as well as if you smoke or have uncontrolled high blood pressure. 

If you are considering HRT, it is important to discuss your medical history and any potential risks with your GP or healthcare provider.

For more information about the misinformation around HRT and breast cancer, read this article from surgical oncologist Prof Michael Baum.

RELATED: Taking HRT after breast cancer with the BBC's Kirsty Lang

Understanding the different types of HRT

The types of HRT can be confusing. There are:

  • Systemic HRTs that work across the whole body. 
    • Combined preparations have both oestrogen and progesterone in the same medication
    • Or there are non-combined, i.e. those that are only oestrogen or only progesterone.
  • Local or vaginal HRT that works in and around the vaginal area. 

The type of HRT you are prescribed will depend on your individual needs and medical history. Your healthcare provider may also recommend a specific route of administration, such as tablets, patches, gels, or vaginal preparations.

What’s important to know is that unless you have had your womb (uterus) removed (a hysterectomy), then you need both oestrogen and progesterone in your systemic HRT. This is because progesterone helps protect the lining of the womb against endometrial cancer.

Oestrogen-only HRT may be prescribed for women who have had a hysterectomy, as there is no risk of endometrial cancer. 

But, oestrogen-only HRT may increase the risk of ovarian cancer and should be used with caution in women who retain their ovaries after a hysterectomy and/or with a history of this type of cancer.

For a full overview of what HRT is and the types of HRT available, you can read more here: ‘HRT Explained.

How to get HRT in the UK

Once you are ready to start taking HRT, the first step is to consult with a healthcare provider.

In the UK, HRT can be obtained through a GP (general practitioner) on the NHS.

You will need to schedule an appointment with your GP, who will evaluate your medical history, symptoms, and any risk factors. 

They may also order blood tests if you are under the age of 45 to measure hormone levels and assess your overall health. If you’re over 45, you don’t need blood tests.

RELATED: How and where to get help for menopause (this includes tips on how to prepare for your doctor’s appointment).

If you are prescribed HRT, your healthcare provider or doctor will provide a prescription, which you can take to a pharmacy to fill. 

You can also obtain HRT from a private clinic if you choose. This may be an option for you if your budget allows, as the waiting lists maybe significantly shorter, and you can guarantee to see a menopause specialist.

RELATED: Easy HRT prescribing guide

Have you ever wondered how an online menopause clinic works? 

Or whether you get to see an actual doctor in an online appointment? 

And how prescriptions work after the consultation?

Read our behind-the-scenes post to answer all these questions and more about our new online clinic, The Latte Lounge Plus.

The new prescription certificate rules for England

You may have seen that in April 2023, the new HRT prescription pre-payment certificate came into effect in England*.

Instead of paying for each individual prescription, women can now access HRT treatment for a year by paying a one-off fee equivalent to two single prescriptions, currently priced at £18.70.

Unfortunately, the certificate does not cover testosterone, despite it being reported to help with symptoms such as low libido, brain fog and low mood.

The certificate covers a range of HRT prescription items, including patches, tablets, and topical preparations. 

It can be used for an unlimited number of types of preparation, and there is no limit to how many times the certificate can be used during the 12-month validity period.

To apply for the certificate, you can do so in person at a registered pharmacy or through the NHS Business Services Authority

For more information on HRT prescriptions, read our article ‘Accessing affordable HRT: All you need to know about the new HRT prescription pre-payment certificate’.

(*In Wales, Scotland, and Northern Ireland, all prescriptions, including HRT, are free.)

How to get HRT from your GP

If you prefer to obtain HRT from your GP, you will need to schedule an appointment. 

Your GP will then evaluate your medical history and symptoms and may recommend blood tests to assess your hormone levels. 

If you are prescribed HRT, your GP will provide a prescription, which you can take to a pharmacy to fill. 

HRT is available on the NHS, although there may be a waiting time for appointments and prescriptions.

It’s important to know that GP practises may have someone in the practice who has a special interest in menopause care. If you can, request to see this person since they are most likely to be knowledgeable about HRT.

If you feel that your GP is not adequately addressing your concerns or providing appropriate treatment, you may wish to seek a second opinion or consider obtaining HRT from a private clinic instead.

How to get HRT privately

If you prefer to obtain HRT from a private clinic, there are several options available in the UK. 

Private clinics may offer shorter waiting times for appointments and prescriptions, as well as more personalised care - although, of course, there will be a cost involved for this.

When choosing a private clinic, it is important to do your research and ensure that the clinic is reputable and staffed by qualified BMS registered healthcare professionals. 

You may wish to read reviews, ask for recommendations from friends or family, and check the clinic's accreditation and certifications.

It’s also worth checking exactly how the costs work and what is included in the price.

The Latte Lounge has a searchable directory of menopause specialists on our website, too.

In-person and online clinics

As well as traditional in-person clinics, there are also online clinics that offer menopause consultations, including the ability to prescribe HRT. 

Online clinics can be convenient and accessible, as they allow you to consult with a healthcare provider or doctor and obtain a prescription from the comfort of your own home.

Alternatives to HRT

If you find that HRT is not for you, or you decide that you do not need or do not want to take HRT, there are several alternatives that can still alleviate menopausal symptoms, including:

Lifestyle changes such as regular exercise, a healthy diet, and stress management which can help alleviate menopausal symptoms. 

Herbal remedies such as black cohosh, red clover, and soy that may also be effective for some women. 

Non-hormonal medications such as antidepressants and blood pressure medications that may also be prescribed for if the cause of the symptoms is more complex.

RELATED: Managing your menopause without HRT

Frequently asked questions about HRT in the UK

Is HRT safe?

HRT is generally safe for most women, but there are some risks associated with its use, particularly for women with a history of breast cancer, blood clots, or liver disease. 

It is important to discuss your individual risk factors with your healthcare provider or doctor before starting HRT.

RELATED: HRT benefits & risks with Dr Avrum Bluming

How long should I take HRT?

You can take HRT for as long as you need or want to. The length of time that you should take HRT depends on your individual needs and medical history. 

Some women may take HRT for a few months to alleviate menopausal symptoms, while for others, it may take longer to see results and/or they decide to take HRT for life.

Your doctor can provide guidance on the appropriate length of treatment for you.

HRT patch

What are the side effects of HRT?

Side effects of HRT can include nausea, bloating, breast tenderness, and headaches. 

These side effects are usually mild and temporary. More serious side effects, such as blood clots and stroke, are rare but can occur in some women. These tend to be linked to HRT when taken as a pill. There is not the same increased risk risk of clots if taken transdermally via a patch, gel or spray.

Making an informed decision about HRT in the UK

Before taking HRT, it is important to understand how it may help you and benefit you. You may find it useful to consult with a healthcare provider and carefully consider your individual medical history and risk factors. 

There are several options for obtaining HRT in the UK, including through a GP or private clinic, as well as online clinics. 

It is also important to be aware of alternatives to HRT and to make an informed decision about the best treatment option for you.

RELATED: A Latte Lounge member’s real-life experience of being perimenopausal and taking HRT

Access our online menopause clinic - and online appointments with a doctor - from just £45

"Feeling fantastic, better than I have been in years. It’s as if a five-year hangover has suddenly gone."

– Leanne, 48

This article has been checked and verified by our medical advisors.

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