The NHS has made significant strides in menopause care since 2022, when HRT prescriptions were capped at £30.25 per year and the government appointed its first Menopause Employment Champion. But many UK women are still being dismissed, misdiagnosed, or waiting months for specialist appointments. This guide gives you the knowledge to navigate the system confidently.
NICE Guidelines: What Your GP Should Be Doing
The National Institute for Health and Care Excellence (NICE) published updated menopause guidelines in 2015 (NG23) and has since reinforced them. Under these guidelines, GPs should: diagnose perimenopause based on symptoms alone in women over 45 (without requiring blood tests), offer HRT as a first-line treatment for menopausal symptoms, and discuss the risks and benefits of HRT in an individualised way.
⚠️ ⚠️ Know your rights: Under NICE guidelines, your GP should not require a blood test (FSH) to diagnose perimenopause if you are over 45 and have typical symptoms. If your GP insists on blood tests before discussing treatment, you are within your rights to request a referral to a menopause specialist.
HRT on the NHS
Since April 2023, women in England can purchase a Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC) for £30.25 per year, covering all HRT prescriptions regardless of the number of items. This has made HRT significantly more affordable for many women. In Scotland, Wales, and Northern Ireland, prescriptions are free.
Types of HRT Available on the NHS
- Oestrogen (patches, gel, spray, tablets) — the most commonly prescribed form
- Progesterone (Utrogestan — body-identical) or synthetic progestogen (Norethisterone, Medroxyprogesterone)
- Combined HRT — oestrogen plus progesterone in one preparation
- Testosterone — increasingly available on NHS prescription for low libido
- Vaginal oestrogen — available separately and does not count toward the HRT PPC
Getting a Referral to a Menopause Specialist
If your GP is unable to help or you are not responding to initial treatment, you are entitled to ask for a referral to a menopause specialist. The British Menopause Society (BMS) maintains a directory of NHS and private menopause specialists at thebms.org.uk. Many NHS trusts now have dedicated menopause clinics, though waiting times vary.
The Menopause Workplace Pledge
Since 2022, the UK government has actively encouraged employers to support employees through menopause. The Menopause Workplace Pledge has been signed by over 2,000 employers. If your symptoms are affecting your work, you may be entitled to reasonable adjustments under the Equality Act 2010 — menopause symptoms can constitute a disability if they have a long-term, substantial effect on daily activities.
Private Options in the UK
If you are struggling to access care through the NHS, private menopause clinics and telehealth services (including Newson Health, Stella, and Livi) offer consultations typically ranging from £150–£300. Many women find that a private initial consultation, followed by NHS prescriptions, is the most cost-effective approach.