HRT for menopause in the UK: what it is, who it helps and how to get it on the NHS

HRT (hormone replacement therapy) is a treatment that eases the symptoms of menopause. During menopause a woman's sex hormone levels fall, causing hot flushes, disturbed sleep, mood changes and other troubling symptoms. HRT replaces the missing hormones. Here is who it suits and what forms it comes in, based on the NHS.

Who is HRT for, and why?

HRT is prescribed for women troubled by menopause symptoms. Its main job is to relieve those symptoms and restore quality of life. There is an added benefit: HRT helps protect bones against osteoporosis (a condition in which bones become fragile and break more easily), the risk of which rises after menopause.

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What forms does it come in?

HRT comes in several forms: tablets, skin patches, gel, spray and vaginal preparations. This choice means treatment can be tailored to a woman's lifestyle and health. There are two main hormones — oestrogen and progestogen — usually given together (known as combined HRT). There is also a separate medicine, tibolone, which likewise relieves menopause symptoms and supports the bones.

Are there risks?

As with any treatment, HRT has both benefits and possible risks, and the balance differs between women. That is why it is tailored individually with a doctor, taking into account age, health and family history. You should not choose a product yourself: a doctor will explain the options, choose a form and dose, and adjust them if needed.

How to get HRT on the NHS

HRT is prescribed by a doctor — usually a GP (family doctor). You book an appointment and discuss your menopause symptoms. If it is suitable, the doctor issues a prescription, and the medicine is then dispensed at a pharmacy. For long-term treatment prescriptions are usually repeated, so it is worth asking the doctor or pharmacy how best to renew them.

What about prescription costs?

HRT is a prescription medicine, and in England there is usually a fixed charge per item for prescriptions (several groups are exempt). For people who need medicines regularly, a prescription prepayment certificate can be cheaper — it lets you get the medicines you need for a set sum without paying per item. A pharmacy can advise what suits you.

What is worth remembering?

Menopause is a natural stage, but you do not have to endure severe symptoms: effective help exists. If hot flushes, insomnia or mood changes are affecting your life, it is worth discussing HRT with a doctor. They will weigh the benefits and risks in your case and help find a suitable option.