Practicalities
NHS or private menopause care: an honest guide
The NHS provides menopause care for free. Here is when it works well, and when paying might suit you.
LoveMyLife clinical team
MRCGP-led
25 May 2026
7 min read
You do not have to pay for menopause care. The NHS provides it free, the same medicines are available on prescription, and for many women the NHS is the right starting point. This guide is an honest look at what each route offers, so you can choose with clear eyes.
We run a private service, so treat this as our best attempt at a fair comparison rather than a neutral one. The aim is to help you decide, including deciding that the NHS is right for you.
What the NHS gives you
Your NHS GP can diagnose menopause, prescribe HRT, and review you, at no cost beyond the standard prescription charge in England, which is free in Scotland, Wales and Northern Ireland. Many GPs have a real interest in menopause and some practices have a menopause lead. The medicines are the same body-identical products available privately. If cost is a concern, the NHS is not a lesser option clinically; it is the same medicine.
Where the NHS can fall short
The constraints are practical rather than clinical. Appointments are short, which makes a detailed first menopause conversation hard to fit in. Continuity can be difficult, so you may see a different clinician each time. Waits for a routine appointment vary. And not every clinician has specific menopause training, so depth of experience differs from practice to practice. For straightforward care these matter little; for a complicated history they can matter more.
The HRT prepayment certificate
If you are in England and paying prescription charges, the HRT prepayment certificate is worth knowing about. For a one-off annual fee, roughly the cost of two single prescription charges, it covers your HRT prescriptions for twelve months however many items you need. It is specific to HRT and is one of the better-value things in the system. We cover how it works alongside shared care in a separate article.
What a private service adds
What you pay for privately is time and continuity, not better medicine. A first menopause assessment with us is a longer appointment, the same clinician can follow you over time, and you can usually be seen sooner. We use a structured symptom score at every review and adjust the dose as your symptoms respond. For some women that attentiveness is worth the cost; for others the NHS covers their needs perfectly well.
A reasonable way to choose
If your symptoms are straightforward and you are happy with your GP, start with the NHS.
If cost is the deciding factor, the NHS gives you the same medicines for far less.
If you have tried the NHS route and feel unheard, or you want more time and continuity, a private assessment is reasonable.
If your history is complex, what matters most is seeing someone with menopause experience, whichever route that is.
Many women move between the two over time, for example starting privately for a thorough assessment and then continuing on the NHS through shared care. That is a sensible use of both.
What to ask, whichever route you choose
Good care looks the same on the NHS or privately, so the questions worth asking are the same. It is reasonable to ask whether your symptoms could be hormonal, whether HRT is suitable for you, and which form is safest given your history. If you are offered oral oestrogen and have any clot risk factors, it is fair to ask whether a patch, gel or spray would be safer. And it is reasonable to ask when you will be reviewed, because a first dose is a starting point, not a final answer.
If you feel rushed or unheard, that is worth naming. Asking for a longer appointment, a follow-up, or a clinician with menopause experience is not being difficult; it is asking for the standard of care the guidelines describe.
The honest summary
There is no clinical reason to pay privately for the medicine itself; HRT is HRT. What private care buys is time, continuity and convenience. If those are the things you are missing, it may be worth it. If they are not, the NHS will serve you well, and we would rather tell you that than pretend otherwise.
Clinically reviewed
Dr Seth Rankin · MBChB MRCGP - Founder and Medical Director, LoveMyLife
Read next
Staying with your NHS GP: shared care and the HRT prepayment certificate
Combine private continuity with low-cost NHS prescribing.
What happens in a menopause assessment, and the Greene Climacteric Scale
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Why menopause is so often under-treated
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Ready to start?
If you want to move from reading to acting, the next step is a short assessment with a doctor on the GMC GP Register. It takes about ten minutes and tells you whether HRT is right for you.
Begin your assessment at this link. Online or in person at Westfield London.