The number of women over 40 receiving hormone replacement therapy (HRT) on the UK's National Health Service (NHS) has reached a record two million in the 2025/26 period. This figure represents more than double the 800,000 prescriptions issued in 2020/21, according to new figures from the NHS Business Services Authority (NHSBSA).
HRT is prescribed to alleviate menopausal symptoms by replacing declining levels of estrogen and progesterone. It helps manage symptoms such as hot flashes, night sweats, sleep disturbances, mood swings, anxiety, and vaginal dryness. The surge in prescriptions reflects increased awareness of menopause and available treatment options, stated Sue Mann, national clinical director in women's health for NHS England.
However, disparities in access have been noted. Women from the most deprived areas are less likely to receive an HRT prescription, with fewer than one in 10 accessing the treatment compared to 14.2% in the least deprived regions. Newham in east London recorded the lowest rate with four prescriptions per 100 women, while Brighton and Hove reported 23 prescriptions per 100 women.
Experts also caution about potential risks associated with HRT. Dr. Ellie Cannon noted in November that there is a slightly increased risk of breast cancer, particularly for those using combined estrogen and progesterone therapy. It is estimated that approximately 2% of all breast cancer cases in the UK, equating to about 1,000 new diagnoses annually, may be linked to HRT.
The significant increase in demand has also put a strain on medicine supply chains. Olivier Picard, chairman of the National Pharmacy Association, highlighted that surges in prescriptions can exacerbate existing medicine shortages. He noted that shortages of certain strengths of Estradot patches are among the longest-running in NHS history. "When prescribing habits change, we must make sure supply chains can keep up or we risk worsening access to medicines for patients and put more pressure on over stretched pharmacy teams," Picard said.
The NHSBSA is reminding women that they can purchase a HRT prescription prepayment certificate for £19.80, which covers prescription charges for 12 months. Without this certificate, each HRT prescription costs £9.90.