--- title: "HRT: benefits, risks and GP review | HealthAnswers" description: "HRT can ease menopause symptoms and protect bones. Benefits and risks are individual. It is not contraception. A GP starts and reviews it on the NHS." url: https://healthanswers.co.uk/treatments/hormone-replacement-therapy/ robots: noindex --- # HRT: benefits, risks and GP review | HealthAnswers Treatments HRT can ease menopause symptoms and protect bones. Benefits and risks are individual. It is not contraception. A GP starts and reviews it on the NHS. Written by HealthAnswers editorial team Medically reviewed by [Dr Neil Singh MBChB - nMRCGP](https://healthanswers.co.uk/our-doctors/neil-singh/) · GMC 7039648 Reviewed 13 August 2026 ## Quick answer Should I talk to a GP about HRT? Hormone replacement therapy replaces oestrogen, and usually progestogen, that fall around menopause. It can ease hot flushes, night sweats and vaginal dryness, and it helps protect bones. A GP discusses your personal benefits and risks before prescribing. HRT is not contraception. The NHS route is a GP in every UK nation. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Hormone replacement therapy (HRT), including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 8 sections ## Key facts about hormone replacement therapy - HRT can ease hot flushes, night sweats and vaginal dryness and helps protect bones. - People with a womb need combined HRT so the womb lining is protected. - Patches and gels may carry a lower clot risk than tablets for many people. - Benefits and risks are individual — a GP assesses your history before prescribing. - HRT is not contraception; use a separate method if you could still get pregnant. - The usual NHS door is a GP in England, Scotland, Wales and Northern Ireland. ## Should I use this page, or skip it? Use this page if menopause symptoms are disrupting life and you want to know what a GP discussion about HRT involves. Skip it and call 999 for sudden chest pain, severe breathlessness, collapse, or a swollen painful leg with feeling very unwell. This page cannot prescribe or weigh your personal cancer and clot history. HRT is not contraception. If you could still get pregnant, keep a separate method. See [menopause](https://healthanswers.co.uk/conditions/menopause/) for the wider picture. ## What is HRT and what can it help? HRT replaces oestrogen that falls in perimenopause and menopause, and usually adds progestogen if you have a womb. It can ease hot flushes, night sweats, sleep disruption, mood change linked to the transition, and vaginal dryness. It also helps protect bones, which matters especially if menopause comes early. It will not fix every midlife stressor. Joint aches and dry skin sometimes improve. A GP starts from how much symptoms affect you, not from a blood test alone in typical-age menopause. Early menopause is a stronger reason to discuss bone protection as well as flushes. ## How do tablets, patches and vaginal oestrogen differ? Systemic HRT treats whole-body symptoms and comes as tablets, patches, gels or sprays. Patches and gels may carry a lower clot risk than tablets for many people, which is why they are often preferred if clot risk is a concern. Follow the product you are prescribed. Vaginal oestrogen as a cream, pessary or ring treats local dryness and discomfort with little absorption. It can be used alone or with systemic HRT. Combined HRT is for people with a womb; oestrogen-only is usual after hysterectomy. ## How do I start HRT on the NHS? Book a GP in any UK nation. They will ask about breast cancer, clots, stroke, liver disease, [migraine](https://healthanswers.co.uk/conditions/migraine/), and bleeding. Benefits and risks are individual. Licensed body-identical oestradiol and micronised progesterone are available on the NHS; unregulated compounded creams are not the same thing. Review after a few months, then at least yearly. Breast tenderness, bloating and spotting often settle. Persistent heavy bleeding after the early months needs investigation, not a shrug. If HRT is unsuitable, ask about vaginal oestrogen, CBT for flushes, and non-hormonal options. The GP route is the same in England, Scotland, Wales and Northern Ireland. ## Is it contraception, and when do I stop? No. Perimenopause can still include ovulation, so you can still get pregnant. Use contraception until a clinician says you can stop. A hormonal [coil](https://healthanswers.co.uk/treatments/contraceptive-coil/) can sometimes provide the progestogen part of HRT and prevent pregnancy. Do not assume a patch replaces a pill. There is no universal stop date. Many people continue while symptoms persist, with yearly review. Taper if you can when stopping. Early menopause often means continuing HRT at least until the average menopause age unless it is contraindicated. ## When is it 111 or 999? Use a GP for side effects that are annoying but not dangerous, such as settling breast tenderness or spotting in the first months. Use 111 in England, Scotland and Wales if you cannot get a GP and are unsure; Northern Ireland uses GP out-of-hours via nidirect. Call 999 for sudden severe chest pain, breathlessness, collapse, or signs of a stroke. A painful swollen calf with feeling unwell is urgent. Those symptoms on HRT are treated as clot or stroke until a clinician says otherwise. ## Do NHS doors differ across the UK? HRT is started and reviewed by a GP in England, Scotland, Wales and Northern Ireland — there is not a separate national “HRT clinic” you must find first. Call 111 in Great Britain if you cannot get a GP and symptoms or side effects are worrying you; Northern Ireland uses GP out-of-hours via nidirect. 999 is the same everywhere for chest pain, collapse or stroke signs. Licensed NHS products are the usual route; unregulated compounded creams are not a safer private shortcut. ## Who should skip this page? Skip this page if you already have chest pain or a swollen leg — that is urgent care. It is not a testosterone guide, not a contraception start page, and not a private compounded-hormone advert. If the main problem is [heavy periods](https://healthanswers.co.uk/conditions/heavy-periods/) before menopause, say that clearly so the GP does not treat only flushes. ## ! Important safety information for hormone replacement therapy See a GP if menopause symptoms are affecting your life and you want to discuss HRT or alternatives. Seek urgent help for sudden severe chest pain, breathlessness, a painful swollen leg, or a severe headache with vision changes while on HRT. Call **999** if those symptoms are severe or you collapse. Report persistent heavy bleeding after the first months of combined HRT rather than ignoring it. ## Common questions about hormone replacement therapy What is hormone replacement therapy? HRT is medicine that replaces oestrogen, and usually progestogen, that fall during perimenopause and menopause. It can relieve flushes, sweats, sleep disruption and vaginal dryness, and it helps bone strength. It comes as tablets, patches, gels, sprays and vaginal preparations on NHS prescription. A GP decides whether it is suitable for you. Who can take HRT? Many people with bothersome menopausal symptoms can consider it after an individual risk discussion. A history of breast cancer, blood clots, stroke or liver disease may mean HRT is unsuitable or needs specialist advice. There is no single age cut-off that replaces that conversation. Alternatives exist if HRT is not for you. Why do some people need combined HRT? If you have a womb, oestrogen alone can overstimulate the lining. Progestogen is added to protect it. After a hysterectomy, oestrogen-only HRT is often used. Vaginal oestrogen treats local dryness with little absorption into the bloodstream and can be used alone or with systemic HRT. Follow the product you are prescribed. What are the main benefits and risks? Benefits include fewer flushes and sweats, better sleep for many, easier sex if dryness was the problem, and bone protection. Combined HRT can slightly raise breast cancer risk with longer use; tablet HRT can slightly raise clot and stroke risk compared with patches or gels. Your GP will put those risks in the context of your own history. Is HRT contraception? No. You can still get pregnant around perimenopause. Use a separate contraceptive method until a clinician advises you can stop. Some people use a hormonal coil as the progestogen part of HRT and as contraception. Do not assume patches replace a pill or condom. See a GP if that overlap is confusing. What is body-identical HRT? NHS body-identical HRT uses oestradiol and micronised progesterone that match the hormones the body makes, as standard licensed products. Compounded 'bioidentical' mixes from some private clinics are unregulated and not recommended by NICE. Ask for licensed NHS products rather than a custom cream with unverified doses. How long can I stay on HRT? There is no fixed stop date for everyone. Review at least yearly with a GP. Many people take it while symptoms continue. When you stop, a gradual reduction can be easier. Symptoms may flicker back for a while. Do not stop suddenly without a plan if you have been on a significant dose. ## Sources - [NHS — Hormone replacement therapy (HRT)](https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/) - [NHS — Menopause](https://www.nhs.uk/conditions/menopause/) - [NICE — Menopause: identification and management (NG23)](https://www.nice.org.uk/guidance/ng23)