How much does HRT cost in the UK? NHS and private prices compared

HRT is cheap. The medication, that is. A month of oestrogen gel and micronised progesterone costs less than most people spend on coffee. What varies, from nothing to several hundred pounds, is the cost of getting to a prescription that suits you and keeping it that way.

This article sets out the actual numbers: what the NHS charges, what private clinics charge, what the medicines cost if you pay for them yourself, and what we charge at Arc. Prices change, so treat the figures as a guide and check anything that matters to your decision.

HRT on the NHS

The appointments are free. The medicine is free in Scotland, Wales and Northern Ireland, where there are no prescription charges.

In England you pay a prescription charge per item, currently around £10, which adds up quickly when oestrogen and progestogen are separate items collected monthly. The HRT prescription prepayment certificate, introduced in 2023, covers a list of HRT medicines for twelve months for a one-off fee of around £20. If you take any HRT at all in England, it almost always pays for itself within the first two months. You buy it online from the NHS Business Services Authority, and you need to have it before the prescription is dispensed.

A few things fall outside it. Testosterone is not licensed for women in the UK, so it is not on the HRT certificate list, and most GPs will not prescribe it at all. Some vaginal oestrogen products are available to buy over the counter at a pharmacy, which some women find simpler than a prescription.

If you are exempt from prescription charges for another reason, such as age or a medical exemption, HRT is free.

The real cost of NHS HRT is time rather than money: the wait for an appointment, the ten minutes when you get one, and the number of appointments it can take to arrive at a dose that works. Our article on HRT on the NHS versus private covers when that route works well and when it does not.

Private menopause clinics

Private clinics in the UK broadly charge in one of three ways.

Pay per appointment. An initial consultation of 45 to 60 minutes typically costs £150 to £300, with follow-ups at £75 to £150. Prescriptions and blood tests are extra. Over a first year with two or three follow-ups, this usually comes to £400 to £700 before medication.

A monthly bundle. A fixed monthly fee, commonly £80 to £100, that includes the consultations, the medication and sometimes a monitoring blood test. Simple, and good value if you use everything in the bundle, less so if you are on a low-cost regime and paying the same as someone on an expensive one. We compared one well-known bundle with our own pricing in Arc HRT vs Voy.

A membership for the doctor, medication separately. A lower monthly fee that covers your reviews and prescribing, with medication charged at or near cost. This is the model we use.

Whichever model, ask any clinic to break its price into the doctor’s time, the medication and the tests. If it will not, you cannot compare it with anything.

What the medicines cost

Private prescriptions are dispensed by a pharmacy at the pharmacy’s price, plus often a small private prescription fee. Typical monthly costs:

Medication	Typical private cost per month
Oestrogen gel or spray	£10 to £20
Oestrogen patches	£10 to £25
Micronised progesterone capsules	£10 to £15
Combined patches	£15 to £30
Vaginal oestrogen	£5 to £15
Testosterone cream or gel (female dose)	£15 to £30, bought as a tube or sachets that last several months

So a common regime of oestrogen gel plus progesterone comes to roughly £20 to £35 a month privately, and adding testosterone takes it to perhaps £40 to £60. Those are the figures to hold in mind when a bundle quotes you £90 a month “including medication”.

Blood tests

You do not need a blood test to be diagnosed or to start HRT if you are over 45 with typical symptoms. You usually do if you are under 45, if you are considering testosterone, or if something else needs ruling out. Our page on whether you need a blood test sets this out.

Privately, a female hormone panel costs anywhere from £60 to £200 depending on what is included. Ours are listed with prices and what they measure, and the core panel covers oestradiol, FSH, LH, testosterone, SHBG, prolactin and thyroid from £90 as a home finger-prick kit, or more with a nurse visit or at a partner clinic near you.

What Arc HRT charges

• Initial consultation: £99, currently reduced from £150. Sixty minutes by video with a UK GMC-registered doctor, a full review of your symptoms and history, and a written plan. If you decide not to go further, that is the end of it.
• Membership: £69 a month, only once you and your doctor decide to start treatment. It covers four scheduled reviews a year, the clinical team between them, prescriptions and dose changes, and testosterone reviewed and monitored where appropriate. Cancel any time.
• Medication: pay as you go, at what it costs us plus a small margin.
• Blood tests: from £90, only where you need one.

Over a first year, that is roughly £930 for the doctor and reviews, plus your medication at the prices in the table above. Full details are on our pricing page, and the thinking behind the model is on personalised HRT.

Mixing NHS and private

Many women start privately to get seen quickly and have their treatment set up properly, then ask their GP to take over prescribing on the NHS. For standard HRT, most GPs will, once they have a letter from the private doctor setting out what you are on and why. For testosterone, most will not, and it usually stays a private prescription.

There is no obligation on a GP to take on a private prescription, and some practices have a policy against it, so it is worth asking before you assume. We write to your GP with your consent after every consultation so the option is always open to you.

If you are already with another private clinic and want to move, switching to Arc starts with a review of what you are on now rather than starting from scratch.

The bottom line

The medication costs £20 to £60 a month privately and far less on the NHS, especially with the prepayment certificate in England or free prescriptions elsewhere in the UK. What you are paying for privately is the doctor’s time, access and continuity, and that is where the real differences between clinics lie. Compare the doctor’s time, the medication and the tests separately, and the right choice for you usually becomes obvious. Our guide to HRT in the UK covers everything else you need to know before you decide.