Understanding HRT Costs in the UK: What You Will Pay and How to Save
HRT in the UK can be affordable with the right knowledge. Learn about NHS prescription costs, PPC savings, and private alternatives.
The real cost of HRT in the UK
Hormone replacement therapy is one of the most effective treatments for perimenopause symptoms, yet many women are uncertain about what it actually costs. The answer depends on whether you access HRT through the NHS or privately, which type of HRT you use, and whether you take steps to manage your prescription costs. Getting clarity on this early prevents the unpleasant surprise of ongoing costs you had not anticipated.
NHS prescription charges for HRT
In England, each NHS prescription item costs a standard charge that sits around 9.90 pounds per item as of 2026. Most HRT regimens involve two items, an oestrogen and a progestogen, which means a typical monthly cost of around 20 pounds if paid per item. In Wales, Scotland, and Northern Ireland, prescriptions are free regardless of the medication, so this cost only applies to women in England. For many women the cost is manageable, but it does compound over months and years.
How a prescription prepayment certificate saves money
A Prescription Prepayment Certificate, commonly called a PPC, is one of the most useful and underused tools for managing NHS prescription costs. For a fixed annual fee of around 111 pounds, you can collect as many NHS prescription items as you need with no additional charge per item. If you pick up two HRT items per month, that already costs around 237 pounds per year at standard charges. The PPC immediately saves you more than 100 pounds annually, and the saving grows if you also take vitamin D, thyroid medication, or other regular prescriptions.
Body-identical HRT and private prescription costs
Body-identical HRT, sometimes called bioidentical HRT, refers to hormones that are chemically identical to those your body produces. Products like Utrogestan and Oestrogel are available on the NHS and are body-identical, which is an important clarification. Where costs can rise is when women seek compounded bioidentical hormones from private pharmacies, which are not regulated in the same way and can cost several hundred pounds per month. These are not recommended by the British Menopause Society and are worth discussing carefully with a qualified specialist before committing.
Private clinic prescription costs
If you get an HRT prescription from a private menopause clinic, the doctor may write it as a private prescription rather than an NHS one. Filling a private prescription at a pharmacy means paying the actual drug cost rather than the NHS flat rate. For standard HRT medications, this might cost between 15 and 60 pounds per item depending on the product. Some private clinics write prescriptions that your NHS GP can then convert to NHS prescriptions, which brings costs back to the standard charge. Always ask the clinic about this process before your appointment.
Tracking symptom response to make HRT worthwhile
HRT is not universally effective at the first dosage, and many women go through adjustments before finding the right type and dose. Tracking your symptoms consistently before and after starting HRT gives you and your prescriber clear evidence of what is and is not working. This shortens the trial-and-error period and reduces the number of appointments needed to get the prescription right. Using PeriPlan to log symptoms and track patterns over time means you arrive at each review with data rather than impressions, which makes the conversation with your prescriber more precise.
Budgeting HRT as a long-term expense
Many women take HRT for five, ten, or even more years. Over that timescale, the cost of prescriptions, reviews, and the occasional specialist appointment is substantial. Planning for this as a regular monthly outgoing rather than a variable expense makes budgeting much easier. Set aside a dedicated health fund for prescription costs, any supplements you take alongside HRT, and at least one annual review appointment. If your financial situation changes and you are struggling with prescription costs, speak to your pharmacist about whether you are entitled to free prescriptions based on income or other criteria, as some women are exempt from charges they did not realise they qualified for.
Related reading
Get your personalized daily plan
Track symptoms, match workouts to your day type, and build a routine that adapts with you through every phase of perimenopause.