Menopause and HRT clinic

What is a menopause and HRT clinic?

The menopause is when periods stop, usually around the early 50s. The years of changing hormones leading up to it are called the perimenopause, and symptoms often start then. A menopause clinic is an appointment to talk through your symptoms, your health and your choices.

Many people are helped by hormone replacement therapy (HRT), which replaces the oestrogen the body makes less of, with a progestogen added if you still have a womb. HRT can ease hot flushes, night sweats, mood, sleep, joint aches and vaginal dryness, and it helps protect the bones. It is a treatment for symptoms (and bone health in some people), not an anti-ageing therapy or a way to prevent heart disease or dementia.

HRT is not the only option, and it is not right for everyone. A good clinic explains the realistic benefits and the risks — including the effect on breast cancer, blood clot and stroke risk — and how the way you take it (a patch or gel rather than tablets, for example) changes some of those risks. The aim is a plan that fits your symptoms, your health and what matters to you.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Oestrogen through the skin compared with tablets

NICE advises considering a patch or gel rather than tablets if you are at higher risk of blood clots, including a body mass index over 30. The route changes clot and stroke risk; it does not remove the breast cancer considerations of combined HRT.

Preparing for your appointment

• Keep a short diary of your symptoms, how bad they are and how they affect daily life, and note your recent periods.
• Write down your full medical history, especially blood clots, stroke, heart disease, migraine, liver problems or any hormone-sensitive cancer.
• Note any family history of breast cancer, ovarian cancer or blood clots.
• Bring a list of all your medicines and supplements, including anything bought online.
• Be ready to talk about what matters most to you — symptom relief, bone health, avoiding certain risks — so the plan fits your priorities.
• Make sure you are up to date with breast screening and cervical screening, and mention any unusual bleeding.
• Think about your questions in advance, including how long you might stay on treatment and how it will be reviewed.

What happens

The clinician asks about your symptoms, periods, general health, and personal and family history, and checks things such as your blood pressure and sometimes your weight. Blood tests are not usually needed to diagnose menopause in women over 45 with typical symptoms, though they are sometimes used in younger people or unclear cases.

You then discuss the options. If HRT is suitable, the clinician explains the type (oestrogen alone if you have had a hysterectomy, or combined with a progestogen if you still have a womb), the way to take it, and the benefits and risks for you. Vaginal oestrogen, testosterone for low desire, and non-hormonal options are discussed where relevant.

You usually leave with a shared plan and, if agreed, a prescription, plus advice on what to expect and when to come back. A review is normally arranged at about 3 months to check how you are getting on, and then around once a year.

Is this appointment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The headline risks are breast cancer, blood clots and stroke. Combined HRT slightly raises breast cancer risk, more so the longer it is used, and the risk falls again after stopping; oestrogen-only HRT carries little or no increase. Tablet HRT raises blood-clot and stroke risk, whereas oestrogen through the skin does not at standard doses. These risks are individual, so ask the clinician to explain what they mean for you given your age, weight, family history and how you take HRT.

Published figures to discuss

The benefits and risks of HRT depend on your age, when you start, the type and route, how long you use it, and your personal and family history. Exact numbers vary between studies and are often small in absolute terms. The points below summarise the direction and rough size of the main risks from UK guidance rather than precise individual figures.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery from the appointment itself. If you start HRT, the focus is on how your symptoms respond over the following weeks and on reviewing the plan.

• Breast tenderness, bloating, mild nausea or headaches in the first weeks
• Irregular bleeding or spotting in the early months of HRT
• Symptoms easing gradually over several weeks rather than overnight
• Needing one or two adjustments to find the dose and type that suit you

Aftercare

• Use HRT as prescribed, and give it several weeks before judging whether it is working.
• If you have a womb, take the progestogen part (or use the hormone coil) as directed to protect the womb lining.
• Report any unexpected, heavy or persistent bleeding so it can be checked.
• Keep up with breast and cervical screening as invited.
• Tell your clinician if you develop new health problems or start new medicines.
• Attend the 3-month and yearly reviews, and raise any side effects rather than just stopping.
• Stick to regulated, MHRA-approved HRT and avoid unregulated 'bioidentical' or compounded hormones.

• Symptom diary to track your response
• A note of your medical and family history
• List of all medicines and supplements
• Screening (breast and cervical) up to date
• Questions about benefits, risks and review timing
• The clinic's contact details for side effects or bleeding
• A reminder set for your 3-month review

⚠ Get urgent help if…

• Vaginal bleeding that first starts more than 6 months after beginning HRT (or more than 3 months after changing the dose or type), that carries on beyond those times, becomes heavy or concerning, or happens after sex — this needs prompt assessment to rule out a problem such as womb cancer
• A new breast lump or other breast change
• A swollen, hot or painful calf, or sudden chest pain or breathlessness (possible blood clot)
• Sudden weakness, numbness, difficulty speaking or a severe headache (possible stroke)
• Yellowing of the skin or eyes, or severe tummy pain
• A severe or unusual headache, especially with migraine and aura

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is meaningful relief of the symptoms that were troubling you, with side effects that are tolerable and risks you understand and accept. HRT does not stop you ageing, does not guarantee relief of every symptom, and is not used to prevent heart disease or dementia. The plan is judged on how you feel and is reviewed and adjusted over time, not fixed forever.

There is no fixed time limit on HRT; the decision to continue is reviewed regularly by weighing your symptoms against your changing risks. Some people use it for a few years through the worst symptoms, others for longer. Bone protection lasts while you take it and lessens after stopping. Vaginal oestrogen can be continued long term for ongoing dryness or urinary symptoms.

Related tests, treatments or support

HRT is often combined with vaginal oestrogen if dryness persists, and testosterone may be added for low desire that has not improved with HRT alone. Menopause-specific CBT and lifestyle measures can be used alongside or instead of HRT. A hormone coil can provide the progestogen part of HRT while also giving contraception, which is useful in the perimenopause.

Follow-up & long-term care

You are normally reviewed at about 3 months after starting or changing HRT, then around once a year. Reviews check symptom control, side effects, blood pressure, and whether the benefits still outweigh the risks. Some bleeding is expected while your body settles — in the first 6 months of starting HRT, and for up to 3 months after a change of dose or preparation. Bleeding that first starts after those times, carries on beyond them, becomes heavy or concerning, or happens after sex should prompt earlier contact, as should any new breast change or new health problem.

• Take HRT as prescribed and reorder in good time to avoid gaps
• Attend 3-month and annual reviews
• Keep up with breast and cervical screening
• Report unexpected bleeding, breast changes or new symptoms promptly
• Review continuing HRT with your clinician rather than stopping suddenly

Repeat, follow-on and what comes next

• Finding the right dose, type and route often takes one or two adjustments.
• Treatment is reviewed regularly and may be changed, continued or stepped down as your symptoms and risks change.
• Unexpected or persistent bleeding may need investigation, such as an ultrasound or hysteroscopy.
• HRT can be restarted or switched rather than abandoned if the first choice does not suit.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear plan with a 3-month review and then annual reviews.
• Written information on benefits, risks and what side effects to expect.
• Clear advice on which bleeding or symptoms need prompt assessment.
• Use of regulated, MHRA-approved HRT only, with sensible monitoring of blood pressure and symptoms.
• A named contact route for side effects, questions or problems between appointments.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Length and type of appointment, and whether it is a first assessment or a review
• Any blood tests or investigations arranged
• Number and length of follow-up appointments
• Whether testosterone or specialist treatments are included
• Prescription and the cost of the HRT itself, which varies by product
• Letters or reports to your GP or other clinicians

• The clinician's fee for the first appointment and for reviews
• Whether any tests are included or charged separately
• How follow-up and the 3-month review are charged
• Whether prescriptions and the medicines themselves are included
• The cost of any letters or reports
• What happens, and what it costs, if treatment needs changing or extra visits are needed
• Confirmation that only regulated, MHRA-approved HRT is prescribed

On the NHS? Menopause assessment and HRT are available on the NHS, usually starting with your GP, with referral to a specialist clinic where needed; private clinics offer quicker or longer appointments using the same regulated treatments.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Given my symptoms and health, do you recommend HRT, and which type and route for me?
• What are my personal risks for breast cancer, blood clots and stroke with this plan?
• Should I use a patch or gel rather than tablets in my case?
• How long might I stay on HRT, and how will we review it?
• What are my non-hormonal options if I cannot or prefer not to take HRT?
• Do I still need contraception, and what would you suggest?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my appointment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this appointment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for menopause and hrt clinic

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE NG23 — Menopause: identification and management NHS — Hormone replacement therapy (HRT) British Menopause Society — Tools for clinicians and information BMS/RCOG — The dangers of compounded bioidentical HRT (BJGP)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.