Concierge menopause care · UK
Hormone replacement therapy, done properly.
A BMS-accredited menopause specialist, a transdermal-first regimen with micronised progesterone, and testosterone where it genuinely helps — aligned to NICE NG23 (2024) and the British Menopause Society.
Why patients choose us
- 01
A BMS-accredited menopause specialist
Not a five-minute GP appointment and not an online algorithm. A named menopause specialist who knows NICE NG23, the BMS guidance, and how to individualise a regimen.
- 02
Transdermal-first, micronised progesterone
The safer combination — lower VTE risk, better tolerated. We recommend the up-to-date regimen, not whatever the last decade left on the repeat.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private HRT costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A specialist consultation in our network: £220–£350, prescription costs £120–£360 a year.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial menopause consultation (60 min) | £220–£350 | 60 min | Same visit |
| Follow-up / 3-month review | £120–£200 | 20–30 min | Same visit |
| Annual review | £140–£220 | 30 min | Same visit |
| Private HRT prescription (annual cost) | £120–£360 | Repeat | Same day |
| Testosterone consultation & prescription | £250–£450 | 45 min | Same visit |
| Full menopause bloods (FSH, LH, oestradiol, thyroid, ferritin, lipids) | £180–£320 | 15 min | 2–5 days |
Prices vary by clinic, by the specialist, and by whether bloods or testosterone are added. Once on a stable regimen many patients ask their NHS GP to take over the prescription — where the item charge is £9.90 or £115.15 for an annual prepayment certificate. We come back with a firm quote within one working day.
The problem
The right regimen, the right route, the right specialist.
HRT in the UK is either a 10-minute GP appointment with an oral tablet, or an online form and a courier. Neither is really menopause care. A specialist visit — done once, properly — is the difference.
-
Not sure if it is menopause?
Perimenopause hides behind sleep, mood and brain fog. A specialist works out what is menopausal and what is not.
-
On HRT but still not right?
Wrong route, wrong progestogen, wrong dose. A one-off review with a specialist usually fixes it.
-
Want to talk about testosterone?
A specialist knows when it is worth trying, how to prescribe it in the UK, and how to monitor it — most GPs will not.
The journey
From enquiry to a stable regimen — what happens, in order.
One specialist from first message to your three-month review — including the fine-tuning most patients need.
Phase 1 · Before your consultation
Concierge, off-stage for you
Phase 2 · The consultation
An hour with a specialist
Phase 3 · After
Review and shared care
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, last period, medical history, family history, and what has already been tried.
- 02
Before
We come back with a recommendation
Within one working day: the right specialist, whether bloods are needed, and an indicative price for the initial consultation and prescription.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Video or in-person, depending on the clinic and your preference.
- 04
The consultation
The consultation
A full menopause history, a look at contraindications, blood pressure and BMI, and a shared decision on regimen — route, dose, progestogen, and testosterone if relevant.
- 05
The consultation
The prescription
A private prescription — transdermal oestrogen, micronised progesterone or Mirena, and vaginal oestrogen or testosterone as needed.
- 06
The consultation
Starting HRT
Written instructions on how to apply patches, gel or spray, what to expect in the first three months, and what is not normal.
- 07
After
Review at 3 months, then annually
A short review at three months to titrate the dose, then annual reviews to re-check symptoms, risks and whether to continue.
Typical end-to-end: 1–2 weeks from enquiry to first prescription. First stable regimen: 3 months.
When it helps
When HRT is the right step.
The situations we see most, plus the one red flag that means an appointment today rather than a repeat prescription.
-
Hot flushes and night sweats
Vasomotor symptoms — the most common reason to start HRT, and the symptom it treats best.
-
Sleep, mood and brain fog
Broken sleep, low mood, anxiety and word-finding difficulty in perimenopause often respond to systemic oestrogen.
-
Vaginal dryness and painful sex (GSM)
Genitourinary syndrome of menopause — dryness, dyspareunia, urgency, recurrent UTIs. Vaginal oestrogen alone is often enough.
-
Joint aches and skin changes
Diffuse joint stiffness and dry, thinning skin that appear alongside other menopausal symptoms.
-
Reduced libido
Persistent low sexual desire that troubles you — sometimes helped by oestrogen alone, sometimes by adding testosterone.
-
Premature ovarian insufficiency (POI)
Menopause before 40. HRT is essentially mandatory until natural menopause age for bone and cardiovascular protection, unless contraindicated.
-
Early menopause (40–45)
A strong case for HRT to preserve bone density and cardiovascular health, alongside symptom control.
-
Red flag: unexplained bleeding
Any postmenopausal bleeding, or new heavy or irregular bleeding on HRT after the first three months, needs urgent assessment — not a repeat prescription.
Regimen options
HRT is not one thing — it is a combination.
The pieces on the table — the oestrogen route, the progestogen, vaginal oestrogen, testosterone, and the non-hormonal alternatives — and which fits which situation.
-
Transdermal oestrogen — patch
Evorel or Estradot changed twice a week. First-line per BMS: no increased VTE risk, steady levels, easy to titrate.
-
Transdermal oestrogen — gel or spray
Oestrogel or Sandrena gel, Lenzetto spray, applied daily. Same VTE-safe route as patches, useful if skin reacts to adhesive.
-
Oral oestrogen
Elleste, Zumenon, Progynova. Convenient, but carries a 2–3× VTE risk and a small stroke risk — reserved for women without vascular risk factors.
-
Micronised progesterone (Utrogestan)
The closest to natural progesterone and best-tolerated option. Nightly 200mg for 12 nights (sequential) or 100mg daily (continuous), if you have a uterus.
-
Mirena IUS
Levonorgestrel coil — endometrial protection plus contraception in perimenopause, in one device, for five years.
-
Vaginal oestrogen
Cream, pessary or ring — Vagifem, Ovestin, Estring, Imvaggis. Minimal systemic absorption, safe long-term, can be used alone or alongside systemic HRT.
-
Testosterone (off-label)
AndroFeme or off-label Testogel/Tostran at a fraction of the male dose, for persistent low libido (HSDD) that has not responded to oestrogen alone.
-
Non-hormonal alternatives
SSRIs/SNRIs, gabapentin, clonidine, CBT and fezolinetant (Veozah, NICE TA1035) — options when HRT is not wanted or not safe.
Our vetted UK network
A small panel of menopause specialists, we picked them.
BMS-accredited menopause specialists across the UK, with video consultations available nationally. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every specialist in our network.
-
BMS-accredited menopause specialists, not general private GPs
-
Transdermal oestrogen and micronised progesterone offered as first-line
-
Testosterone prescribing available for HSDD, with proper monitoring
-
Willing to work alongside your NHS GP for shared-care prescribing
Safety and risks
What the numbers actually say — honestly.
HRT is safer than the 2002 WHI headlines suggested — but the risks are real and route-dependent. The point of a specialist visit is to make the trade-off yours, not the algorithm’s.
-
VTE risk depends on the route
Oral oestrogen roughly doubles VTE risk. Transdermal patches, gel and spray do not — which is why they are first-line for anyone with vascular risk factors.
-
Breast cancer risk is small
Combined HRT adds around one extra breast cancer per 1,000 women per five years of use (NICE NG23, 2024). Oestrogen alone carries little or no increase.
-
Coronary heart disease
HRT does not increase coronary risk, and may reduce it if started within ten years of menopause or before age 60 — the "timing hypothesis" from the WHI re-analysis.
-
Endometrial protection is essential
If you have a uterus, systemic oestrogen must be balanced with a progestogen or Mirena. Unopposed oestrogen raises endometrial cancer risk.
-
The first three months
Breast tenderness, spotting, bloating and mood dips are common in the first 8–12 weeks as your body adjusts. Persistent symptoms after that mean a dose or regimen change, not stopping.
-
Bone and long-term benefits
HRT protects bone density and reduces fracture risk while you take it — a significant benefit for women with early menopause, POI, or low BMI.
-
Duration is individualised
There is no fixed stop date. Many women take HRT for 2–5 years; others take it for decades. Annual review balances benefit and risk for you specifically.
-
When HRT is not the right answer
Current oestrogen-sensitive breast cancer, untreated endometrial hyperplasia, active VTE or severe liver disease. Prior breast cancer is a specialist decision.
-
Red flags
Unexplained postmenopausal bleeding, a new breast lump, calf swelling or sudden severe chest pain or breathlessness need same-day assessment.
Reading your treatment plan
Your plan in four parts. Read the last one first.
Whichever regimen is chosen, the letter your specialist sends keeps to the same shape.
A quiet reminder
Clinical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the plan before your review, just ask.
- 01 History
Symptoms, LMP, family history
What you are experiencing, when your last period was, and family history of breast, ovarian, cardiovascular or clotting problems.
- 02 Assessment
BP, BMI, contraindications, bloods
Blood pressure, BMI, medication review, and blood tests only where the picture is unclear (age under 45, atypical symptoms, POI suspected).
- 03 Regimen
Route, dose, progestogen, testosterone
The specific regimen agreed with you — transdermal or oral oestrogen, dose, sequential or continuous progestogen, Mirena, vaginal oestrogen, testosterone if indicated.
- 04 Plan
Review schedule and shared care
Read this first: when to review, what to watch for, and whether your NHS GP will take over the prescription after the initial phase.
Recognised by major UK insurers
Cover for menopause consultations varies by insurer — most policies cover the specialist visit; prescription costs are usually self-pay. We confirm cover before booking.
Frequently asked
Everything we get asked about HRT.
Quick answers on cost, safety, testosterone, and how long you can stay on it.
-
Do I need blood tests before starting HRT?
Usually not. NICE NG23 says the diagnosis is clinical over age 45 — symptoms and last menstrual period are enough. Bloods (FSH, LH, oestradiol) are used if you are under 45, if premature ovarian insufficiency is suspected, or if the picture is atypical.
-
Is transdermal HRT safer than oral?
For clotting and stroke risk, yes. Oral oestrogen roughly doubles VTE risk; transdermal patches, gel and spray do not. That is why the British Menopause Society recommends transdermal as first-line, especially if you have any vascular risk factors.
-
How much does private HRT cost in the UK?
An initial specialist consultation is roughly £220–£350, follow-ups £120–£220, and private prescriptions add £10–£30 per item per month — around £120–£360 a year. The NHS charge is £9.90 per item, or £115.15 for an annual prepayment certificate.
-
What is the breast cancer risk on HRT?
Small. NICE NG23 (updated 2024) puts the added risk from combined HRT at around one extra case per 1,000 women per five years of use, on top of a baseline of roughly 5–10 per 1,000 at age 50–60. Oestrogen alone carries little or no increase. Micronised progesterone appears to carry less risk than synthetic progestogens.
-
Can I have HRT if I still have periods?
Yes. Perimenopausal women use a sequential regimen — oestrogen every day plus 12 nights of progestogen each cycle, giving a monthly withdrawal bleed. Once you have been period-free for a year (or from age 54), you switch to a continuous, bleed-free regimen.
-
What about testosterone for low libido?
Recognised by NICE NG23 (2024) and BMS for hypoactive sexual desire disorder in postmenopausal women, once oestrogen is optimised. AndroFeme (unlicensed, imported) or off-label Testogel/Tostran at a small fraction of the male dose. It needs specialist initiation and blood monitoring.
-
How long can I stay on HRT?
There is no fixed stop date. Some women take it for 2–5 years; others for decades. NICE removed the arbitrary "shortest time" wording — the decision is made annually, based on how you feel and your personal risk profile.
-
Can I have HRT if I have had breast cancer?
Systemic HRT is generally not recommended after oestrogen-sensitive breast cancer, but this is an individual specialist decision. Vaginal oestrogen for GSM may still be considered with your oncology team. Non-hormonal options — SSRIs, CBT, fezolinetant — are the usual route.
Related
Looking for something else?
-
Menopause
The condition — symptoms, diagnosis and beyond HRT.
Learn more -
Feminising hormone therapy
Gender-affirming oestrogen and anti-androgen therapy.
Learn more -
Hormone therapy for breast cancer
Endocrine therapy — tamoxifen, aromatase inhibitors.
Learn more -
All tests
Every test and procedure we arrange.
Learn more