Skip to main content

Menopause · UK

A private menopause clinic, by a BMS-registered specialist.

A proper 45-minute consultation with a British Menopause Society specialist - NICE NG23-aligned, transdermal-first, body-identical where it fits, and honest about risks. HRT is not the only answer, but it is a good one for most.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private menopause clinic costs in the UK.

Indicative ranges across UK private providers.

In short

A BMS-specialist consultation: £250–£450, plan and prescription in the same visit.

Service Indicative range
Specialist consultation (initial) £250–£450
Follow-up consultation £150–£250
Menopause blood panel (FSH, thyroid, ferritin) £120–£280
DEXA (bone density) if indicated £150–£300
Private HRT prescription (per month) £30–£90
NHS route (GP or specialist clinic) Free · £11.90 pre-pay

Prices vary by clinic, by the specialist, and by whether testosterone or additional bloods are added. NHS HRT is free on prescription for women (the pre-payment certificate is £11.90 for a year of repeats).

The problem

The right specialist, the right HRT, the right conversation.

Menopause care in the UK is patchy - ten-minute GP slots, long specialist NHS waits, and a wall of confusion between HRT, body-identical, testosterone and non-hormonal options. We fix all three before you commit to a plan.

  • Not sure it is menopause?

    Thyroid, iron, depression and stress mimic it. A specialist takes the time to rule the mimics in or out.

  • Worried about HRT risks?

    You should hear the numbers, not slogans. Breast, clot, stroke and heart - in your context, with your history.

  • Been told no by a GP?

    Migraine, family history, or a past clot do not automatically rule out HRT. A specialist knows where the real lines are.

When it helps

When a specialist menopause clinic is the right step.

The situations we see most - perimenopause typically starts 4–8 years before the final period (median UK age 51) - plus the one red flag that means gynaecology, not us.

  • Hot flushes and night sweats

    Vasomotor symptoms - the classic reason women reach for help. HRT resolves them in eight or nine cases in ten.

  • Sleep disturbance and fatigue

    Waking at 3am, drenched or wired. Sleep is often the first thing HRT restores, and the most life-changing.

  • Mood, anxiety and brain fog

    Low mood, irritability, tearfulness, poor concentration. Frequently misdiagnosed as depression when it is perimenopause.

  • Joint and muscle pain

    Aching joints, stiff hands, sore hips - a very common perimenopausal symptom that HRT often eases.

  • Vaginal dryness and painful sex

    Genitourinary syndrome of menopause. Local vaginal oestrogen is safe, effective and often life-changing on its own.

  • Recurrent UTIs and urinary urgency

    Recurrent cystitis and bladder urgency after menopause respond well to local vaginal oestrogen - antibiotics are not the only answer.

  • Premature ovarian insufficiency

    Menopause under 40 (POI) or 40–45 (early). HRT is recommended until at least the natural age of menopause - this is not optional.

  • Red flag: post-menopausal bleeding

    Any bleeding after 12 months of no periods needs urgent gynaecology assessment - not a menopause clinic booking.

Treatment options

HRT is one option, and a good one. It is not the only one.

What each option on the table actually involves - and which fits which symptom pattern and history.

  • Transdermal HRT (patch, gel, spray)

    Oestrogen through the skin - Evorel, Sandrena, Oestrogel, Lenzetto. Lower VTE and stroke risk than tablets; the UK first-line route.

  • Oral HRT (tablet)

    Elleste, Femoston, Kliovance and others. Convenient - but a slightly higher clot risk than transdermal. A reasonable choice for many.

  • Micronised progesterone (Utrogestan)

    Body-identical progesterone. The preferred progestogen where a uterus is present - often kinder on mood and breast tissue.

  • Testosterone (Testogel, AndroFeme)

    Off-label in the UK for women, BMS-supported. For persistent low libido on adequate oestrogen - small daily doses, monitored.

  • Local vaginal oestrogen

    Vagifem tablets, Ovestin cream, Estring ring. Low-dose, largely non-systemic - safe for most, including many after breast cancer.

  • Fezolinetant (Veoza)

    A new non-hormonal option (NK3 receptor antagonist) licensed in the UK from 2024 for hot flushes when HRT is not suitable.

  • SSRIs, SNRIs, gabapentin, CBT

    Non-hormonal routes for vasomotor symptoms and mood - venlafaxine, escitalopram, gabapentin, or menopause-specific CBT.

  • Consultation only

Safety and shared decisions

What HRT really involves - honestly.

Menopausal hormone therapy is well-studied and, for most women under 60, benefits outweigh risks. The numbers are worth hearing in full - that is what a specialist consultation is for.

  • Breast cancer risk in context

    The small increase in breast cancer risk with combined HRT sits below that of drinking two units of alcohol daily or being overweight. Numbers should be shared, not skipped.

  • Transdermal is kinder to clots

    Oestrogen through the skin does not raise VTE or stroke risk in the way oral oestrogen does. It is why patch, gel and spray are UK first-line.

  • Progestogen protects the womb

    If you have a uterus, oestrogen without progestogen is not safe - endometrial cancer risk climbs. Micronised progesterone is usually the kindest choice.

  • The timing hypothesis matters

    HRT started under 60 or within ten years of menopause is associated with cardiovascular benefit. Starting much later is a different conversation.

  • Vaginal oestrogen is very safe

    Local oestrogen barely enters the bloodstream. Even most women with a breast cancer history can use it safely - a shared decision, not a blanket no.

  • HRT is not lifelong-committed

    You can stop, restart, change dose or change route. NICE does not put an arbitrary time limit on HRT for symptomatic women.

  • POI needs HRT, not just symptom relief

    Premature ovarian insufficiency (menopause under 40) needs oestrogen until at least the natural age of menopause - for bone, heart and brain.

  • Lifestyle still counts

    Exercise, Mediterranean diet, sleep hygiene, less alcohol, not smoking - every one of them helps symptoms and reduces risk alongside HRT.

  • Red flags

    Any bleeding after 12 months without periods, a new breast lump, unilateral leg swelling, sudden severe headache or chest pain - same-day medical help.

Reading your consultation note

Your consultation note in four parts. Read the last one first.

Every menopause specialist writes to their own style, but the shape of a good note is the same.

A UK menopause specialist reviewing a patient’s consultation notes

A quiet reminder

HRT names read like alphabet soup - ask your care team to explain them if anything is unclear.

Ask your care team to explain anything that is unclear.

  1. 01 Header

    Symptoms, history and risk profile

    What you came in with, your gynaecological and family history, and the risks that shaped the plan - clot, breast, migraine, cardiovascular.

  2. 02 Assessment

    Menopause stage and any bloods

    Whether you are perimenopausal, menopausal or post-menopausal, and any FSH, thyroid or ferritin results - with what they mean.

  3. 03 Plan

    HRT choice, dose, route and progestogen

    The regimen prescribed - oestrogen preparation and dose, progestogen where relevant, testosterone or vaginal oestrogen if added.

  4. 04 Impression

    Review schedule and what to watch for

    Read this first: when to come back, how to titrate the dose, and the symptoms that mean call sooner rather than wait.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for menopause consultations varies by insurer. Consultations are often covered where symptoms are documented; HRT prescriptions are typically self-pay.

Frequently asked

Everything we get asked about a menopause clinic.

Quick answers on HRT safety, testosterone, breast cancer history, cost, and how it compares to the NHS route.

  • Do I need blood tests before starting HRT?

    Usually not, if you are over 45 and have typical symptoms - NICE NG23 says the diagnosis is clinical. If you are under 45 (and especially under 40), FSH is checked to look for premature ovarian insufficiency. Thyroid and ferritin are often worth checking to rule out other causes of fatigue and low mood.

  • Is HRT safe? What about breast cancer risk?

    For most women under 60, or within ten years of menopause, the benefits of HRT outweigh the risks. Combined HRT carries a small increase in breast cancer risk that sits below the risk from drinking two units of alcohol daily or being overweight. Oestrogen-only HRT (after hysterectomy) does not appear to raise breast cancer risk. Your specialist will walk you through the numbers for your own situation.

  • Patch, gel, spray or tablet - which is best?

    Transdermal oestrogen (patch, gel or spray) is UK first-line because it does not raise blood clot or stroke risk in the way oral oestrogen does. Tablets are convenient and fine for many women without those risks. The choice is personal - one size does not fit all.

  • Can I have HRT with a history of migraine?

    Usually yes, including with migraine with aura, provided transdermal oestrogen is used and the dose is steady. Oral oestrogen and combined oral contraceptives are the ones that need caution - HRT itself is not off the table.

  • What is testosterone for, and can I get it?

    Testosterone is prescribed for persistent low sexual desire that has not responded to adequate oestrogen replacement. It is off-label in the UK for women but supported by the British Menopause Society. Testogel is used in small daily doses (about a fifth of the male dose) with blood monitoring.

  • What if I have had breast cancer?

    Systemic HRT is generally avoided after breast cancer, but local vaginal oestrogen is often safe with shared decision-making, and non-hormonal options - SSRIs, CBT, gabapentin, fezolinetant - genuinely help. This is a joint conversation with your oncologist and menopause specialist, not an automatic no.

  • How much does a private menopause clinic cost in the UK?

    An initial specialist consultation is typically £250–£450, follow-ups £150–£250. Private HRT prescriptions run £30–£90 a month depending on the regimen. NHS HRT is free of charge on prescription for women, and a pre-payment certificate covers a year of repeats for £11.90.

  • How long can I stay on HRT?

    There is no arbitrary NICE time limit. As long as symptom benefit outweighs risk in a shared review, HRT can continue. Many women stay on it into their sixties and beyond. Others stop, and some restart later.

  • Can I get HRT on the NHS?

    Yes. Your GP can prescribe HRT, and there are NHS specialist menopause clinics for complex cases - waiting times vary. If NHS access is quick where you are, we will tell you. If it is not, a private specialist appointment gets you a plan in a week.

  • When is it not menopause?

    Thyroid disease, iron deficiency, depression, sleep disorders and some medications can mimic menopausal symptoms. A specialist consultation covers all of this - not just HRT-or-not.

Related

Looking for something else?