What to Know About Over-The-Counter HRT in the UK

This September — for the first time ever — women in the UK have been able to purchase hormone replacement therapy (HRT) over-the-counter. Multiple health experts are regarding it as a huge milestone in the broader effort to bring greater awareness of and access to treatment for women going through perimenopause and menopause.

With this historic shift in how women might be able to manage symptoms related to menopause — we’re answering the top questions from our audience on over-the-counter HRT.

Frequently asked questions about over-the-counter HRT

Where can I get HRT without a prescription?

One of the leading high street pharmacies, Boots, is now selling HRT at over 590 stores and online without a prescription. It’s available in a pack of 24 tablets for around £29.99. Some people are able to get this for free with a prescription through the NHS, and you can check your eligibility here. The government is looking to reduce these costs in the future, and HRT is set to be stocked in all Boots pharmacies by the end of October.

What kind of HRT is available over the counter?

There are many types of HRT, but currently, only one specific kind will be offered over-the-counter — which is Gina 10 mcg. This particular HRT comes as vaginal tablets and is a form of local estradiol that’s inserted directly into the vagina with an applicator. Gina is designed to address vaginal pain and discomfort that is common in menopause.

Why the sudden change in how women can access HRT?

This type of HRT has been studied for many years, since the 1990s in fact, with research showing it’s relatively safe for women coping with menopausal symptoms. This change in access is following the review from the RCOG, the Faculty of Sexual and Reproductive Healthcare, and the British Menopause Society.

The government received over 100,000 responses from UK women around the first women’s health strategy and found that menopause was the most cited health issue by women aged 40-59.

Earlier this year, advancements came when the tablets were reclassified by the UK’s regulatory agency (MHRA) from ‘prescription-only’ to a ‘pharmacy medicine’. It’s the first time the agency has reclassified a hormone replacement therapy for OTC use. This increased access came after a summer of supply chain issues that led to Gina medication shortages for women across the UK.

Do any other countries offer this or is it only available in the UK?

One reason this has caught headlines is that it’s the first time something like this is happening! Generally, hormone therapy prescriptions require a medical consultation from a healthcare provider rather than from a pharmacist.

How do I know if this particular HRT (Gina) is a good option for me?

If you’re over 50 years old and haven’t had a period in over a year, the Medicines and Healthcare products Regulatory Agency (MHRA) has listed this particular over-the-counter HRT as suitable for you.

As estrogen levels decline, women may experience vaginal atrophy, when the vaginal tissues become thinner, drier, and less elastic. This can cause symptoms like vaginal dryness, itching, burning, and painful sex, all of which can be debilitating for women. HRT helps replace lost estrogen to alleviate symptoms. If you’ve been noticing symptoms, it’s a good idea to talk to a local pharmacist or your primary care provider to find out if this particular HRT is right for you.

For women who are having trouble accessing care, or for those wanting a more discreet option, over-the-counter HRT is an easily accessible and affordable option to help manage menopausal symptoms.

Are there risks of taking over-the-counter HRT that I should be aware of?

The MHRA states that the risk of side effects with the tablet is very low, however, there are some circumstances that may require women to get a prescription from their doctor for this particular form of HRT. This may include women who have had a type of breast, endometrial, or ovarian cancer, blood clots, stroke, and other cardiovascular diseases.

It may take a few weeks to feel any changes in symptoms, and it's not uncommon to experience side effects at first as your body adjusts. It's important to remember that hormones affect us all differently, so what works for you, might not work for your friend — and vice versa!

If you have any questions or uncertainties, your doctor can help you decide if HRT is right for you, and which type may be best and most suitable for your particular situation.

Should I still consult my doctor before getting over-the-counter HRT?

It’s always a good idea to talk to your doctor before starting a new supplement or medication regimen. Why? Because we are all biologically different! Although this HRT has been studied for years, it’s always good to check with your doctor about whether or not it’s right for YOU.

Are there natural forms of HRT that I can try?

Phytoestrogens! These plant-based estrogen compounds have been extensively studied in recent years to better understand the role they can play in our health and wellness. They may help with declining estrogen symptoms and are classed either as lignans or isoflavones, both of which can be isolated from their food sources and taken as a supplement.

Phytoestrogens from food may yield other beneficial effects related to bone and heart health, and seem to have very few, if any, negative side effects. A review of high-quality studies in 2016 found that when women added isoflavones into their daily routine, there was a modest reduction in daily hot flashes and an improvement in vaginal dryness. You can find plant estrogens naturally in broccoli, carrots, oranges, legumes, soy products, herbs, and more!

Do you have more questions about HRT, Gina, or what other forms of hormone therapies might be available in local pharmacies? Let us know in the comments below and our team of experts will work to get you the answers you need.

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