"It's just hormones, push through."— what you've probably been told
Perimenopause / HRT
NICE NG23 covers identification and management of perimenopause and menopause, including when HRT should be offered, discussed, and reviewed. It is explicit that diagnosis in women over 45 with typical symptoms should not require blood tests.
The wait: Many women are dismissed for years and offered antidepressants instead of HRT.
Many GPs still send women under 45 away with antidepressants, or refuse HRT on outdated risk grounds. NG23 is clear: HRT should be offered for vasomotor symptoms after a balanced discussion of benefits and risks, and ongoing menopausal symptoms warrant review, not dismissal.
- An NG23-aligned assessment for perimenopause / menopause
- A balanced discussion of HRT options as set out in NG23
- Documentation of any reasons HRT is being declined or delayed
My GP says I'm too young for HRT — is that right?
NG23 doesn't set a lower age cut-off. The letter asks for the NG23-aligned assessment and a documented reason if HRT is being withheld.
What's usually said in the room
"It's just hormones, push through."
What the guideline actually says
Many GPs still send women under 45 away with antidepressants, or refuse HRT on outdated risk grounds. NG23 is clear: HRT should be offered for vasomotor symptoms after a balanced discussion of benefits and risks, and ongoing menopausal symptoms warrant review, not dismissal.
Outcomes from people with Perimenopause / HRT
One short email each Sunday — anonymised stories from people who got their GP to take them seriously.