"It's just hormones, push through.", what you've probably been told
Perimenopause / HRT
NHS guideline 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.
What GPs miss
Many GPs still send women under 45 away with antidepressants, or refuse HRT on outdated risk grounds.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.
The letter asks for
- 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
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Frequently asked questions
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 you hear vs. what NG23 says
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Many GPs still send women under 45 away with antidepressants, or refuse HRT on outdated risk grounds.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.
Benefits and rights for Perimenopause / HRT
HRT on the NHS
What NG23 says your GP should offer.
Read the guide →
GP won't prescribe HRT — what to do
How to escalate when your GP gatekeeps.
Read the guide →
Right to Choose: menopause
Put a referral request to a menopause specialist on your record.
Read the guide →
Testosterone HRT on the NHS
Who can get it, how to ask, what NICE says.
Read the guide →
Prescription refused — what to do
Your rights when a GP refuses to prescribe HRT.
Read the guide →
Outcomes from people with Perimenopause / HRT
One short email each Sunday, anonymised stories from people who got their GP to take them seriously.