Menopause affects every woman, but the quality of care varies dramatically depending on where you live and which GP you see. There's a big gap between what research shows works and what many women actually experience in the NHS.
What the evidence shows about HRT
In 2002, a major study created widespread fear about hormone replacement therapy (HRT). That fear has been corrected by newer research, but many GPs are still cautious about prescribing it. Current guidelines from NICE (the organisation that reviews medical evidence) are clear: for most women, HRT started around menopause offers more benefits than risks. It helps with hot flushes, protects bones, and supports heart health when started early.
Yet many GPs still avoid prescribing HRT, prescribe doses that are too low, or don't mention it as an option at all. If your GP is reluctant to discuss HRT, this often reflects outdated training rather than what the current evidence actually supports.
Menopause is more than just hot flushes
Your heart health changes after menopause. Your bones lose density faster. Your sleep, mood, and thinking can all shift. A complete menopause care plan addresses all of these — not just the hot flushes.
If your GP's approach is limited to "here's an HRT prescription" with no broader health check, that's incomplete care. You deserve assessment of your whole health picture, not just symptom relief.
Finding specialist menopause care
NHS menopause clinics exist but often have long waiting lists. A British Menopause Society-accredited specialist — whether on the NHS or private — brings expertise that most GPs simply don't have.
Look for a specialist who takes a comprehensive approach: full hormone assessment, heart health evaluation, bone health screening, and a care plan tailored to your individual health profile and what you actually want.
Related: Private GP vs NHS GP: What You're Actually Paying For