More women than ever are taking HRT. So why is getting hold of it still such a headache?

For years, women were told to get on with the menopause. Hot flushes, sleepless nights, brain fog, anxiety and the strange feeling that your body had suddenly rewritten its own rulebook were treated as an inevitable part of getting older. Something to endure rather than something that might deserve treatment.

Thankfully, that conversation has changed dramatically.

More women are talking openly about menopause, more are asking their doctors about their options and more are taking HRT. In fact, new figures show that the number of women receiving HRT on the NHS has more than doubled in just five years.

That feels like progress. There is, however, a rather frustrating catch.

We may have become much better at prescribing HRT, but actually getting hold of the medication you have been prescribed can still be another matter entirely.

Two million women are now receiving HRT

New figures from the NHS Business Services Authority show that around two million women aged 40 and over received NHS-prescribed HRT for menopause at least once in 2025/26.

Back in 2020/21, that figure was around 800,000.

The biggest users are, perhaps unsurprisingly, women in their early fifties. HRT prescribing is highest among women aged 50 to 54, the point at which many women are navigating menopause alongside careers, families, relationships and everything else life has decided to throw into the mix.

On the face of it, the numbers are encouraging. Menopause has spent decades being under-discussed and, for many women, undertreated. Seeing more women accessing treatment suggests the message that symptoms do not simply have to be tolerated is finally getting through.

But a huge increase in demand also means somebody has to make sure there is enough medication to meet it. And that is where things become less reassuring.

The HRT shortage problem hasn’t gone away

If you take HRT, you may already be familiar with the routine.

You request your repeat prescription, head to the pharmacy and discover that your usual patches are unavailable. Perhaps they will be back next week, maybe another pharmacy has them, maybe you need to speak to your doctor about an alternative.

Suddenly, a medication you take routinely becomes another piece of life admin.

The National Pharmacy Association has warned that the rapid growth in HRT prescribing could put further strain on medicine supplies if supply chains do not keep pace.

There are already problems with certain HRT products. Estradot patches, for example, have been affected by ongoing shortages, with Serious Shortage Protocols in place for some strengths.

It is not the first time HRT supplies have struggled to keep up with demand either. Shortages became a major issue in 2022 as rapidly growing numbers of women sought treatment, eventually prompting government intervention.

That history makes the latest prescribing figures particularly interesting. We have gone from fewer than one million women receiving NHS HRT to around two million in five years. The demand for menopause treatment has changed enormously, and the systems supplying it need to change with it.

A prescription isn’t much use if nobody has it in stock

Anyone who has tried to find a hard-to-source medication knows how quickly the process can become exhausting.

The frustrating thing is that your medicine may be available somewhere. The problem is finding out where.

One pharmacy being out of stock does not necessarily mean every pharmacy is. But traditionally, the burden of finding another supply has often fallen on the patient, which can mean calling or visiting pharmacies individually.

It is one of the reasons electronic prescribing platforms are becoming increasingly useful, particularly when they connect clinicians to larger pharmacy networks rather than just replacing a piece of paper with a digital prescription.

Daniel Bulkin, Founder of Healistic, an e-prescribing platform used by private clinicians, believes the ability to find medication is becoming almost as important as the ability to prescribe it.

“Medicine shortages are a huge problem, and patients are increasingly finding that getting a prescription doesn’t necessarily mean their usual pharmacy will have the medication available.

“For women taking HRT medication, that can be particularly frustrating because many have already spent time finding the treatment and dose that works for them. They shouldn’t then have to spend days ringing pharmacies trying to find it.

“This is one of the reasons e-prescribing platforms like Healistic are becoming so popular. If you can connect a prescription with a much wider pharmacy network and source medication based on where stock is actually available, you can take a lot of that work away from the patient.

“Technology can’t create more medication when there is a genuine national shortage, but it can make it much easier to find the stock that is out there.”

It sounds remarkably simple, but it tackles one of the biggest issues of modern healthcare: we can send money around the world in seconds and see exactly which supermarket has a particular pair of shoes in stock, yet finding out which pharmacy has your medication can sometimes involve an afternoon on the telephone.

Where you live still makes a surprisingly big difference

There is another story hiding within the new figures too. Women are not accessing HRT equally.

The highest prescribing rates are in the South East, where 15.7 women per 100 women aged over 40 received HRT. London has the lowest regional rate, at 10.4 per 100.

Look closer and the differences become even more striking. Brighton and Hove recorded the highest local authority prescribing rate at 23 women per 100. In Newham, East London, it was just four.

There is a socioeconomic divide too. Among women aged 50 to 54, 35.3 per 100 women living outside the most deprived areas received HRT, compared with 20.5 per 100 in the most deprived fifth of the country.

That matters because the menopause itself obviously does not become less troublesome depending on your postcode or income.

The NHSBSA says understanding these differences will be important in ensuring improvements in menopause care do not end up widening existing health inequalities.

And as HRT becomes increasingly normalised, that may be the next big conversation. It is one thing to make women more aware of the treatments available to them. It is another to make sure every woman has a realistic chance of accessing them.

We’ve won one battle. There are others to fight

The rise in HRT prescribing should not be viewed as bad news, quite the opposite.

Women are asking more questions about their health. Menopause is being discussed at kitchen tables, in workplaces and in doctors’ surgeries in a way it simply wasn’t a generation ago. Treatments that many women previously knew little about have become part of everyday conversation.

That is a significant cultural shift, but it has exposed the next problem.

There is little point encouraging women to ask for help, improving diagnosis and writing more prescriptions if the medicine itself becomes difficult to find. Access to HRT does not end when somebody presses “send” on a prescription.

The good news is that the systems around prescribing are changing too. Better stock visibility, wider pharmacy networks and electronic prescribing could make the familiar hunt from pharmacy to pharmacy much less common.

After years of women being told to simply put up with menopause symptoms, two million women receiving HRT feels like genuine progress.

They shouldn’t have to fight another battle at the pharmacy counter.