Do you need a referral for hormone replacement therapy?

Hormone replacement therapy can include oestrogen, with a progestogen for people who have a uterus, and may be delivered as tablets, patches, gels or other preparations. The clinician considers your symptoms, menstrual and menopause history, medical conditions, medicines, family history and personal preferences.

Some clinics accept direct appointments for menopause care. Others require a referral from a primary-care clinician or another doctor. A prescription should follow an individual review rather than a standard package chosen without checking your circumstances.

Ask the clinic or health service whether you can book a menopause consultation directly and whether it needs a referral, recent test results or a medication list. Prepare a record of hot flushes, sleep changes, vaginal symptoms, mood changes and bleeding, including when they began and how they affect daily life.

Tell the clinician about unexplained vaginal bleeding, previous blood clots, liver disease, breast or womb conditions, migraines and medicines. Ask which form of treatment is being considered, how it will be monitored and what alternatives may help if hormones are unsuitable.

Arrange prompt medical review for bleeding after menopause, heavy or persistent bleeding, or new pelvic pain rather than starting hormones without assessment. Seek urgent care for chest pain, sudden breathlessness, coughing blood, or one-sided leg swelling and pain.

Ask whether your symptoms fit a menopause-related pattern, whether you need a referral, which hormone combination and route may suit you, and whether you need womb protection. Confirm the follow-up plan, expected changes, warning signs and when to review the prescription.