Key Summary
- A record two million women aged 40 and over in England received NHS HRT prescribing in 2025/26.
- In 2020/21, the figure was just 800,000.
- Women in the least deprived areas are nearly twice as likely to receive HRT.
A record two million women aged 40 and over in England received NHS prescribing for hormone replacement therapy (HRT) in 2025/26, representing a significant surge in demand.
According to new figures published by the NHS Business Services Authority (NHSBSA), HRT prescribing has more than doubled from the 800,000 women supported in 2020/21. The highest rate of growth was recorded among women aged 40 to 49.
HRT replaces hormones that fall during perimenopause, menopause, and postmenopause to relieve symptoms. However, despite overall growth, the NHSBSA data highlights persistent inequalities across geography, local deprivation, and urban-rural divides.
Health disparities
Women living in the UK’s most affluent areas remain significantly more likely to access HRT treatment than those in economically disadvantaged communities.
In 2025/26, 14.2% of women aged 40 and over received NHS HRT in less deprived areas, compared to just 8.8% in the 20% most deprived areas.
The report also reveals marked geographical variations:
- Rural vs Urban: Women living in rural areas are more likely to receive NHS HRT prescriptions than those in urban areas.
- Integrated Care Systems (ICS): NHS North East London reported the lowest prescribing rate at 8 per 100 women aged 40 and over, while NHS Surrey and Sussex recorded the highest at 17 per 100.
- Local Authorities: Newham recorded the lowest local authority prescribing rate at 4 per 100 women, while Brighton and Hove saw the highest at 23 per 100.
In terms of delivery methods, transdermal products-such as patches, gels, or sprays applied directly to the skin-remain the most commonly prescribed form of oestrogen HRT across all patient demographics. Conversely, the prescribing of oral oestrogen tablets has continued to decline.
Olivier Picard, Chair of the National Pharmacy Association (NPA), said: “This is very significant data and shows that a record number of women are accessing HRT support through the NHS.
“However, these surges in prescriptions for particular products do have unintended short-term consequences for medicine supply to patients and can exacerbate medicine shortages that blight pharmacies on a daily basis.
“Although supply for some HRT products are improving, shortages of certain strengths of Estradot are now some of the longest running of any medicine in NHS history.
“When prescribing habits change, we must make sure supply chains can keep up or we risk worsening access to medicines for patients and put more pressure on overstretched pharmacy teams.”
