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Why are women still paying for HRT?

The government has made hormone replacement therapy cheaper, but any cost exacerbates the gender health gap.

By Sarah Dawood

Hormone replacement therapy (HRT) is a treatment that many women rely on to relieve symptoms of the menopause. These can include hot flushes, night sweats, mood swings, a reduced sex drive, vaginal dryness and even osteoporosis, a condition that weakens the bones. But alleviating the effects of female ageing comes at a price.

Until 1 April 2023, women had to pay a standard prescription charge – £9.65 – to access HRT. The length of this prescription was very much dependent on the whims of the doctor or prescriber, meaning that some women might have had to pay this charge several times a year.

Now, the government and the NHS have launched a scheme that makes HRT significantly cheaper. A new HRT pre-payment certificate (PPC) costs £19.30 (the price of two single prescription items) and will last 12 months, potentially saving women hundreds of pounds. This is the same concept as a regular PPC, which allows people unlimited prescriptions of any kind for one year at £111.60.

[See also: Social care funding cuts threaten NHS recovery and UK economy]

There is no doubt that this is a significant improvement. However, much like period products, this change does beg the question: why isn’t HRT simply free in the first place?

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At a time of staggering inflation, rising prices hit women disproportionately. The extra costs that women face mean that the gender poverty gap is widening. Even before you factor in female-only products, figures from the Office for National Statistics last year showed that prices are higher for generic women’s items than men’s, such as clothing, shoes and haircuts.

Conversely, access to contraception is free across the UK, offered on the NHS without a prescription charge. This undoubtedly helps to reduce sexual health inequality and ensure marginalised demographics can access birth control. But of course, both men and women reap the rewards of this. If only this approach could be taken for the many healthcare issues that predominantly impact women.

There are people who already receive free prescriptions, such as those on income-related benefits, but this does not cover the full range of individuals who are struggling to afford essentials. For example, a YouGov survey from September 2022 found that one in eight (13 per cent) people who currently have periods said they would probably not be able to afford period products in the next 12 months.

[See also: Kamila Hawthorne interview: “GPs should be trusted to do their jobs”]

Scrapping prescription charges for HRT would not only positively impact individuals, but the economy. Research conducted by the menopause support app Balance last year found that menopause costs the economy £10bn, mostly due to women leaving the workforce, and the costs of rehiring and retraining staff. According to the Fawcett Society, the gender equality charity, one in ten women had left a job due to menopause symptoms, while a quarter had taken time off work. Making HRT universally accessible would help many women to manage their symptoms and remain economically active for longer.

But the government seems reticent to adopt more systemic policies. Just last month Kemi Badenoch, the Women and Equalities’ Minister, refused to outlaw menopause discrimination, confirming that it would not be added as a protected characteristic to the Equality Act 2010. Part of the justification was that it is not a permanent trait, despite the fact that pregnancy and maternity are already protected by the act.

More holistic, fundamental change is needed to tackle the economic disadvantages facing women, and the NHS has a key role to play. Free access to menopause relief would help more women to participate in work for longer and experience less discomfort. Including HRT in the prescription charge exemption list would go at least some way towards reducing gender-based inequity. Prescriptions are already free for pregnant women and those who have had a baby in the past 12 months, so why not extend this right to menopausal women too?

[See also: The government is insulting women with its lack of menopause support]

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