How to get HRT online in the UK, legitimately

How the process works

A legitimate online service follows the same clinical logic as a good in-person consultation:

1. A structured clinical assessment. Symptoms, cycle history, full medical history, medicines you take, and screening for the conditions that change whether HRT is appropriate.
2. Review by a registered prescriber. A GMC-registered clinician, or a pharmacist independent prescriber, reads your record and decides.
3. A prescription, or a decline. A service where nobody is ever declined is not assessing anything.
4. Dispensing by a registered pharmacy, delivered to you.
5. Follow-up. Review, dose adjustment, and somewhere to go when something is not right.

Steps 3 and 5 are where services differ most.

What to check before you hand over money

Is the clinical provider CQC-registered? In England, providers of online primary care must be registered with the Care Quality Commission. Registration details are public and searchable on the CQC website.

Are prescribers named and registered? Prescribing must be done by a registered professional. The GMC register is public and free to search.

Is the pharmacy GPhC-registered? Dispensing pharmacies must be on the General Pharmaceutical Council register, which is also public.

Do they take a full medical history? A form that asks only which product you want is not an assessment. Look for questions about clots, cancer history, liver disease, blood pressure, migraine and unexplained bleeding.

Can they say no? A genuine service declines people, refers them, and says so.

Is there aftercare? Ask what happens when the dose is wrong, because it often is at first, and whether that costs extra.

Warning signs

• Prescribing without any medical history
• No named regulated prescriber anywhere on the site
• Compounded "bioidentical" hormones marketed as tailored to you, which UK bodies do not recommend
• Prescribing driven by saliva hormone testing
• Pressure to buy long supplies up front with no review
• No UK regulatory information published anywhere
• Anything shipped from outside the UK without a UK prescription

What it costs

Private HRT is generally priced either per consultation plus the medicine, or as a monthly plan. Consultation-first models front-load the cost, sometimes substantially, before you know whether you are suitable.

At fira: the assessment is free, and treatment is £75 a month or £180 a quarter, covering the medicine, delivery, clinician review and every dose change. There is no consultation fee.

If you use the NHS instead, the HRT prepayment certificate covers a year of NHS HRT prescriptions in England for the price of two prescription charges, which is cheaper for the medicine than any private route. Worth knowing before you spend anything.

When online is not the right route

Online assessment is not appropriate for everyone, and a good service will tell you rather than take your money:

• Any bleeding after menopause, which needs examination and usually a scan
• Breast changes or a new lump
• Complex history, including previous hormone-sensitive cancer or clotting disorders, where specialist input is needed
• Symptoms under 40, which need proper investigation rather than a prescription

What we do

A free clinical assessment, reviewed by a UK-registered prescribing clinician working within a CQC-registered clinical service. If treatment is right for you, it is dispensed by a UK-registered pharmacy and delivered. If it is not, we say so and you are not charged.

fira is a brand of Orbyt Group Ltd, company number 12623899.