The HRT postcode lottery: women 3 times more likely to get menopause treatment in some UK areas

New analysis reveals a striking threefold gap in HRT prescribing rates depending on where women live in England.

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Published: October 8, 2026 at 12:21 PM

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Where you live could make a significant difference to the menopause care you receive, according to new analysis of NHS and ONS data.

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The study, carried out by British sleep brand Mossva ahead of World Menopause Day on 18 October, found more than a threefold difference in identified HRT patients between areas of England. Cornwall & Isles of Scilly had the highest rate, with 72.3 HRT patients per 1,000 residents, compared with 21.3 per 1,000 in Northeast London.

The figures are based on women aged 40 to 75 and look at HRT prescribing rates across England’s 42 Integrated Care Boards (ICBs).

Which areas have the highest HRT prescribing rates?

According to the analysis, the five areas with the highest rates were:

At the other end of the table, Northeast London recorded the lowest rate at 21.3 per 1,000, followed by Black Country at 28.4, North West London at 29.9, North Central London at 34.7 and Birmingham & Solihull at 34.8.

The figures don't necessarily show how many women are clinically eligible for HRT in each area, but they do highlight substantial geographical differences in the number of identified patients being prescribed treatment.

Even areas with similar populations can have different rates

The research also compared areas with similar proportions of women aged 40 to 75.

In Gloucestershire, women in this age group make up 22.9% of the population, with an HRT prescribing rate of 70.9 per 1,000. In Lincolnshire, women aged 40 to 75 account for 23.4% of the population, yet the HRT prescribing rate is 50.8 per 1,000.

That's a difference of 28% in the prescribing rate despite only a 0.5 percentage point difference in the proportion of the population aged 40 to 75.

There are also wider inequalities in HRT access

The analysis follows a 2025 10-year study from the University of Birmingham, which found that white women and women living in more affluent neighbourhoods in England were more likely to receive HRT than non-white women and those living in more deprived areas.

Access improved in 2023/24 after the introduction of a new scheme allowing women to receive a year's worth of HRT treatment for less than £20. However, the new analysis suggests geographical differences in prescribing rates remain.

Tom Savage, the founder of Mossva, said the company wanted to make the data more personal for women.

We didn't want to produce another national menopause report that women could read and forget. We wanted to make the data personal.

Tom Savage, founder of Mossva

He said the company's postcode tool was designed to show women what the picture looks like where they live and what they might expect in terms of treatment during menopause.

Savage also highlighted the impact menopause symptoms can have on sleep, while stressing that practical changes to the bedroom environment can be considered alongside appropriate medical support.

Night sweats are also putting pressure on sleep

Symptoms such as night sweats can have a huge impact on how women feel and sleep every night, and how they function the next day.

Tom Savage, founder of Mossva

The analysis also looked at search data around menopause symptoms, including night sweats.

Searches for menopause symptoms peaked in the UK in January 2026, while searches for ‘best bedding for night sweats’ were up 160% year on year. Mossva estimates that 41% of people in the UK experience night sweats.

“Symptoms such as night sweats can have a huge impact on how women feel and sleep every night, and how they function the next day," says Savage. "While having access to the right medical support is essential, practical changes to the bedroom environment can also be considered when night sweats and other menopause symptoms make sleep unbearable."

The company says its new Menopause Lens on its Sleep Disruption Map allows women to enter their postcode and see how their area compares with the rest of England for menopause care.

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For anyone concerned about menopause symptoms or whether HRT could be suitable for them, speaking to a GP or other qualified healthcare professional is the best way to get personalised advice.

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