What a shop isn't allowed to tell you about HRT — and who is

HRT is the question underneath most of what people are actually searching for. And it is the one question a shop like ours is least qualified, and least permitted, to answer.

Rather than write around that, here is the honest version.

What we are not allowed to do

The advertising rules are direct about it. A marketer must not discourage essential treatment for conditions where medical supervision should be sought, and must not offer specific advice on, diagnosis of, or treatment for such conditions unless it is done under the supervision of a suitably qualified health professional.

That single rule rules out a great deal:

• We cannot tell you whether HRT would suit you.
• We cannot weigh its risks and benefits for your history.
• We cannot tell you which type, dose or delivery method to ask for.
• We cannot suggest that anything we sell is an alternative to it.

That last one deserves its own paragraph.

“A natural alternative to HRT”

You will see this phrase. It is one of the most reliably unlawful sentences in the category.

HRT is a licensed medicine. Positioning a food supplement as a substitute for it is a medicinal claim, and a food making a medicinal claim becomes an unlicensed medicine in the eyes of the law. It also risks the more serious problem above: nudging someone away from a treatment decision that should be made with a clinician.

There is no compliant version of that sentence. Not “natural alternative”, not “HRT-free approach”, not “for women who can't take HRT”. If a brand is using it, they are either unaware of the rule or unbothered by it, and both are worth knowing before you buy.

What we are allowed to do

One thing, and the rules say so explicitly: accurate and responsible general information may be offered.

So here is some.

Where the actual answers are

These are the sources a UK clinician would point you to. They are free, they are not selling you anything, and they are better than anything a shop could write.

• NHS — Menopause and perimenopause. The plain-English starting point, covering symptoms, treatment and support.
  nhs.uk/conditions/menopause-and-perimenopause
• Women's Health Concern. The patient arm of the British Menopause Society. Their factsheets are the most useful patient-facing documents in the UK, written by the same clinicians who advise the profession.
  womens-health-concern.org
• British Menopause Society. Mainly for clinicians, but it runs a directory of menopause specialists if you want to find one.
  thebms.org.uk
• NICE guideline NG23, Menopause: identification and management. The actual guideline your GP works from. Dense, written for clinicians, and occasionally worth reading anyway if you want to see the reasoning behind the advice you are given.
  nice.org.uk/guidance/ng23 — it is revised periodically, so check the “last updated” date rather than trusting a summary you read somewhere.

One thing worth carrying with you

This is general safety information rather than advice, and it comes straight from the clinical guideline.

If you are taking systemic HRT and you get unscheduled vaginal bleeding — beyond the first six months of starting, or beyond three months of a change in dose or preparation — the guidance is to seek medical help promptly. It links to the suspected cancer pathway, which is why it is worth knowing rather than waiting to see.

More generally: any bleeding after the menopause is a reason to see a GP. Not a reason to panic. A reason to be seen.

Going to the appointment

The most useful thing we can offer is not information, it is preparation. Ten minutes is not long, and almost nobody can accurately describe the previous four weeks from memory.

Write down what has actually been happening, and when. Note your two or three worst days. List everything you are already taking, including supplements and anything bought over the counter — that matters more than people realise, because some botanicals interact with prescribed medicines. Bring your questions written down.

Three reasonable ones, if you are not sure where to start: What are my options? What are the risks and benefits of each for someone with my history? What should I expect if I do nothing?

Why we are telling you this

Because the honest position for a shop in this category is a narrow one. We can tell you what is in a product, what it cost, and what its label is legally permitted to claim. We cannot tell you what to do about your own body, and any shop that offers to should worry you.

You do not need to have earned an appointment by suffering longer. If something is affecting your sleep, your work or your relationships, that is reason enough to raise it.

General information, not medical advice. Nothing here should delay you speaking to a GP or pharmacist about your own situation.