HRT in Ireland: how to get it, and when it's free

Is HRT free in Ireland?

Yes, if you live in Ireland. Since 1 June 2025, you can get free HRT from a pharmacy taking part in the free HRT scheme if you have a prescription from a GP, registered nurse or midwife, and you have a medical card or are registered for the Drugs Payment Scheme.¹ You can apply for a Drugs Payment Scheme card if you're ordinarily resident in Ireland.

HRT comes as tablets, skin patches, gels, sprays, vaginal creams or pessaries.¹ Only some pharmacies supply it free, so ask yours before you hand in your prescription.⁴ VAT was also removed from HRT in Budget 2023.³

How to get HRT in Ireland

Talk to your GP if you're finding your symptoms difficult; you can also tell a public nurse, and they'll check whether HRT could suit you.^6,1 Your GP can usually confirm perimenopause or menopause from your symptoms, and may suggest a blood test.⁷

Before you start, the GP may do blood tests and a general check-up, depending on your age. You'll usually start on a low dose that can be increased later, with a review 3 months after you start or change HRT, then usually once a year.⁸

Can I get HRT without seeing a doctor?

Not without a prescriber. HRT is a prescription medicine, not sold over the counter: under the free HRT scheme the prescription comes from a GP, a registered nurse or a midwife, and the HSE's advice on HRT assumes a GP who reviews you 3 months after you start and then usually once a year.^1,8 A video consultation counts as seeing a doctor: the doctor goes through your symptoms and history and decides with you whether HRT is right for you.

Can my GP refuse to prescribe HRT?

A GP prescribes HRT only when it is suitable for you. The HSE lists situations where it may not be, such as a history of breast, ovarian or womb cancer, liver disease, pregnancy, or untreated high blood pressure, and says that after blood clots you may need patches or gel rather than tablets.⁸ NICE recommends offering HRT for hot flushes and night sweats after discussing the benefits and risks with you.⁹ If you disagree with a decision, ask for the reasons, see another GP, or ask about a referral to a specialist menopause clinic, which takes the more complex cases.⁴

Specialist menopause clinics

Most people in menopause can manage their symptoms at home or with a GP.³ Your GP may refer you to a specialist clinic if treatment doesn't help your symptoms, you have ongoing side effects, you can't have HRT, or you have a complex medical history; the clinics only see the most complex cases.⁴ There are six, one in each maternity network:

• The National Maternity Hospital
• The Rotunda Hospital
• The Coombe Hospital
• Cork University Maternity Hospital
• University Hospital Galway
• Nenagh General Hospital Women's Health Hub

Types of HRT

HRT is either combined (oestrogen and progestogen) or oestrogen-only, and oestrogen-only HRT is recommended if you've had your womb removed in a hysterectomy.¹⁰ If you still have periods, sequential (cyclical) combined HRT is used; continuous combined HRT is usually recommended once you're post-menopause.

• Tablets, usually taken once a day.¹⁰
• Skin patches, stuck on below the waist.¹⁰
• Gel, smoothed onto the skin once a day.¹⁰
• Spray, 1 to 3 sprays once a day on the inner arm or inner thigh.¹⁰
• A hormonal coil (intrauterine system) can supply the progestogen part; it can stay in for up to 5 years and also works as contraception.¹⁰

Vaginal oestrogen comes as a cream, gel, vaginal tablet or pessary, and your GP may prescribe it for vaginal dryness.^10,4 Tibolone works like combined HRT but also has a testosterone effect; it's only suitable if your last period was more than a year ago. Testosterone in small amounts may help your sex drive. It isn't licensed for menopause symptoms, but a doctor may prescribe it off label, usually only if you're post-menopause, have a low sex drive and HRT alone hasn't helped, with blood tests before and during treatment.

Benefits and risks of HRT

The main benefit is relief from perimenopause and menopause symptoms, and HRT also helps prevent osteoporosis.²

• Breast cancer: combined HRT slightly increases the risk, with around 5 extra cases in every 1,000 women who take it for 5 years; oestrogen-only HRT causes little or no increase. The risk rises the longer you take HRT and the older you are, and falls again after you stop.²
• Blood clots: tablets increase the risk, though it's very low; patches, sprays and gels don't.²
• Stroke: tablets, but not patches, gel or spray, slightly increase the risk.²
• Womb cancer: oestrogen on its own can increase the risk, and oestrogen-only HRT is recommended only if you've had your womb removed.^2,10

HRT may not be suitable if you've had breast, ovarian or womb cancer, have liver disease or are pregnant. If you've had blood clots, you may need patches or gels rather than tablets, and untreated high blood pressure needs to be controlled before you can start.⁸ Most people stay on HRT for 2 to 5 years, sometimes longer. You can still get pregnant while taking HRT, so use contraception until 2 years after your last period if you're under 50, or 1 year if you're 50 or over. A hormonal coil used for HRT also works as contraception.¹⁰

Bleeding on HRT: what to expect

On sequential (cyclical) combined HRT a regular bleed each month is expected; the advice here is about unscheduled bleeding.^10,9 Vaginal bleeding is common during the first 6 months of systemic HRT, and within any 3 months of changing the dose or the preparation. NICE's guideline, updated on 15 April 2026, says to seek medical help promptly for unscheduled bleeding that goes on beyond those timeframes, and points doctors to the British Menopause Society's guidance on unscheduled bleeding.¹¹ Any bleeding after your periods have stopped for 12 months and you are not on HRT needs checking by a doctor.¹²

Doctor by video, prescriptions from abroad

If you can't get a GP appointment soon, or you're away from home, Mobi Doctor connects you with a licensed EU-registered doctor over video, usually within 15 minutes, daily 7am–11pm CET. The doctor talks through your symptoms and options and decides with you whether HRT is right for you.

Using a prescription from another EU country in an Irish pharmacy

Pharmacists in Ireland can dispense a prescription from a registered doctor in another EEA country if the medicine is authorised in Ireland and is not a controlled drug.⁵ The prescription has to be signed and dated by the doctor and show their name, qualification, work address and contact details, your name and date of birth, and the medicine's common name, form, strength, quantity and dose. Irish pharmacists are advised not to accept a prescription shown only on your phone, because it can't be traced back to the prescriber; a paper copy, or one the prescriber emails to the pharmacy, can be.¹³

The free HRT scheme is described for prescriptions from a GP, registered nurse or midwife, together with a medical card or Drugs Payment Scheme card.¹ Before you go, ask the pharmacy whether it can supply your HRT under the scheme with a prescription from a doctor in another EU country; if it can't, you pay the pharmacy's price.

Travelling with HRT in the EU

A prescription from a doctor in one EU country is valid in all the others, but it's dispensed under the rules of the country where you collect it.¹⁴ Ask for the common (generic) name, form, strength and dose on it, not just the brand, and for a paper copy if you'll use it abroad. Some medicines are not authorised or available in every EU country.

HRT goes by different names around Europe, such as THS in Spain and THM in France.^15,16 The care-abroad section of the perimenopause test lists who to see first and what HRT is called in several EU countries. Before you travel, check the Medicine Shortage Tracker and Travel Health pages.

What HSE, Citizens Information and NICE say

The sources this page is built on, what each says, and the version we read on 6 November 2026.

Not sure it's perimenopause?

Symptoms can start 7 to 10 years before your periods stop.⁶ The free perimenopause test reads your periods and 12 common symptoms in about 2 minutes and gives you a summary to bring to your GP. If you've seen lists of 34 symptoms online, the 34 symptoms of perimenopause, checked goes through each one.

Questions people ask

About this page

This page gives general information based on published guidance. It does not diagnose you and does not replace advice from a doctor who knows your situation.