Hormone Therapy
Bioidentical Hormones For Menopause
Hormone Therapy
Understand your menopause treatment options, wherever you are in the UK.
Our hormone consultations are designed to provide you with a specialist menopause assessment and personalised bioidentical hormone therapy.
If you have more complex symptoms or health conditions we can also investigate wider health factors. Using a functional medicine approach we determine what is hormonal and what may have other underlying drivers.
Our medical team has over 40 years of combined clinical experience in hormones, functional medicine and the assessment of complex health conditions.
Consultations can be online, via phone, or in-clinic. Blood testing can take place at our London-based clinic or in your local area.
“Although I was on HRT with my GP, I felt I wasn’t functioning at 100%. Before starting BHRT I was feeling helpless, finding it impossible to lose weight, my mood was inconsistent and my thought processes didn’t feel very clear, and was struggling with consistency with my sports training.
At Harpal Clinic it was a relief to have a full half hour consultation with a doctor who was looking at the whole picture and taking into account my lifestyle, including my sports endurance activities. It led to significant changes in my dosing and medications.
Four months into treatment I am steadily losing the additional weight, I feel my brain is functioning much more clearly. I have been able to train consistently and my mood has definitely stabilised. Treatment through Harpal Clinic has made a significant difference to my quality of life. I now feel like I am doing everything I can to keep functioning at 100% into the next few decades.”
Alison, 62
Unsure if your symptoms are hormonal or related to other health factors? Our medical team’s expertise can investigate underlying drivers of symptoms to distinguish
what is hormonal and what symptoms may have other causes.
what is hormonal and what symptoms may have other causes.
Dr Harpal Bains
MBBS, DFSRH, PGCAestMed (Dist)
As featured in Vogue, GQ, Women’s Health, The Financial Times, and Elle.
Depending on your symptoms, medical history and clinical needs, we prescribe both body-identical hormones, as well as bioidentical hormones which are prepared by specialist compounding pharmacies.
Body-identical hormones are medications containing hormones structurally identical to those produced naturally by the body, such as estradiol and micronised progesterone.
Bioidentical hormones are prepared by specialist compounding pharmacies when a licensed medicine does not meet a patient’s specific dosing or formulation requirements.
Commonly used to manage menopause symptoms such as hot flushes, sleep disturbance and mood changes. It also plays an important role in longer-term health, particularly bone health. Recent research has also shown that hormone therapy can improve several cardiovascular risk markers, including LDL cholesterol and lipoprotein(a).
Traditionally prescribed alongside oestrogen in women with a uterus to protect the womb lining. However, we recognise that progesterone also has wider effects in the body, including calming activity within the nervous system and support for sleep and relaxation. For this reason, some women without a uterus may still choose to use progesterone for these wider benefits.
Sometimes prescribed to women for symptoms such as low libido, fatigue or reduced motivation. Some newer research suggests that in women, testosterone may influence muscle mass, bone density and cognitive function, although the strongest clinical evidence for testosterone therapy in women relates to sexual desire after menopause.
A key precursor in the synthesis of progesterone, oestrogens, and androgens. Pregnenolone may be assessed in some cases as part of a broader evaluation of adrenal and hormone function. Pregnenolone is also considered a neurosteroid and has been studied for its role in neurotransmission, neuroplasticity, and cognitive processes.
An adrenal hormone precursor involved in the production of downstream sex hormones. It may be considered where symptoms such as fatigue or reduced stress tolerance are present and to support broader hormone balance.
A hormone that regulates the body’s sleep-wake cycle and circadian rhythm. It may be prescribed to improve sleep architecture (structure) and also plays roles in antioxidant activity (particularly in our mitochondria – where our cells produce energy), and immune regulation.
Our two main consultations are Focussed & Comprehensive.
Both options follow the same structure and clinical process. The price difference between them reflects the amount of clinical and consultation time allocated to you.
Both include:
Consultations can be online, via phone, or in-clinic. Blood testing can take place at our London-based clinic or in your local area via one of our providers (Superdrug or Goodbody).
Specialist hormone care and a functional medicine approach to healthcare involves an in-depth analysis of laboratory testing, symptoms and medical history when deciding upon a treatment plan. The consultation pathway fees reflect the level of clinical time required for this analysis, report preparation and ongoing support.
A menopause and hormone assessment and structured treatment plan, with the ability to obtain bioidentical hormone therapy as well as supplement and lifestyle recommendations where clinically appropriate.
Laboratory testing is not included in the consultation fee.
A menopause and hormone assessment with the ability to obtain bioidentical hormone therapy as well as supplement and lifestyle recommendations where clinically appropriate. Combined with a broader clinical assessment of chronic or complex health conditions, including additional clinical analysis and a structured plan to address multiple health factors.
Laboratory testing is not included in the consultation fee.
If you choose to complete testing at our clinic location phlebotomy is included.
We can accept external test results if they include the markers our doctor requires and were taken within the last 3 months. All patients begin with an initial consultation, where the doctor reviews any existing results and advises on any further testing if needed.
If you choose an online consultation, we can send a home test kit so you can arrange a blood draw locally at one of our providers (e.g., Superdrug or Goodbody). Phlebotomy is booked and paid for separately. This typically costs £20-£50, depending on provider and location. Please note: Do not book your phlebotomy appointment until you’ve received your test kit. If you choose to complete testing at our clinic location phlebotomy is included.
Bioidentical hormone medication typically costs around £50 per month per hormone, depending on the exact hormone medication and dose.
Once your dosing has stabilised (usually after around six months), compatible hormones can often be compounded into a single capsule. This can make treatment more convenient and increasingly cost-effective over time.
We work closely with specialist compounding UK pharmacies that we have partnered with for over 8 years. This long-standing relationship ensures reliable supply, consistent prescribing standards ensuring safety and security.
Orders for compounded medications typically take 7–10 days, as each order is prepared individually once your order is placed. Our helpful and knowledgeable patient care team will assist you with each step of the ordering process.
Bioidentical hormone therapy requires ongoing monitoring and clinical review to ensure your treatment remains appropriate and effective.
We typically review your medication at:
If additional support is required, appointments can also be scheduled sooner, with shorter intervals between reviews where appropriate.
Yes. Ongoing patient support between consultations is a core part of how we deliver care. Between follow-up consultations you can access our doctor Q&A service, allowing your questions to be reviewed and answered by your prescribing doctor at no additional cost via our patient care team.
You will also have access to health coaching sessions to support the implementation of your doctors recommendations as well as lifestyle recommendations.
The communication between your consultations is via our friendly and knowledgeable patient care team. Our patient care team is always available by phone and email, ensuring you can quickly speak with someone who understands your care.
Menopause doesn’t just signal the end of a woman’s ability to reproduce; it also causes epigenetic changes which play a pivotal role in accelerating biological ageing, negatively impacting longevity and limiting independence.
Although women live longer than men, research reveals that from age 65, women can also expect to spend more of their remaining lives with a disability. The changes that occur in the body due to menopause mean that women are at far greater risk than men of osteoporosis, depression, arthritis, and even Alzheimer’s disease.
We don’t believe in just accepting this. We don’t believe that it’s acceptable to live half of your adult life in poor health, especially when you can take control and continue to enjoy the activities you love with the help of bioidentical hormones.
Prioritising BHRT can support healthy aging by helping maintain hormonal balance as you move through midlife. It supports strong, healthy bones, brain health, cardiovascular health, and overall wellbeing in addition to perimenopausal and menopausal symptom relief.
Begin with an initial longevity medicine consultation to clarify your goals and determine the most appropriate testing and pathway for you. The payment structure of this option is designed for women without complex health concerns who are considering bioidentical hormone optimisation for menopause alongside longevity medicine testing.
After speaking with your doctor and reviewing their recommended testing and pathway report, you can then progress to either the Focused or Comprehensive consultation pathway, with the cost of this consultation deducted from your chosen pathway.
Menopause usually occurs around the age of 45-55, although many women begin experiencing symptoms during perimenopause, which can start in their mid-30s to mid-40s.
Symptoms occur due to fluctuating and declining levels of hormones such as oestrogen, progesterone and testosterone. Symptoms vary widely, with some women experiencing only mild changes. Other women may find hormonal shifts significantly affect their daily life.
Common symptoms of perimenopause and menopause include:
As awareness and research into women’s health continues to grow, a wider range of symptoms are becoming increasingly recognised.
Symptoms such as hot flushes and night sweats are well known, but hormonal changes during perimenopause and menopause can affect multiple systems in the body. Why? Oestrogen receptors are present in many tissues including the brain, cardiovascular system, skin, joints and urogenital tract, meaning hormonal changes can influence a wide range of symptoms.
In addition to the more well-known symptoms, some women may experience:
Some women also report symptoms that are less commonly discussed, such as itchy ears, tinnitus, burning mouth, or tingling sensations. These symptoms are becoming increasingly reported, although research is still ongoing and they may have multiple possible causes.
Bioidentical hormones and body-identical hormones both contain hormones that are molecularly identical to those naturally produced by the body. The main difference lies in how they are manufactured and prescribed.
At Harpal Clinic, we prescribe both bioidentical and body-identical hormones, selecting the most appropriate option based on clinical suitability and your individual preferences.
Bioidentical hormones are prepared by specialist compounding pharmacies and can be formulated in personalised doses and delivery methods, based on your symptoms, physiology and test results. Many bioidentical hormones are derived from plant sources, and can be compounded and delivered in simple formulations, often consisting of just the hormone suspended in a carrier such as olive oil. They can be delivered in a range of formulations including capsules, tablets, creams, gels, topical preparations or lozenges, depending on what is most appropriate for you.
Body-identical hormones are manufactured by pharmaceutical companies and supplied as medicines in standardised doses and formulations. We prescribe body-identical hormones where appropriate and offer them alongside bioidentical options, depending on clinical suitability and your preference.
Conventional HRT usually consists of hormones manufactured in fixed doses. These may contain synthetic hormones, which also differ structurally from the body’s own hormones. Your GP may also offer you body-identical hormones (as described above), which match the body’s hormones, but are only supplied in standardised formulations.
BHRT may be appropriate if you are experiencing menopausal symptoms such as hot flushes, fatigue, sleep disturbance, mood changes, low libido, or cognitive changes; and would prefer a specialist assessment and individualised dosing and formulations.
Some patients come to us because they are already receiving hormone therapy through their GP, but feel their treatment does not fully address their symptoms. Most women explore bioidentical hormones because they are looking for individualised dosing, or because they prefer hormones that are molecularly identical to those produced naturally by the body and from a natural source. Others coming to us see the value in having a more detailed clinical assessment, especially if their current hormone therapy has not fully resolved their symptoms.
Bioidentical hormones are regulated differently than standardised HRT medicines.
Standard HRT products are medicines that are manufactured in fixed doses. Compounded bioidentical hormones are individualised medicines prepared for a specific patient when standard licensed products do not meet their clinical needs. For example:
In the UK bioidentical hormones are supplied under the Human Medicines Regulations 2012 “Specials” framework, which allows doctors to prescribe unlicensed medicines when:
These medicines are produced by specialist compounding pharmacies operating within strict regulatory frameworks.
Our UK compounding pharmacy is:
Compounding allows treatment to be tailored to the patient, this includes personalised dosing and formulations that may not be available in standardised HRT products.
Having this approach to hormones enables clinicians to prescribe care that is individualised and carefully matched to a patient’s clinical needs, while still being produced within regulated pharmaceutical standards.
Yes. As with all medications, when prescribed and monitored by an experienced doctor, hormone therapy can be a safe and effective treatment for menopausal symptoms.
At Harpal Clinic:
As with all medical treatments, hormone therapy must be prescribed responsibly and reviewed regularly to ensure it continues to be appropriate for the patient.
Yes. Many patients start BHRT even if they have never previously used hormone therapy and are already post-menopausal.
This is a group of patients we commonly see at Harpal Clinic, particularly those who:
Because we specialise in hormone health, menopause care and longevity medicine, we regularly work with individuals starting therapy later in life and create treatment plans tailored to their individual health profile.
We find that many women notice improvements within a few weeks of starting hormone therapy. Symptoms such as hot flushes, night sweats, and sleep disturbances are often the first to improve. Most doctors recommend allowing 8-12 weeks to evaluate the full effect as the body adjusts and treatment is optimised.
Because hormone therapy is personalised, follow-up appointments are usually used to review symptoms and adjust dosing so treatment works as effectively as possible.
Hormone therapy is primarily used to treat symptoms of hormone deficiency, particularly during perimenopause and menopause. However, hormones can also play an important role in your long-term health too.
Some of the strongest areas of research include:
For this reason, some clinicians consider appropriately prescribed hormone therapy to be part of a healthy ageing or longevity medicine approach, particularly when started around the peri/menopausal transition.
That said, hormone therapy should always be individualised and medically supervised, as the benefits and risks can vary depending on a person’s medical history and health profile.
Consultations are conducted by GMC-registered doctors specialising in hormone therapy and menopause care. Our doctors also have additional expertise in functional medicine and the management of complex health conditions.
Women choose Harpal Clinic because our medical team has over 40 years of combined clinical experience in female hormone health. We regularly see patients who have already tried conventional menopause care but feel their symptoms have not been fully understood or optimised.
Women come to us specifically seeking bioidentical hormones, while also wanting the reassurance of a more specialist, in-depth approach to their care. Our consultations allow time for a detailed clinical assessment to better understand hormone levels, overall health, and whether symptoms are truly hormonal or influenced by other underlying factors.
For women with more complex symptoms or chronic conditions, consultations can explore broader health factors that may influence hormonal symptoms. This approach helps us determine what is hormonal and what may have other underlying drivers, allowing hormone therapy to be prescribed within the context of your overall health rather than treating hormones in isolation.
Yes. Blood testing is performed before starting BHRT.
These tests allow us to assess hormone levels and evaluate other key markers that may influence treatment decisions. Understanding your hormone test results helps ensure therapy is safe and appropriately tailored.
For patients who cannot attend the clinic, we can arrange a blood test kit to be sent to your home address. Blood testing can also be complemented with more advanced hormone testing (e.g., DUTCH testing) where appropriate.
Yes. We offer DUTCH (Dried Urine Test for Comprehensive Hormones) testing.
This test provides insight into how the body produces and metabolises hormones, as well as markers such as cortisol patterns, melatonin, and oestrogen metabolism. We can arrange several types of DUTCH testing, with the DUTCH Complete being the flagship test. Your doctor will advise whether this would be appropriate for you, but you are also welcome to discuss this during your consultation if it is something you are interested in exploring.
We can also offer the HUMAP test. This is also a comprehensive urinary hormone assessment that evaluates hormone levels and how hormones are metabolised in the body.
These tests may be useful if you:
In addition to blood testing, your doctor may recommend further optional testing, especially if you are interested in taking a deeper dive into your health.
Examples of these can be:
Hormone DNA testing
Genetic testing that can help identify how your body may produce, metabolise and respond to hormones.
This may be useful if you:
Adrenal and stress hormone testing
Where symptoms suggest it could be helpful, we may recommend an adrenal function and cortisol test. This can provide insight into how the body responds to stress and how cortisol patterns change throughout the day, which may influence energy levels, sleep and hormone balance.
Gut testing
In some cases, gut microbiome testing may also be recommended. The gut microbiome can influence how hormones such as oestrogen are metabolised and cleared from the body through the estrobolome, the collection of gut bacteria involved in oestrogen metabolism.
Assessing gut health can sometimes provide additional insight into how hormones are processed and eliminated.
NHS menopause care is designed to provide treatment for large numbers of patients. Therefore, it generally follows standardised prescribing guidelines through a GP service, typically using synthetic or body-identical hormone preparations available within NHS formularies. Some of these commercially manufactured hormone products may also contain excipients (inactive ingredients) that certain patients do not tolerate well.
As a specialist hormone clinic, Harpal Clinic is able to offer a more personalised and in-depth approach to menopause care.
At Harpal Clinic we:
Yes. We have many patients completing their treatment remotely.
We are able to arrange:
If you choose an online consultation, we can send a home test kit so you can arrange a blood draw locally at one of our providers (e.g., Superdrug or Goodbody). Phlebotomy is booked and paid for separately. This typically costs £20-£50, depending on provider and location.
Please note: Do not book your phlebotomy appointment until you’ve received your test kit.
The cost of BHRT can vary depending on your doctor’s suggested recommendations and how many of those you choose to go ahead with.
Bioidentical hormone medication typically costs approximately £50 per month per hormone, although the exact amount will depend on the exact hormone medication and dose. Once your dosing has stabilised (usually after six months), compatible hormones can often be compounded into a single capsule. This means that treatment becomes not only more convenient, but also increasingly cost-effective over time.
