New analysis finds a threefold regional gap in HRT prescribing. Explore the figures, the postcode tool & what the data can actually tell us.
A new analysis reports wide regional differences in HRT prescribing across England. The figures deserve attention, but they cannot tell us where women experience the worst menopause symptoms.
The HRT postcode lottery becomes more than an abstract argument when menopause symptoms are disturbing your sleep. A new analysis by sleep brand Mossva reports substantial differences in prescribing across England, raising questions about how consistently women are being supported.
One comparison is especially revealing. In Gloucestershire and Lincolnshire, women aged 40–75 account for almost the same proportion of the population. Yet their reported HRT prescribing rates are markedly different.
That is worth examining. It is also worth being precise about what has been counted before turning a regional comparison into a verdict on anyone’s care.
Similar age profiles, different prescribing rates
Mossva analysed NHS and Office for National Statistics data, examining women aged 40–75 alongside regional HRT prescribing figures.
In Gloucestershire, women in that age range represent 22.9% of the population. In Lincolnshire, the figure is 23.4%: a difference of just 0.5 percentage points.
The reported HRT rates are 70.9 identified patients per 1,000 residents in Gloucestershire and 50.8 in Lincolnshire. Lincolnshire’s rate is approximately 28% lower.
The similar population shares make the contrast more interesting than a simple comparison between England’s highest and lowest figures. They do not, however, establish that the two areas have identical treatment needs, or explain why their prescribing differs.
An age bracket can help frame a question. It cannot answer it on its own.
The HRT postcode lottery in numbers
|
Women’s Health / England
The Menopause
Care Divide
HRT patient rates vary considerably across England. These are the five Integrated Care Board areas with the highest recorded rates and the five with the lowest, measured per 1,000 people in the source data.
|
||||||||||||||||||||||||||||||||||||||||
|
The widest contrast highlighted by Mossva is between Cornwall & Isles of Scilly and Northeast London.
Cornwall & Isles of Scilly has England’s highest rate in the company’s analysis, at 72.3 identified HRT patients per 1,000 residents. Northeast London’s figure is 21.3.
That puts the former at roughly 3.4 times the latter.
These rates use residents as their denominator. They should not be read as the proportion of menopausal women receiving treatment. Nor does a threefold prescribing difference establish that women in one area are three times more likely to suffer, have more severe symptoms or receive poorer care.
The figures reveal variation. Establishing how much of that variation reflects unmet need requires more than a ranking.
A wider question about access
There is a broader reason to examine these differences. A 10-year University of Birmingham study reported in 2025 found that white women and women in more affluent neighbourhoods in England were more likely to receive HRT than non-white women and those in more deprived areas.
That finding adds context to the regional picture. It does not establish what is driving the gap in any particular area on Mossva’s map.
For readers, the distinction matters: a local prescribing rate can prompt useful questions about access, but it cannot describe the support an individual woman has sought, needed or received.
Putting a postcode into the picture
Mossva’s Menopause Lens, part of its Sleep Disruption Map, lets users enter a postcode and compare their area with the rest of England.
Tom Savage, founder of Mossva, said: “We didn’t want to produce another national menopause report that women could read and forget. We wanted to make the data personal.”
There is a commercial context: Mossva sells eucalyptus lyocell bedding aimed at hot sleepers and people experiencing night sweats. Its interest in sleep is central to the tool’s presentation.
Savage also said: “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.”
That nightly experience gives the numbers their human importance. The useful question to take from the map is why prescribing differs so substantially, and whether women’s needs are being met. A postcode can begin that conversation; it cannot tell a woman what her menopause will be like.
