Money, Economic Inequality and the High Cost of Menopause

by Jennifer Upton

A Tale of Two Experiences

Recently, over coffee, a close friend of mine who had recently finished her journey through menopause smiled and exclaimed, “I’m saving a lot of money! I don’t have to buy tampons or pads anymore.”

I looked down into my cup, quietly adding up the cost of my HRT prescriptions as well as all the products I’d been buying to treat the symptoms I was experiencing.

Moisturizer for vaginal dryness, supplements for hormone balance, pads for stress urinary incontinence and special shampoo for hair thinning.

I looked up, puzzled, “Don’t you have to pay for your HRT and all the other stuff you need?”

She paused, “Well…yes. I’m on about 10 different vitamins along with estrogen gel and progestin.”

We both fell silent as a homeless woman walked past the café window.

“I guess we’re lucky we can afford all these things,” my friend mused.

“Yes, we are.”

As an American living abroad in the UK, I was even more keenly aware of how expensive it is for my friends back in the states.

The truth is menopause is expensive. So is perimenopause.

Where in the world…means a world of difference in costs.

Prices for treatments vary widely depending on where you are in the world.

In the United States, for a person with no insurance, “the cost for estradiol topical vaginal cream (0.1 mg/g) is around $91 for a supply of 42.5 grams, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans.” (1)

In England every HRT prescription on the NHS costs just £9.35 per item.

It’s free in Scotland and Wales.

Good news for some, bad news for others

The good news is, more women both in the U.S. and UK are asking to see their healthcare providers for perimenopause and menopausal symptoms.

The bad news is that with increasingly long waiting lists on the NHS in the UK, more women are choosing to go private.

A recent poll found that, in the past year, five times as many women sought paid-for medical help for symptoms such as hot flushes and sexual discomfort compared with the previous year. (2)

Although more expensive than the NHS, going private in the UK isn’t nearly as expensive as it is for a person with no insurance in the U.S.

Even if a patient chooses to go private in Great Britain, the average per prescription price is £20.

In the U.S., women of lower means often have no support.

Until recently, little was known about how underserved women in the U.S. cope with menopausal symptoms. Almost as if they didn’t exist.

In 2021, one of the first studies of its kind was undertaken in Arizona “To better understand self-reported menopausal symptoms in underserved and homeless women living in extreme heat during different seasons.”

What they found was interesting.

It seems as if those underserved are also the least likely to complain.

The study revealed, “Women did not think temperature outside influenced their menopausal symptoms at either time point (69% in winter vs. 57% in summer….Menopausal, underserved, homeless women living in Arizona reported few vasomotor symptoms regardless of seasons.”

Instead, the women surveyed “endorsed psychological and somatic complaints.” (3)

They believed any symptoms relating to menopause were in their minds.

As the global economy shrinks, unemployment on the rise and inflation out of control, more and more women, will be increasingly underserved.

With ongoing cost of living crisis, many even median earning women are opting out of HRT and other treatments because they simply can’t afford it.

Many are going the natural route and administering self-treatment.

How can I treat the symptoms of Menopause without HRT?

  • Herbs and vitamin supplements (Calcium and Vitamin D are very important)
  • Exercise regularly
  • Eat a diet high in fibre and phytoestrogens (both found in legumes)
  • Take cool showers at night
  • Practice Yoga, Tai Chi and/or meditation
  • Quit smoking
  • Cut out caffeine
  • Get plenty of rest
  • If you have trouble sleeping, do breathing exercises before bed to relax the body and prepare it for sleep
  • Stay hydrated

It’s not all doom and gloom!

Even those experiencing financial hardship can seek out all possible avenues of support

In the U.S., Ex-military can visit a hospital or clinic through the Veteran’s Health Administration.

There are about 1,400 free clinics all over America and others covered by Medicaid that treat menopause and its symptoms.

In the UK, menopause is not considered a disability in and of itself, but some severe symptoms may qualify, in which case an employer would be required to make reasonable accommodations and safeguard the employee from less than favorable treatment. (4)

The NHS Menopause page serves as a connection point for UK women seeking help.

Once you find the support you need, please spread the word!

Many are so caught up in their daily lives that they aren’t aware of the support that’s out there.

In these trying times, with the gap in equality growing wider by the day, it’s more important than ever for women to support each other.

mySysters is an app for women in perimenopause and menopause. Good Housekeeping and Woman’s Day named mySysters the Best App for Women in Perimenopause and a Must Have App for Women.

  • The information and other content provided in this blog, website or in any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment.

Jennifer Upton is an American (non-werewolf) writer/editor in London. She currently works as a freelance ghostwriter of personal memoirs and writes for several blogs on topics as diverse as film history, punk rock, women’s issues, and international politics. For links to her work, please visit or send her a Tweet @Jennxldn