Perimenopause & hormones
HRT in Sweden: how menopause care works, and what to ask
If you've moved here from another country, menopause care in Sweden can feel unfamiliar. Here's how the system works, step by step, and how to get the most out of your appointment.
In Sweden, you usually start with your vårdcentral (local primary care clinic), not a gynecologist. A doctor there can go through your symptoms with you and talk about hormone therapy, which comes as tablets, patches, spray or gel, and you decide together.[1][2] Bleeding more than a year after your last period goes to a gynecological clinic.[1]
I moved to Sweden in 2018, after running my own practice in Portland, Oregon. So I know how it feels to need care in a system you don’t know yet. Many of my English-speaking clients ask me the same questions about menopause care here, so I’ve collected the answers in one place.
Where do I start?
For symptoms you think come from perimenopause or menopause, 1177 points you to your vårdcentral.[1] You can go to the vårdcentral nearest to you when you need to see a doctor or a nurse.[3]
Specialist clinics, such as gynecology, often need a referral. Your vårdcentral usually writes it, and there can be a waiting time.[4]
Contact a gynecological clinic directly if:[1]
- you start bleeding again more than a year after your last period
- your bleeding is very heavy
- your bleeding changes in a way that worries you
Not sure where to go? Call 1177 and you’ll speak to a nurse, who can help you figure out the right place. From a foreign number, call +46 771-11 77 00.[3]
How does it work in Sweden?
Most people here have their last period at 51–52, though it can be anywhere from 45 to 57. Menopause is confirmed once a full year has passed since your last period.[5] Perimenopause can start years before that, and symptoms often show up early. You’ll find the common signs in perimenopause symptoms.
At the appointment, the doctor asks about your symptoms, other conditions, and any medicines or supplements you take.[1] A gynecological exam isn’t required to get a prescription for hormone therapy. It may be needed if you have symptoms in the genital area.[1]
In Sweden, you take part in decisions about your treatment.[1] That’s why it helps to come prepared.
What 1177 says about the options
I don’t recommend for or against HRT. That decision is yours and your doctor’s. Here is what 1177, Sweden’s public health information service, describes, so the words are familiar when you hear them:[2]
- Estrogen for the whole body: tablets, patches, gel or spray. Treatment often starts with a low dose, which can be raised if symptoms haven’t eased after two to three months
- Progestogen or bioidentical progesterone: taken together with estrogen if you still have your uterus, to protect its lining
- Hormonal IUD: can be used together with estrogen
- Local estrogen in the vagina: cream, gel, pessaries, tablets or a ring, for dryness, pain during sex and urinary symptoms
- Without hormones: some prescription medicines can reduce hot flashes and night sweats, and hormone-free moisturizing creams and gels help with dryness
1177 also notes that if you have a higher risk of blood clots, patches, gel or spray may be a better choice than tablets.[2] Which form suits you depends on your own health history, and that’s a conversation for your doctor.
If you don’t want hormones, or can’t take them, I’ve written more about that in perimenopause without HRT.
What does it cost?
Care at the vårdcentral has patient fees, which are set by each region and are usually similar across Sweden. There’s also a yearly cap on what you pay for outpatient care.[6]
Almost all prescription medicines are part of the high-cost protection for medicines. Once you’ve paid 3,800 SEK in a 12-month period, you don’t pay more for covered medicines for the rest of that period. For medicines outside the protection, you pay the full price yourself.[7]
The protection applies if you live or work in Sweden. It also applies if you have a European health insurance card from another EEA country or Switzerland.[7]
Fully private care that isn’t funded by a region is paid in full by you.[6]
Questions to bring to your appointment
Appointments go by quickly. Writing things down beforehand makes it easier to cover what matters to you. You could bring:
- a list of your symptoms from the past few weeks: sleep, hot flashes, mood, periods, energy
- the date of your last period, and how your cycle has changed
- everything you take, including herbs and supplements[2]
- any blood clots, heart problems or liver conditions, now or in the past, in you or your family[2]
And some questions to ask:
- Which forms of hormone therapy would suit me, and why?
- How will we follow up, and when?
- What should I do if I get bleeding or side effects?
- What are the options without hormones?
- If I want to stop later, how do I do it?
1177 says it’s often best to lower the dose gradually and to talk to your doctor before you stop.[2]
Language and interpreters
If you don’t speak Swedish, you may be entitled to an interpreter, and it’s free. Contact your clinic before the visit to arrange it.[4] If you prefer English, it’s worth asking about it when you book.
Where I fit in
I’m a US-trained naturopath and acupuncturist in Östermalm, and I work in parallel with your doctor, whether or not you take HRT. I don’t prescribe medicines, and questions about doses go to your doctor.
What we can do together is look at the whole picture: sleep, food, stress, digestion and what you’ve already tried. Your written plan can include advice on food and sleep, herbs, supplements and Japanese-style acupuncture. I always go through everything you take before I recommend anything. If you’d like, I can also help you put your symptom notes and questions in order before your next appointment with your doctor.
You can read more about how I work in perimenopause support. A first visit is 60 minutes, at Kommendörsgatan 9 or online, in English or Swedish. All options are on prices. Not sure if it’s the right fit? You can book a free 15-minute call on Tuesdays between 1 and 2 pm, or send me an email.
When to see a doctor
Contact your vårdcentral or call 1177 if you have:
- bleeding more than a year after your last period (this goes to a gynecological clinic)[1]
- very heavy bleeding, or bleeding that changes in a way that worries you[1]
- new, severe or unclear symptoms
- symptoms that come back, or side effects, while you take hormone therapy[2]
- low mood that doesn’t lift
If you think your condition is life-threatening, call 112.[3]
Sources
-
- Klimakteriebesvär. 2026. https://www.1177.se/sjukdomar--besvar/hormoner/klimakteriet/klimakteriebesvar/
-
- Läkemedel vid klimakteriebesvär. 2026. https://www.1177.se/undersokning-behandling/behandling-med-lakemedel/lakemedel-utifran-diagnos/lakemedel-vid-klimakteriebesvar/
- 1177 Region Stockholm. Healthcare in Region Stockholm. 2025. https://www.1177.se/en/Stockholm/other-languages/other-languages/soka-vard/hitta-ratt-vard-nara-dig---andra-sprak---stockholms-lan/
-
- How healthcare works in Sweden. 2024. https://www.1177.se/en/other-languages/other-languages/soka-vard/sa-fungerar-varden-i-sverige/
-
- Patientavgifter och högkostnadsskydd. 2026. https://www.1177.se/sa-fungerar-varden/kostnader-och-ersattningar/patientavgifter/
-
- Läkemedel på recept: kostnader. 2026. https://www.1177.se/undersokning-behandling/behandling-med-lakemedel/att-fa-recept-och-att-kopa-lakemedel/lakemedel-pa-recept--kostnader/
Common questions
Do I need to see a gynecologist to get HRT in Sweden?
Not necessarily. According to 1177, your first step for symptoms you think come from menopause is your vårdcentral (local primary care clinic). A gynecological exam isn't required for a prescription, but it may be needed if you have symptoms in the genital area. Specialist clinics often need a referral, which your vårdcentral usually writes.
How much does HRT cost in Sweden?
Almost all prescription medicines are part of Sweden's high-cost protection for medicines. Once you've paid 3,800 SEK within a 12-month period, you don't pay more for covered medicines for the rest of that period. The protection applies if you live or work in Sweden, or have a European health insurance card from another EEA country or Switzerland.
Can I get help in English?
You can call 1177 and speak to a nurse; from a foreign number, the number is +46 771-11 77 00. If you don't speak Swedish, you may be entitled to a free interpreter. Contact your clinic before your visit to arrange one. At my clinic, visits are in English or Swedish.
Can I see you if I'm already on HRT?
Yes. I work in parallel with your doctor, whether or not you take HRT. We go through your sleep, food, stress and symptoms, and your plan takes into account everything you already take. Questions about your dose, switching or stopping go to your doctor or gynecologist.
Want to know how I can help?
Book your first visit with me in Östermalm, or start with a free 15-minute call.