HRT in Spain: Can You Buy It Over the Counter in 2026?
No — HRT is prescription-only in Spain. UK and US prescriptions are not covered by the EU rule, so you need a Spanish prescription from a licensed doctor.
Dr. Daniel Cuenca Leal
Colegiado nº 284627651 · Ilustre Colegio Oficial de Médicos de Madrid
Medically reviewed by Dr. Daniel Cuenca Leal · Updated September 30, 2026
Can you buy HRT over the counter in Spain?
Quick answer: No. Every HRT product on sale in Spain is prescription-only ("Medicamento Sujeto A Prescripción Médica") in the Spanish medicines agency's CIMA database, so you cannot buy it over the counter. Spanish law lets any licensed doctor (médico) prescribe prescription-only medicines, and it requires no particular specialty.
If the doctor decides a medicine is appropriate, you receive a private electronic prescription as a PDF by email, issued through a private e-prescription platform such as REMPe. You can get an HRT prescription in Spain by video consultation through our service. Show the PDF at a pharmacy; the pharmacist checks it before dispensing it.
This guide is for informational purposes only and does not replace personal medical advice from a qualified healthcare professional.
In Spain's public health system, menopause care is one of the primary-care services under Real Decreto 1030/2006, while rules for cross-border visitors are outlined by Your Europe (European Commission).
| Route | Wait | What you pay | Language | Prescription |
|---|---|---|---|---|
| Public health system (SNS) | Varies | EHIC: same rights as people insured in Spain, for care that can't wait | Varies | Public (SNS) prescription |
| Private clinic | Varies | Clinic fee; the EHIC does not cover private care | Varies | Private prescription |
| UrgentDoc video consultation | You choose a time from doctors' offers | Fee shown on the doctor's offer before you pay; medicine paid at the pharmacy | English | Private electronic prescription (PDF by email) if the doctor decides it is appropriate |
Who can prescribe HRT in Spain?
Spanish law lets any licensed doctor (médico) prescribe prescription-only medicines, and it requires no particular specialty, as set out in Spain's medicines law (RDL 1/2015).
Our doctors are licensed doctors who speak English. When you book an appointment, the doctor reviews your symptoms, takes a medical history, and evaluates whether hormone replacement therapy is clinically suitable. A prescription is never promised, as any prescribing decision remains entirely at the discretion of the treating doctor.
Will a Spanish pharmacy accept a UK or US HRT prescription?
Spain's rule for dispensing prescriptions issued in other EU countries does not cover UK or US prescriptions, so you need a Spanish prescription. Under Real Decreto 1718/2010, a prescription from another EU country can be dispensed in Spain if the medicine is authorised here, though the pharmacist may still refuse if in reasonable doubt.
A Spanish prescription is legally valid throughout Spain. The pharmacist checks it and will not dispense it if there are reasonable doubts about its authenticity or validity.
What is my HRT called in Spain?
A Spanish prescription names the active ingredient, and a brand only when the doctor considers it medically necessary; the doctor decides the medicine and the dose. If you take medication at home, you can look up other medicines in our medicine translator.
The pharmacist dispenses the medicine the doctor prescribed. Substitution is only allowed exceptionally, when the medicine is out of stock or urgently needed, and only with one of the same composition, form, route and dose, under Spain's medicines law (RDL 1/2015). Spain's rule for prescriptions from other EU countries does not cover UK or US prescriptions, so a pharmacist cannot turn a UK or US brand into a Spanish product: a Spanish product needs a Spanish prescription.
Active product authorisations and national availability are catalogued in the AEMPS CIMA database, while UK formulations are detailed in the UK product information (EMC).
| If you use (UK name) | In Spain | What to know |
|---|---|---|
| Oestrogel | Oestraclin | Estradiol 0.06% gel in a tube with a measuring applicator, not a pump; the doctor sets the dose. |
| Evorel 25-100 | Evopad only | No medicine called Evorel is in CIMA; same stated estradiol hemihydrate per patch, twice weekly. |
| Evorel Conti and Evorel Sequi | No marketed version | No combined estradiol-plus-progestogen patch is marketed in Spain; the doctor discusses another regimen, such as an estradiol patch with separate progesterone capsules. |
| Estradot | Estradot | Same name in Spain in 25, 37.5, 50 and 75 microgram patches; there is no Estradot 100. |
| Utrogestan 100 mg oral | Progeffik or Seidigestan | The Spanish Utrogestan is vaginal capsules licensed for fertility treatment and pregnancy-related uses, not HRT; both capsules say not to use them with a peanut or soy allergy. |
| Femoston 2/10 | Femfascon 2 mg/10 mg | Same composition and 14+14 continuous sequential regimen; in Spain the name "Femoston" means a different, continuous combined tablet. |
| Femoston 1/10 | No marketed version | Its Spanish version, Femfascon 1 mg/10 mg, is no longer authorised, and the doctor discusses an alternative. |
| Femoston-conti | Femoston 1 mg/5 mg or 0.5 mg/2.5 mg | In Spain "Femoston" means the continuous combined tablet. |
| Lenzetto | Lenzetto | AEMPS lists a supply problem expected to end on 30 November 2026; the prescribing doctor decides whether to use another marketed treatment. |
| Bijuve | Bijuva | Continuous combined estradiol and progesterone capsule; supply problems on both packs, expected to end on 30 November 2026. |
| Premique or other conjugated oestrogens | No marketed version | No conjugated estrogens are marketed in Spain; Duavive has no marketed pack. |
| Mirena used for womb protection | Mirena | In Spain licensed for contraception and heavy periods only, a hospital-diagnosis prescription, needs in-person fitting; our doctors do not prescribe it. |
| Testosterone | No product licensed for women | No testosterone product is licensed for women in Spain; products such as Testogel are licensed for male hypogonadism. |
What does a Spanish HRT prescription have to show?
Spanish regulations enforce formatting requirements for every medical order under Real Decreto 1718/2010.
| Requirement category | What a Spanish private prescription must show |
|---|---|
| Medicine information | The active ingredient (a brand only when the doctor considers it medically necessary, with a brief justification). |
| Patient identification | The patient's DNI or NIE, or for a foreign citizen the passport number. |
| Prescriber details | The prescriber's name and two surnames. |
| Prescriber contact | Direct contact details with the international prefix. |
| Prescriber location | Professional address including the town and "Spain". |
| Professional credentials | Professional qualification and número de colegiado. |
| Authentication | An electronic signature on an electronic prescription. |
| Documentation | The patient information sheet that goes with every prescription. |
How does a video consultation for HRT work?
Before starting or restarting HRT, Spanish product information requires a full personal and family medical history, and says the physical examination, including of the breasts and pelvis, should take account of that history and of the product's contraindications and warnings, as noted in the AEMPS product information for estradiol gel. Our doctors take that history during the video consultation and, if you need an in-person examination first, refer you for one. If you want your individual circumstances reviewed, you can arrange an online menopause consultation.
To request a review through UrgentDoc:
- You book a video consultation with one of our licensed doctors at a time that suits you.
- Doctors send offers, and the consultation fee is shown on the doctor's offer before you choose a time and pay.
- You attend the video appointment where the doctor reviews your medical history, symptoms, and existing treatments.
- The doctor decides whether HRT is suitable and whether an in-person examination or specialist care is needed first; if it is, our doctors refer you for it.
- If the doctor decides a medicine is appropriate, you receive a private electronic prescription as a PDF by email, issued through a private e-prescription platform such as REMPe. Show the PDF at a pharmacy; the pharmacist checks it before dispensing it.
Have these details ready for your consultation:
- Current medicines and known allergies (including peanut or soy).
- A recent blood pressure reading and current weight.
- The date of your last period and whether you have had a hysterectomy.
- Your breast and cervical screening history.
- For renewals, the name, strength and dose of your current HRT.
- A passport, DNI or NIE number to put on the prescription.
Our doctors do not prescribe HRT online, and refer instead, for: current or past breast cancer or another estrogen-dependent cancer; unexplained vaginal bleeding; a past blood clot or a known clotting disorder; a stroke, heart attack or angina; active liver disease; menopause symptoms or periods stopping under age 40. Our doctors refer women under 40, and women with current or past breast cancer or another estrogen-dependent cancer, to specialist care rather than prescribing HRT online. They do not prescribe the hormonal coil (it needs in-person fitting), testosterone for women, or compounded hormones or progesterone creams. After starting, the benefits and risks are reviewed at least once a year.
HRT is not a contraceptive. Pregnancy is still possible during perimenopause, so you still need contraception - ask the doctor when you can stop. If you need concurrent birth control options, you can explore a contraception prescription online.
How much does HRT cost in Spain, and is it free?
On the private route you pay two things: the consultation fee, shown on the doctor's offer before you pay, and the pharmacy's price for the medicine. The EHIC does not cover private healthcare.
In Spain's public health system, menopause care is one of the primary-care services, and an EU visitor's EHIC gives the same rights as people insured in Spain for treatment that can't wait until they get home.
What if you run out of or forget your HRT on holiday in Spain?
If your HRT was prescribed in the UK or the US and you run out of it or forget it while in Spain, you need a Spanish prescription to replace it, because Spain's rule for EU prescriptions does not cover UK or US prescriptions. For a renewal, have the name, strength and dose of your current HRT ready for the video consultation. For women living in Spain long term who need ongoing renewals, our service can assist with repeat prescriptions for UK expats in Spain.
When should you seek urgent or in-person care?
Certain clinical symptoms require hands-on evaluation or emergency services rather than a remote appointment.
Call 112 immediately The AEMPS patient leaflet for estradiol gel lists possible signs of a blood clot: pain and swelling in a leg, a sudden cough, severe chest pain (sometimes also in the arm), difficulty breathing, a severe unusual headache, loss of vision or double vision, difficulty speaking clearly, dizziness, seizures, weakness or numbness affecting a part of the body, and difficulty walking or holding things. If these occur, or if you have swelling of the face, tongue or throat with difficulty swallowing or breathing, call 112 straight away.
Stop treatment and see a doctor immediately Stop your treatment and see a doctor immediately if you develop yellowing of the skin or the whites of the eyes, a large rise in blood pressure, a first-ever migraine-type headache, or pregnancy.
Arrange an in-person medical examination A new breast lump or any other change in your breasts needs an in-person examination, which a video call cannot do. Vaginal bleeding that has not been diagnosed is one of the reasons HRT may not be suitable, so it must be checked in person first. You should also see a doctor as soon as possible in person if you have unexpected bleeding or spotting on HRT that lasts beyond the first 6 months, starts after more than 6 months of use, or continues after stopping.
According to AEEM, Spain's menopause society, menopause before 40 needs a medical assessment. Our doctors refer women under 40 to specialist care rather than prescribing HRT online.
Frequently Asked Questions
Do I need to see a specialist to get HRT in Spain?
No. Spanish law lets any licensed doctor (médico) prescribe prescription-only medicines, and it requires no particular specialty. Our doctors refer women under 40, and women with current or past breast cancer or another estrogen-dependent cancer, to specialist care rather than prescribing HRT online.
Can I get HRT patches in Spain?
Yes, transdermal estradiol patches are marketed in Spain, though brand names and strengths differ from other countries. If you need a renewal, our doctors can review your treatment and prescribe an available Spanish formulation if suitable.
Can I buy vaginal estrogen without a prescription in Spain?
No. Every vaginal estrogen product available in Spain is classified as a prescription-only medicine in official databases. You must consult a doctor to receive a valid medical prescription before a pharmacy can dispense it.
Can a Spanish pharmacist swap my UK HRT for the Spanish version?
No. The pharmacist dispenses the medicine the doctor prescribed. Substitution is only allowed exceptionally, when the medicine is out of stock or urgently needed, and only with one of the same composition, form, route and dose. Spain's rule for prescriptions from other EU countries does not cover UK or US prescriptions, so a pharmacist cannot turn a UK or US brand into a Spanish product: a Spanish product needs a Spanish prescription.
Can I start HRT online for the first time?
Our doctors conduct a full medical and family history during your video consultation to evaluate your suitability. The doctor determines whether HRT is appropriate or if you require an in-person physical examination or specialist care first.
Is HRT a contraceptive?
No, HRT is not a contraceptive. Pregnancy is still possible during perimenopause, so you still need contraception - ask the doctor when you can stop.
If you need your treatment reviewed while in Spain, book a video consultation with one of our licensed doctors.
