Navigating the menopause in France
The symptoms of perimenopause and menopause itself can be difficult to navigate – even more so when you live in a foreign country. Here’s a look at where to get help in France, what treatment is available, and how much it costs.
Depending on where you come from originally, your experience of women’s healthcare in France might fall short of or exceed your expectations. But one thing’s for sure – it’ll be different.
From who can treat you and what treatment is available, to general attitudes towards menopause and the years leading up to it, France has its own rules and customs – and knowing what they are is essential for getting the best support possible.
Where to go, who to see
In France, there are three options if you’re experiencing symptoms of menopause or perimenopause, according to French online health service, Ameli: your GP/family doctor (médecin traitant); a gynaecologist (gynécologue); or a midwife (sage-femme).
There is no need for a referral in order to see a gynaecologist, just find one local to you (for example via Doctolib) and make an appointment. It’s common in France for women to have a regular gynaecologist for routine healthcare such as pap smears/cervical smears.
Patient safety group La Prevention Medicale, explains that a midwife can perform many of the same duties as a GP or gynecologist, although they’re not able to prescribe HRT and “under no circumstances can she monitor a patient with a serious medical history, progressive pathologies, or signs suggestive of a pathology.”
Kay, a 51-year-old British woman living in Brittany, told The Local she’s had a very positive experience of being supported through perimenopause by a midwife: “I was seeing a gynecologist but then she retired and there was no-one to replace her. The hospital told me I could see a sage-femme instead and it’s been great. It’s really easy to get an appointment and I go to her with all my women’s health issues now – I barely see my GP.”
You can book an appointment directly with a local midwife.
If you live rurally, however, you might find that your GP is your only option – unless you’re willing to travel or have an appointment en visio (via video call).
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What to expect
Whether you see your GP, a gynecologist or a midwife, the first thing they’re likely to ask you about is the frequency, duration and nature of your periods (les règles).
They’ll also ask about your symptoms, which might include:
- Bouffées de chaleur – hot flushes
- Sueurs nocturnes – night sweats
- Troubles du sommeil – sleep disturbances / insomnia
- Sautes d’humeur / émotions changeantes – mood swings
- Brouillard mental – brain fog
- Sécheresse vaginale – vaginal dryness
- Prise de poids – weight gain
- Infections urinaires à répétition – recurrent urinary tract infections (UTIs)
- Douleurs articulaires – joint pain
- Baisse de la libido – low sex drive
As well as assessing the severity of your symptoms, they’ll ask you about your personal and family medical history to check for breast cancer, endometrial disease, liver conditions, and cardiovascular risks, which can rule out certain forms of treatment.
You can also expect them to weigh you, take your blood pressure, do a vaginal examination and check your breasts. They’ll also ask when you last had a mammogram, and they might prescribe additional tests to facilitate a proper follow-up.
Menopause and perimenopause treatment in France
Beyond the standard advice on diet and exercise, there are various treatments that might be prescribed or recommended, depending on whether you’re officially in menopause (defined in France as 12 consecutive months without a period) or still in perimenopause.
These range from hormone replacement therapy (HRT) – known in France as traitement hormonal de la ménopause (THM) or traitement hormonal substitutif (TSH) – to non-hormonal prescription and over-the-counter options, including homeopathic remedies, as listed by Vidal, the official clinical database used by French healthcare professionals.
What kind of HRT is available in France?
The current French clinical standard for HRT, as outlined on Ameli, is a combination of ‘transdermal’ estradiol and ‘natural micronised’ progesterone.
Estradiol is administered directly through the skin via either a gel such as Estreva or Oestrodose, or a skin patch such as Vivelledot – this kind of ‘transdermal’ treatment, as it’s known, is favoured over oral oestrogen tablets due to the risk of deep vein thrombosis, pulmonary embolism and ischemic stroke associated with oral pills.
As explained by Ameli, for women with an intact uterus, oestrogen must always be combined with a progestin (progesterone or a derivative) to minimise the risk of endometrial cancer.
French practice tends to favour ‘body-identical micronised’ progesterone capsules such as Utrogestan or Progestan, or dydrogesterone (Duphaston) – these contain an exact chemical copy of the natural progesterone your own ovaries make (body identical), which is ground up into microscopic particles (micronised) that your body can absorb easily.
Genitourinary treatments
For genitourinary problems such as vaginal dryness, urinary tract infections and incontinence (common symptoms associated with a drop in oestrogen), ‘localised’ low-dose oestrogen creams, suppositories, and vaginal rings (such as Physiogine or Ovestin) are widely prescribed.
Testosterone availability in France
Testosterone remains officially unlicensed (non autorisé) for treating menopausal symptoms in France, as it is in most European nations.
In France non autorisé medications are those that will not be refunded via the carte vitale or Mutuelle health insurance – they are, however, often available if you are willing to pay out of pocket.
Who’s eligible for HRT in France?
According to Ameli, HRT can be prescribed to menopausal women (that is, women who have not had a period for 12 consecutive months or more) who have no contraindications – these include a personal history of breast cancer, endometrial cancer, venous thromboembolism or stroke, coronary heart disease, unexplained vaginal bleeding, and severe liver disease.
HRT is generally prescribed for women suffering from ‘climacteric’ symptoms that impact daily life, such as hot flushes, night sweats, sleep disturbances, and mood changes. It is also prescribed for women at high risk of osteoporotic fractures.
Treatment is said to be most effective when taken during the “therapeutic window” (fenêtre d’opportunité) of 10 years from menopause onset, or before age 60.
Accessing HRT during perimenopause
Unlike in the US and the UK, where women are routinely prescribed full combined HRT (oestrogen and progesterone) during perimenopause, traditional French practitioners often resist prescribing oestrogen until 12 months without a period have passed, due to historical warnings about hyperœstrogénie (oestrogen dominance) during perimenopause.
Instead, perimenopausal women in France are often prescribed progesterone-only treatment which is taken from days 11 to 25 of the menstrual cycle, or progesterone-only mini-pills, to regulate heavy bleeding and improve sleep.
However, under the updated guidelines jointly published by the CNGOF and the GEMVi in 2021, some specialists in France are now willing to prescribe transdermal oestrogen alongside micronised progesterone to perimenopausal women experiencing severe symptoms.
The cost of women’s healthcare in France
State health insurance (Assurance Maladie) covers 70 percent of consultation fees if they are in line with the official regulated tariff (tarif de convention) – which for a GP was €30 in 2026 – while your mutuelle (top-up insurance) typically covers the remaining 30 percent.
This applies whether you are seeing a GP, gynaecologist or midwife, or a combination of the three.
If you are seeing a ‘sector 2’ practitioner, they may charge fees at a higher rate – the carte vitale will only cover 70 percent of the regulated fee while mutuelles may or may not pick up the extra, depending on the policy.
Standard HRT prescriptions including oestrogen gels/patches and micronised progesterone capsules are processed via your carte Vitale (health insurance card) and reimbursed by the state at rates between 35 percent and 65 percent. The remaining balance (ticket modérateur) is covered by your mutuelle.
Mammograms, cervical smear tests, and blood tests ordered by a doctor are reimbursed by Assurance Maladie and top-up insurance.
Because it’s unlicensed for menopausal use, transdermal testosterone is non-reimbursable and paid 100 percent out of pocket (typically €40–€60 per bottle).
If you do not yet hold a carte Vitale, you can still see a doctor, midwife, or gynaecologist, but you must pay upfront at the clinic.
Ask the practitioner for a feuille de soins – a kind of receipt. Once you’re registered with Assurance Maladie, you can use it to get a retrospective reimbursement.
