Around a million women rely on hormone replacement therapy (HRT) in Britain, but nationwide shortages are causing disruption and distress across the country.
HRT is prescribed primarily to help combat perimenopausal and menopausal symptoms, which include anxiety, joint pain, disturbed sleep and hot flushes.
The drugs are also vital for the trans women prescribed them to alter their hormones, though experts have said the number of trans women taking HRT is very small, and is not a contributing factor towards the shortage.
Acute shortages have reportedly caused women to share prescriptions, with some said to be made suicidal by the debilitating symptoms they suffer without the medications. Women have also reported travelling hundreds of miles between pharmacies to access their prescriptions.
Here’s what’s happening and what’s being done about it:
Why is there a HRT shortage?
The number of people requesting HRT has increased rapidly in recent years in a trend dubbed ‘the Davina effect’, after presenter Davina McCall created a documentary to break down the stigma associated with HRT and dispel some myths about its safety. She also campaigned for HRT prescription costs to be cut to allow more women to access the treatment.
Recent figures suggest the number of HRT prescriptions in the UK has more doubled in the last five years but stocks are running low, with Besins Healthcare – the manufacturer of a commonly-used hormone replacement gel Oestrogel –reporting supply problems.
What do pharmacies have to do with it?
The Royal Pharmaceutical Society (RPS) is calling on Sajid Javid to allow pharmacists to dispense substitute versions of prescription medicines.
Claire Anderson, the president of RPS, told the Guardian that current laws in England stipulate that community pharmacists must provide the exact product and amount of medication on the prescription.
If the type of HRT product is not available, a substitute cannot be given out without consulting the GP who prescribed the medicine.
“At the moment pharmacists cannot amend prescriptions for HRT, so have to refer women back to their GPs when a medicine is not available,” Anderson said.
“Enabling pharmacists to do so will save time for patients, pharmacists and doctors, as well as lessening the anxiety for women waiting for medicines.”
What is the government doing about it?
The government has announced it will be appointing HRT tsar with orders to solve the shortage.
Sajid Javid told The Mail on Sunday he was “determined” to make sure supplies were meeting the high demand and would use lessons learned during the Covid-19 vaccine rollout.
“I will be urgently convening a meeting with suppliers to look at ways we can work together to improve supply in the short and long term,” he said.
“It’s also clear to me that we need to apply some of the lessons from the vaccine taskforce to this challenge, so we will soon be recruiting for an HRT supply chairperson.”
What advice is there for women struggling to access HRT?
The British Medical Society advises women who are experiencing difficulty in obtaining Oestrogel to consider equivalent alternative HRT preparations. “This could include Sandrena gel (0.5mg or 1mg) or Lenzetto spray preparations,” a statement on their site reads.
“Prescribers should consider using equivalent preparations to those that their patients are currently using. If an exact match is not possible, prescribers can seek guidance available on the BMS website to clarify equivalent doses.”
Dee Murray, CEO and founder of Menopause Experts Group, has said women should only take HRT under the advice of a health professional.
“The HRT shortage is causing stress and potential harm for women, with some pushed to take matters into their own hands and look for supplies online,” she said.
“This could have a devastating impact on their health, as HRT should only be prescribed by qualified healthcare practitioners who understand the patient’s history.”
She also advised taking steps to “survive without HRT”, which include practising mindfulness to reduce stress, cutting down on problem foods that trigger migraines or contribute towards poor sleep (such as caffeine or alcohol) and reducing excess weight which can heighten menopause symptoms.
Again, speak to a medical professional before making drastic lifestyle changes.