Menopausal women left without treatment due to HRT shortage
A NATIONAL shortage of hormone replacement therapy and contraceptive pills is affecting thousands of women across Ireland, campaigners warn.
A series of shortages of the most commonly prescribed HRT products, which replace hormones including oestrogen that naturally decline during menopause, has meant some Irish women have changed the product they use four times since August.
Some women are even resorting to cutting up high-dose HRT patches to try to get the correct dose because the product they were using is no longer available.
Pharmacists have described the situation as ‘distressing’. But as the health authorities advise women to consult doctors about alternatives, campaigners say the options are becoming narrower.
This comes as British doctors and health leaders write to their government calling for action, describing the situation there as ‘catastrophic’.
HRT boosts hormones which decline as women approach or experience the menopause.
Oestrogen and progesterone are offered in different combinations. The menopause affects women differently but many experience changes to their mental health as well as physical symptoms.
HRT is available in tablet form, as a patch, gel or an implant. Tablets are currently in stock but are not suitable for all women.
Loretta Dignam, founder of The Menopause Hub, said: ‘It’s been an ongoing issue for months, women deserve better. These drugs have actually given women back their lives.
‘I mean if they haven’t been sleeping for sometimes years, or they’ve been having anxiety or a lot of symptoms, they are terrified of going back to the way they were.’
Ms Dignam said the weight of the crisis is falling on the women affected, and then on doctors and pharmacists to source new products.
She said: ‘A pharmacist rang me yesterday to say a woman came in and basically cried because she couldn’t get her products.’
A spokeswoman for the Irish Pharmacists Union said: ‘The IPU is aware that there are currently shortages in some HRT medications. Obviously, it can be very distressing for patients when supply problems arise, and Irish community pharmacists are doing all they can to support patients directly in their communities.’
Problems started last year when two patches, Seven Sequi and FemSeven Conti, were withdrawn for further research as they didn’t stick properly to the skin. This in turn increased demand for other patches.
In Ireland, Ms Dignam said the first shortage here was a patch called Evorel Conti, which went out of stock over the summer.
This was a combined patch supplying both oestrogen and progesterone in one hit.
In a domino effect, she said other patches and gels including Evorel, Estradot and Divigel in turn have gone out of stock.
Ms Dignam warned: ‘Some women would have had to change four times in that time. They might have gone to a more expensive solution, and all the problems of having to ring around to pharmacies and trying to source it.’
Some patches come in different strengths marked as 100 or 50 for example.
She said she has heard of women having to buy higher strength patches from a different brand and cutting them diagonally to reduce the dose.
Health Products Regulatory Authority (HPRA) chief Darren Scully wrote to Ms Dignam saying they have told other suppliers to prepare for increased demand. But he warned: ‘We cannot force a company to supply product to Ireland.’
He said there were worldwide problems with Evorel and the manufacturers have said it could be midyear before supply resumes.
This week, a HPRA spokeswoman said: ‘The causes of the HRT shortages relate to both active substance availability and manufacturing delays.
‘The HPRA continues to be in frequent contact with the suppliers to maintain efforts to expedite resupply as soon as possible.’
She said they are hopeful that Evorel products will be available again in May.
Ms Dignam said the shortages and lack of information are adding to an already stressful situation for women. There have been concerns raised about possible links between HRT and an increased risk of breast cancer, so women are advised to consult with their doctors.
Women have also been experiencing problems with the supply of the contraceptive pill.
As with British authorities, the HPRA lists three types of contraceptive pill which are unavailable.
Niall Behan, head of the Irish Family Planning Association, said the shortages of contraceptive pills are an unfair pressure on women. He said the Cilest contraceptive pill has been out of stock since July last year.
Other pills including Zoely and Minulet have also become impossible to find in recent months, he said.
‘It can take women a long time to find a pill that suits them and it is unfair that these products can be withdrawn with little consideration for the needs of the women who use them,’ Mr Behan said.
Regarding the three pills listed on the HPRA website, the spokeswoman said Logynon is expected back in stock at the end of March, with Minulet and Ovranetteexpected to be available for ordering from later this month.
‘The HPRA continues to engage with the suppliers of these medicines to ensure that supply is restored as soon as possible and in the interim a number of other oral contraceptives are available.
‘We recommend that if a patient is experiencing difficulty with any medicine, that they should discuss their treatment with a doctor or pharmacist,’ she said.
A spokeswoman for the Department of Health said its Women’s Taskforce has also looked into the shortages.
‘These drugs have given women back their lives’
‘We cannot force a company to supply us’