Women told: cut HRT patches in half

Kiwis going through menopause have been told to cut their hormone patches in half because of a shortage of medication.

New Zealand is currently out of stock of Oestradiol (Estradot) 50 microgram patches because of logistics ‘‘bottlenecks’’.

The patches are a type of menopause hormone treatment – also known as hormone replacement therapy (HRT) – used for short-term relief of symptoms.

The prescription patches (available in 25, 50, 75 and 100mcg strengths) release oestrogen in a continuous and controlled way, just as ovaries would before menopause. HRT can be stopped suddenly, but is recommended to be done gradually because it is less likely to cause symptoms to come back short-term.

An Auckland woman who went to pick up her repeat prescription this week was told her pharmacy had no 25mcg patches either, and to contact her GP to re-prescribe 75mcg, so she could cut them up to use. The woman, who did not want to be named, said she had been using 25mcg patches for two years to help mitigate the ‘‘terrible trouble’’ she was having with brain fog, mood swings, sore joints, and the inability to string a sentence together during menopause.

But because she was unable to get her usual strength – and the pharmacy didn’t know when they’d have more – she’s cutting 75mcg patches into thirds by hand.

She worried she might not be getting the right dose this way, and was concerned for others in the same boat: ‘‘To muck around with people’s doses is not good. I don’t think it’s very safe.’’

She wasn’t alone: a Stuff employee prescribed 50mcg patches was told by her usual chemist to ring around pharmacies in the hopes of finding some.

Her GP surgery said the best workaround was to cut 100mcg patches in half – and adjusted her prescription so she could do this.

‘‘Obviously, it’s better than nothing. But it doesn’t inspire confidence when you’re having to MacGyver your own HRT dose.’’

The patches – which resemble clear sticky tape – are worn on the body like a plaster for a few days before a new one is applied.

New Zealand’s stock problem comes as the United Kingdom is experiencing an acute shortage of HRT, linked to ’’extraordinary’’ demand outstripping supply.

Nearly 60,000 people in Aotearoa were dispensed oestradiol patches between 2018-20, Ministry of Health data showed.

To bridge the gap, Pharmac has secured an alternative 50mcg patch, branded as Climara, Pharmac’s director of operations Lisa Williams said.

It was being supplied in ‘‘limited quantities’’ to ensure the product is ‘‘equitably distributed’’.

Pharmacists would not see this in the Online Schedule until it was updated for next month, but Pharmac had notified it on its website, and through pharmacy communication channels, Williams said.

Williams said the issue stemmed primarily from delays in the national supply chain, with New Zealand distributors experiencing ‘‘backlogs’’ because of issues with processing orders.

This had delayed deliveries of medicines to wholesalers, and subsequently, to pharmacies.

Williams said a fresh supply of the 50mcg patch has arrived in the country, and was undergoing quality assurance checks.

Pending the outcome of these checks, stock could be available for pharmacies to order late next week.

There have been other recent supply issues with the patches – most recently in October last year, when 25 and 50mcg patches were affected. Between February and May last year, 75mcg patches were out of stock. The only alternative was a product not approved by Medsafe.

The 25 and 50mcg patches also ran out between August 2020 and January 1, last year.