What the HRT crisis really means for women
For more than a year, hundreds of thousands of women across Britain have been struggling to get their HRT medications. NATASHA HOLT looks at the impact the shortage has had on their lives
IT IS estimated that around 13 million women in the UK are either perimenopausal or postmenopausal, with approximately one million using some form of hormone replacement therapy (HRT) to help with symptoms such as hot flushes, night sweats, depression and loss of libido.
However, since late 2018 supplies of certain types of HRT, including Evorel and Estradot patches and the Elleste range of tablets, have been running low across the UK, leaving many women struggling to cope at work or in their daily lives.
Statistics show that one in four women experience debilitating symptoms that can last 15 years after the menopause and without HRT many have found these have returned.
“The impact of the shortages can’t be underestimated,” says Diane Danzebrink, founder of campaign group Make Menopause Matter. “It has caused dreadful, prolonged anxiety and for some the psychological impact has been absolutely devastating.”
WHY HAS THIS HAPPENED?
Since NHS guidelines in 2014 recommended that HRT be more widely used there’s been a huge increase in demand for the medication.
According to the Department of Health and Social Care the current shortage has been caused by “manufacturing, regulatory and commercial issues” outside their control and it’s believed there have been supply problems in China affecting some of the components for HRT patches, which deliver hormones through the skin.
As a result doctors have been prescribing more pills and gels instead so these are now also in short supply. Reports indicate that around half of the more commonly prescribed HRT products are out of stock.
The situation has been incredibly stressful for many women who rely on HRT to help with the physical, psychological and cognitive symptoms of the menopause or perimenopause.
Mandy Walker, a 52-year-old quality manager for care homes, has been perimenopausal for 11 years and spent a decade looking for help with symptoms such as anxiety,
panic attacks, depression and an inability to concentrate.
“I describe it as trying to think through porridge,” says
Mandy from
Telford in Shropshire. “I couldn’t think straight or find the right words for things and my anxiety was overwhelming.
I was convinced
I had early onset Alzheimer’s disease.
“Eventually I felt so
depressed I had thoughts of self-harm and suffered mild agoraphobia.Then finally, just over a year ago, my GP prescribed HRT patches which really helped. It was like finding the Holy Grail.” However after two months on HRT the shortage meant Mandy could no longer get her medication. “I went to 10
pharmacies and none had what I needed.
“By the third month I was taken off HRT altogether because my doctor couldn’t find an equivalent medicine and my anxiety and panic attacks came flooding back. I suffered from palpitations and breathlessness and my periods were so heavy I often couldn’t go into work.
“I felt as though the lifeline I’d been given had been snatched away.
“I’ve now been on HRT pills for the last six months and they are working well but the last time I collected my prescription my chemist told me it would be the last time the tablets would be available.
“Now I’m full of anxiety, wondering if I’ll be able to switch products or if there will be any HRT available at all. If this was happening to men it would be declared a national crisis.”
Alongside the physical concerns, many women are struggling financially as a result of the shortage. Previously, women would obtain their HRT on prescription, costing £9 for those containing just the hormone oestrogen and £18 for those containing oestrogen and progesterone.
Now many women are resorting to buying their medication privately online, where some unscrupulous pharmacists are cashing in and charging up to four times the NHS price.
Other women have had to travel abroad to find their medications or asked family members living overseas to buy them over the counter.
However this can be incredibly risky as HRT should be prescribed by a doctor who keeps a close eye on the patient’s health and insists on regular check-ups because the medication can raise the risk of heart disease, blood clots and some cancers.
WHAT TO DO IF YOU’RE STRUGGLING TO GET SUPPLIES
The British Menopause Society, an organisation for healthcare professionals, is advising women there are still some forms of HRT available and to speak to their GP to determine which would make the best alternative.
Kate Palmer, a consultant gynaecologist on the BMS council, says, “I’d recommend that people make an appointment to see their GP well before their current medication runs out.
“They should tell their GP to check the BMA’s website (thebms. org.uk) as this has a learning tool for doctors, advising them how to prescribe equivalent products.
“So if a patient’s normal patches aren’t available it will show them how to prescribe the same amount of hormones in gel or pill form.
“Although this is clearly a stressful situation for many women we’d like to reassure them that in most cases there is a perfectly good equivalent available.
“Anyone buying their medication online must check they it is from a reputable online pharmacist which at the very least insists on them filling out a health questionnaire – otherwise the medication may not be safe for use.”
It’s hoped the HRT shortage will be resolved this month, leading to some products coming back onto the market, but it will take some time before they are readily available and some items may remain under-stocked until the end of the year.