HRT in the spotlight
LISA SALMON looks at hormone replacement therapy as stocks run low
STOCKS of hormone replacement therapy (HRT) medication are running low, and Health Secretary Sajid Javid has appointed Madelaine McTernan as head of a new taskforce to tackle the problem.
The British Menopause Society (BMS, thebms.org.uk) says more than 75% of women, usually in their late 40s or early 50s, have menopausal symptoms, and an increasing number are taking HRT to help deal with it. Figures suggest HRT prescriptions in the UK have more than doubled in the last five years, but stocks are running low, with one hormone replacement gel manufacturer reporting supply problems.
As a result, many women are worried they may not be able to get their HRT, and might have to endure debilitating symptoms – including hot flushes, night sweats, sleep problems and mood swings.
The BMS expects the shortage to be a short-term issue, but if you’re struggling with a lack of medication – or menopause
symptoms in general – speak to your GP for advice.
According to the NHS, HRT “replaces the hormones that a woman’s body no longer produces because of the menopause”.
The two main types are oestrogen and progesterone – medication tends to be split into combined HRT (taking both hormones) and oestrogen-only HRT, taken via tablets, skin patches, gels and implants.
Dr Louise Newson, founder of The Menopause Charity (themenopausecharity.org) and Newson Health Research and Education (newsonhealth.co.uk), says: “We’ve reached an extremely worrying point with regards to HRT supply in the UK, with thousands of women suffering unnecessarily, as they rely heavily on this to get by in their everyday life.”
Dr Paula Briggs, a consultant in sexual and reproductive health and chair elect of the BMS, says the HRT shortage “is undoubtedly causing problems”, but stresses women should be given information to make an informed decision about how they manage their menopause, and it doesn’t have to be with HRT.
So, what are the risks and benefits of HRT?
Benefits of HRT
“The main benefits of HRT are symptom control,” says Dr Briggs. “It’s the best way of controlling common menopausal symptoms like hot flushes, night sweats and difficulty sleeping.” She adds: “Longer-term treatment maintains bone mineral density, too. Osteoporitic fractures are a major cause of morbidity and ill health, so anything that reduces that risk is good – but it’s got to be in the right dose, and in the right patient.”
Dr Newson believes: “Taking HRT vastly improves your symptoms, and helps protect against long-term health risks or hormone deficiency.
“Even low levels of HRT can have benefits in your body and improve symptoms of the menopause.”
Risks of HRT
The NHS says the risks from taking HRT are very small – it depends on the type you take, how long you take it for and if you have any existing health conditions.
It says there’s little or no change in the risk of breast cancer if you take oestrogen-only HRT, and combined HRT can be associated with a small increase in the risk of breast cancer, related to how long you take
the medication for.
This risk falls after you stop taking it. Experts stress because of this increased risk, it’s especially important to attend all breast cancer screening appointments.
The NHS says there’s no increased risk of blood clots from HRT patches or gels, but a small increase from taking HRT tablets.
HRT doesn’t significantly raise the risk of cardiovascular disease (including heart disease and strokes), and when started before age 60 it may, reduce the danger.
“The main things are cancer and cardiovascular risk,” says Dr Briggs. “But for otherwise healthy women who are below the age of 60, the benefits outweigh the risks.”
She suggests hype around HRT supply problems is creating panic, saying: “Don’t panic, don’t use anybody else’s medication, and make contact with your GP about a reasonable alternative. The shortage should be resolved by June.”