HRT shortage: has ‘medical sexism’ caused menopause drugs crisis?

Thousands of women are struggling to sleep or work as a result of a nationwide shortage of hormone replacement therapy (HRT) that has left some feeling suicidal, campaigners have warned.

An estimated million women in Britain rely on HRT, “which comes in pills, patches and gels”, to relieve debilitating effects of menopause including anxiety, hot flushes and insomnia, The Guardian reported. But nationwide supply problems “have led to some women buying them on the black market or asking friends to buy medicines abroad for them”.

Health Secretary Sajid Javid told The Mail on Sunday that he would try “to make sure that supplies are meeting hugely rising demand” by appointing a new HRT tsar whose role would be modelled on that of Covid Vaccine Taskforce chair Kate Bingham.

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Javid’s intervention was welcomed by campaigners including Labour MP Carolyn Harris, co-chair of the recently formed UK Menopause Taskforce. But Harris added: “We should never have been in this position.”

Why is there a HRT shortage?

NHS prescriptions for HRT treatment have more than doubled in England over the past five years. According to latest figures from Oxford University’s OpenPrescribing science data website, nearly 538,000 prescriptions for HRT treatment were issued in December 2021, compared with 238,000 in January 2017.

This increase in demand has been attributed to “celebrity campaigns, political action and greater media coverage of the menopause”, and to “waning concerns about HRT’s possible side-effects”, said The Mail on Sunday.

Covid-related ingredient supply problems have also been blamed for the acute HRT shortages in recent weeks. Women’s Health Minister Maria Caulfield told the paper that suppliers had assured her that depleted stocks should be back to normal by June.

But with supplies of the most popular forms of HRT currently running short, GPs are being forced to prescribe alternatives. And stocks of these alternatives are now also beginning to run low.

Announcing his HRT tsar plan, the health secretary said: “I know just how much women rely on HRT and that some have been struggling to get certain medicines.”

Javid said that he would also “be urgently convening a meeting with suppliers to look at ways we can work together to improve supply in the short and long term”.

The minister is facing calls “to change the law to let pharmacists alter prescriptions during medicine shortages”, said The Guardian.

Royal Pharmaceutical Society president Claire Anderson said: “At the moment pharmacists cannot amend prescriptions for HRT, so have to refer women back to their GPs when a medicine is not available.

“Enabling pharmacists to do so will save time for patients, pharmacists and doctors, as well as lessening the anxiety for women waiting for medicines.”

Under the proposed shake-up, community pharmacists would also be able to “make changes to quantities, strength and formulation of HRT and other medicines dispensed”, the paper added.

‘Bad planning’

Javid’s intervention “follows deepening concern from MPs and campaigners that women are being left to suffer because ministers are failing to take the issue seriously enough”, said The Mail on Sunday.

And some “local NHS authorities are accused of worsening the situation by only offering a few HRT treatments”, even though women often need to “try several types before finding one that works well for them”.

Tina Backhouse of pharmaceutical firm Theramex, which makes HRT pill Bijuva, said: “When we have shortages, this issue of restricted options of drugs really bites. That’s what we are seeing now. There’s a definite postcode lottery when it comes to HRT.”

UK Menopause Taskforce co-chair Harris blamed this so-called lottery on “bad planning” by both health bosses and the government. One form of treatment, a pill, that was only available to women in certain parts of the country was “stacked high in warehouses” in some parts of the country, while stocks of a popular HRT gel “are empty”, she told The Telegraph.

“The company that actually makes this product and the government didn’t foresee the kind of demand there was going to be on it,” she said.

Campaigners have also blamed “medical sexism and a lack of training” for women being left to suffer debilitating menopause symptoms, “which also include depression and brain fog”, said The Guardian.

Research suggests that “14m working days a year are being lost to the UK economy as a result of menopausal symptoms”, the paper reported.

According to taskforce boss Harris, “women have not been listened to, women have been ignored, they’ve been prescribed and diagnosed with other conditions and the menopause wasn’t even considered”.

“For a menopausal woman this HRT is as important as insulin is to a diabetic,” she added.

Conservative MP Caroline Nokes, chair of the Women and Equalities Select Committee. Nokes told Parliament last week that pharmacies in her Romsey and Southampton North constituency had completely run out of an oestrogen gel that enables her and other “women of a certain age” to “sleep and to work competently”.

Nokes told The Mail on Sunday: “You can’t help but feel that, if this was a drug used exclusively by men, they’d have sent in the army to beef up production by now.”