United Kingdom

What is HRT and why is there a shortage in the UK? | Menopause

The United Kingdom is currently experiencing an acute shortage of hormone replacement therapy (HRT) products. But what is HRT and what causes shortages?

What is HRT?

HRT increases hormone levels, which decrease as women age and approach menopause, especially estrogen. Thus, HRT helps relieve many menopausal symptoms, from hot flashes to night sweats and vaginal dryness. It is estimated that about 80% of menopausal women experience similar symptoms.

According to the NHS, HRT usually includes both estrogen and progestogen, although there are forms that include only the former – they can be used by women who have had a hysterectomy or use the intrauterine system.

There are different regimens and methods for taking hormones and different doses can be used.

HRT can not only improve the quality of life of women, but it can also have other benefits, such as preventing thinning bones.

However, some women have health problems that may make HRT inappropriate for them, while therapy is also associated with an increased risk of breast cancer – although some experts say the risk remains low and higher for some forms of breast cancer. HRT from others.

How many women use HRT?

According to the National Institute of Excellence in Health and Care (Nice), around one million women in the UK use menopausal treatment, although access to HRT has been described as a ‘postal lottery’.

In October, the Department of Health and is available without a prescription in the UK.

Speaking to the Times, Labor MP Carolyn Harris, chair of the government’s menopause working group, said some 30,000 women use Oestrogel, the only estrogenic form of HRT produced by Besins Healthcare UK, which is at the root of the current shortage.

What is behind the current shortage of HRT?

This is not the first time there has been a shortage of HRT. At present, however, the deficiency mainly affects Oestrogel, as well as a handful of other forms of HRT, including FemSeven Sequi patches.

Bessins said the problem with estrogel supply is limited to the United Kingdom and is a result of increased demand for HRT.

The British Menopause Society (BMS) said: “Bezins expects this to be a short-term problem and expects supplies to be available to local wholesale branches soon.”

NHS England data show that HRT prescriptions have more than doubled in the last five years.

“After the recent increase in campaigns and media coverage – the symptoms of menopause, their impact and the role that HRT can play – the demand has grown and more and more doctors are prescribing it. Unfortunately, supply is not in line with increased demand, “said Dr. Clare Spencer of My Menopause Center.

However, some ministers also cite production problems, with the supply of ingredients used by some companies being disrupted by Covid and other problems.

Janet Morrison, chief executive of the Pharmaceutical Services Negotiations Committee, acknowledged the shortage.

“Demand for HRT prescriptions currently exceeds supply after the announcement of changes in HRT fees,” she said. “This can be made worse by prescribers who issue prescriptions for six or 12 months at a time.

What can be done?

BMS advises women who have difficulty receiving Oestrogel to consider equivalent products, such as Sandrena gel, while prescribers should also consider alternatives for their patients.

However, some experts note that women are often on a particular HRT regimen that is appropriate for them, making change problematic.

Speaking to Radio 4’s Today on Monday, Harris said Oestrogel’s shortage was due to poor planning and that the choice of such products had also led to a surge.

She added that although there is an alternative to the pill, it is only available in two geographical areas of the United Kingdom, which means that it is “highly ranked in warehouses”.

On Sunday, Health Secretary Sajid Javid revealed that he plans to create a king of HRT to address the shortage.

But Harris said Javid had to take on the role himself. “He may decide to loosen the rules on forms and do so [pill] a product available all over the country, ”she said.

Spencer also called for action. “The important thing now is for the government to work urgently with producers to increase production and ensure that this situation does not happen again, and that the government is speeding up the reduction in HRT fees, which it promised last year, for which Harris is tirelessly fighting “, she said.