Acute HRT shortages have prompted some women to take extreme measures to access drugs, with some reportedly traveling hundreds of miles, borrowing from friends or even turning to the hidden market. So, what advice do experts have for those who are trying to manage the symptoms of menopause without their usual medications?
Haytham Hamoda, clinical head of menopause at King’s College Hospital and chairman of the British Menopause Society, said that while it should not be the responsibility of patients to deal with the crisis, there are some practical steps that can be taken .
“There are a lot of reports of people going online and on the black market, which adds a bit of a sensational aspect to that,” he said.
Instead, Hamoda recommends that, if necessary, women be able to switch to different HRT products designed to deliver the same concentrations of hormones. The British Menopausal Society has published an equivalence guide for general practitioners and medical practitioners, which lists the closest alternatives to medicines that are in short supply, such as Oestrogel, the only estrogenic form of HRT manufactured by Besins Healthcare UK, and FemSeven Sequi patches.
“There may be some variation in absorption, you may get a little more or less, but that won’t be a big difference,” he said. “In the meantime, that’s what I would encourage people to do.”
To avoid the transition between GP surgery and pharmacy, the patient may ask their GP to check availability in pharmacies in advance. Similarly, most public pharmacies will be able to contact GPs to ask if they can prescribe an alternative medicine instead of sending the patient back for another consultation.
Claire Anderson, president of the Royal Pharmaceutical Society, is calling for the law to be changed so that pharmacists can make such small changes without further consultation with doctors.
Anderson urged women not to exchange drugs with friends, as MP Caroline Knox said she did this week. “People should not use other people’s drugs. Your medicine is prescribed individually for you and you should never share medicines. I would really be very discouraged. “
HRT increases hormone levels, which decrease as menopause approaches in women, especially estrogen. This helps reduce a wide range of symptoms associated with changing hormone levels, including hot flashes, night sweats, vaginal dryness and mood swings. Some also take HRT to protect bone health. However, Anderson points out, different products have different benefit / risk profiles. Combined HRT (containing estrogen and progestogen) is associated with a slight increase in the risk of breast cancer, while HRT tablets – but not gels or patches – are associated with a slight increase in blood clots.
Prof. Waljit Dhillo, an endocrinologist at Imperial College London, said he would advise patients to try to stay on the same treatment if possible, as it could take six weeks for symptoms to stabilize after starting a new form of HRT.
“The problem is that people are stabilized with one preparation, switching to another preparation – it’s not just like changing bread,” he said. However, he said, if the shortage is expected to last more than six weeks, it may be worthwhile for patients to switch to another drug.
Dhillo said that while some people find alternative medicines useful, the clinical evidence that such treatments are effective is “not very good” and should therefore not be treated as a substitute for HRT.
Previous research has also shown that lifestyle changes, such as reducing caffeine and alcohol and exercising regularly, can help deal with menopausal symptoms. “Exercise is a good thing, but it won’t be as effective,” Dillo said.
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