Struggling to find your usual HRT in the midst of a drug shortage? There may be alternatives you can use –

However, the knock-on effects of deficiencies in HRT are significant, with reports of women who commit suicide and others so overwhelmed with menopausal symptoms that their relationships and ability to work are compromised.

Still, the prospect of a quick fix seems small. Health Minister Sajid Javid announced last weekend that he was appointing an HRT czar to try to address the issue, and that he will “urgently hold a meeting with suppliers to examine ways we can work together to improve his offering.” long-term. and in the short term’.

But with the number of HRT prescriptions increasing – they’ve doubled in five years and now stands at 500,000 in the UK alone – some manufacturers are struggling to keep up.

Much of the demand growth is attributed to the “Davina effect”. After last May’s Channel 4 documentary Davina McCall: Sex, Myths And The Menopause, in which the TV host revealed she was using the hormone replacement therapy patch and gel, family doctors reported it was “raining” of new prescription requests.

He celebrated with others outside parliament last October after the announcement that from April 2023, women would only have to pay a one-time prescription fee (£18.70) each year for HRT, instead of paying multiple prescriptions during the year.

Hormone replacement therapy — either in the form of estrogen alone or in combination with progesterone — is given to restore declining levels of these hormones and help some of the 30 or so symptoms that can occur as women approach and enter menopause. These may include insomnia, hot flashes, joint pain, palpitations and memory problems.

Current shortcomings relate to certain formulations of ‘body-identical’ estrogen-only HRT (most women take in combination with separate progesterone formulations). These contain estrogen from sweet potatoes or other plant sources rather than synthetic versions of the hormones produced in the lab.

Estrogen in body-identical formulations is known as 17 beta estradiol. Some women prefer these “more natural” formulations because the hormones are the same as those in your body.

Health Minister Sajid Javid announced last weekend that he was appointing an HRT czar to try to address the issue, and that he will “urgently hold a meeting with suppliers to examine ways we can work together to improve his offering.” long-term. and short term

Formulations of these products in the form of gels, creams or sprays are also considered safer than tablets. This is because the hormone enters the bloodstream directly rather than passing through the intestines and liver, where it can have a systemic effect and increase the risk of blood clots.

Deficiency first became an issue in the UK in late 2018, with mainly estrogen-only Evorel patches and combination patches. This was partly due to increased worldwide demand, and the manufacturer sold as much in the first six months of 2019 as it did throughout 2018. This became a problem as Evorel accounted for 40% of the UK market at the time.

No shortcomings of Evorel have been reported at this time, but have now hit Estrogel, a popular estrogen-only (body-similar) gel. The product’s maker, Besins Healthcare (UK) HRT, says it is “doing everything it can to manage, grow and expedite deliveries”.

Other HRT products are also starting to run out. One was another gel, Sandrena, but the manufacturer said it was confident that demand would be met by the end of April.

Meanwhile, women go to great lengths to try and obtain regular HST products, some meeting strangers in parking lots and bartering for supplies, and others overpaying online to buy HST on the black market.

But there are alternatives to Oestrogel and Sandrena, as Haitham Hamoda, clinical chief of the menopause service at King’s College Hospital in London and president of the British Menopause Society, told Good Health.

Estrogel can be replaced with an identical patch to the body, such as Evorel or Estradot, or the Lenzetto spray, which “delivers through the skin an equivalent amount of estrogen with a similar effect.” Or you can take daily tablets, Progynova and Elleste Solo.

Some women are rightly concerned that their menopausal symptoms may recur if they change their medication.

Getting the right HRT product for every woman “may take some trial and error,” says Mr Hamoda.

Another problem, Mr. Hamoda, is that some doctors may not be familiar with all the other preparations available.

Here (top right), we look for some alternatives to body-identical estrogen-only HRT deficiency. Visit the British Menopause Society website for a complete list and “show this to your doctor,” says Mr Hamoda.

thebms.org.uk