HRT Crisis: Health secretary holds emergency talks as demand soars

·5-min read
Photo credit: Steve Parsons
Photo credit: Steve Parsons

The UK's health secretary Sajid Javid will direct more staff from the UK's vaccine taskforce to fix the hormone replacement therapy shortage.

The announcement was made following crisis talks with drugs manufacturers, in which the health secretary said government would 'leave no stone unturned in our national mission to boost supply of HRT'.

As Women's Health has previously reported, months-long supply shortages of certain medications has left those women unable access their medications struggling to work, sleep, parent - simply live their lives as normal - without them.

The director general of the UK's vaccine taskforce, Madelaine McTernan, was also in attendance. The government announced last week that she had been brought in to implement lessons learned from the rapid rollout of Covid-19 vaccines, in order to improve the supply chain of HRT.

The minister for women's health, Maria Caulfield, said: 'I know HRT can be a lifeline for women suffering from severe menopause symptoms.'

'We are doing everything in our power to make sure women can continue to access the HRT they need to continue living their life, unrestricted by the menopause.'

Pharmacies have been reportedly been flagging shortages of 30 HRT brands since May 2020 and, since then, supplies have been rationed on certain types of HRT medications - notably the topical formulation Oestrogel - meaning women are only able to get a maximum three months supply.

Carolyn Harris, co-chair of the UK menopause taskforce, last week blamed 'bad planning' for the shortage.

'The company who makes this product [Oestrogel] and the government didn't foresee the kind of demand there was going to be for it,' she stated. 'The government really should have done a lot more a lot sooner.'

Last week, the Royal Pharmaceutical Society called for pharmacists in England to be given the power to alter GP prescriptions and make medicine swaps when necessary.

What is HRT and how does it work?

For most women, taking HRT will look like a daily dose of progesterone (either a synthetic progestogen, or body-identical progesterone) and oestrogen in either tablet form or in pessaries, creams and gels, applied topically. Some women are also prescribed a low dose of testosterone to improve tiredness and low libido.

HRT works by topping up plummeting hormone levels to reduce the severity of menopause symptoms - including brain fog, weight gain, vaginal dryness and unmanageable moods - triggered by a drop in the ovaries' oestrogen and progesterone production.

It's the most robustly-evidenced method for relieving menopause symptoms, preventing disease such as heart disease, osteoporosis - even dementia.

But for a long time it was eschewed by many perimenopausal and menopausal women - and their doctors - because of an inaccurately reported connection between some types of HRT and breast cancer.

But thanks to more accurate reporting of HRT's risk:benefit ratio (and as a result of Davina McCall's 2021 Channel 4 documentary Davina McCall: Sex, Myths and the Menopause) demand has risen over the past five years.

The new follow-up documentary, which aired on Monday night, is expected to galvanise more women into taking HRT - and increase pressure on supplies.

In Davina McCall: Sex, Mind and The Menopause the broadcaster explores how HRT could ease some of the most disabling mental health and brain functioning symptoms (including brain fog and memory loss) and even have a protective effect against developing dementia in older age.

Your HRT fundamentals guide

Working out how to manage (peri) menopausal symptoms can be complicated. Our expert-informed menopause meds guide will help make the process a little simpler

How do I talk to my doctor about HRT?

Dr Newson has created resources for patients frustrated by a lack of effective menopause treatments available – and for NHS GPs too busy to comb through medical journals for the latest science.

She recommends bringing her prescribing guide to your GP appointment, and using the symptom tracker to clearly demonstrate a pattern of perimenopausal symptoms – both resources are available at menopausedoctor.co.uk.

Is there a class of hormones that’s best?

Body-identical hormones are safe, regulated forms of oestrogen, progesterone and testosterone that are naturally derived (as opposed to synthetically, as with hormonal contraception) and regarded by Dr Newson as the gold standard in terms of maximal efficacy and safety, with minimal side effects.

They’re derived from yams (a starchy root vegetable) and have the exact same molecular structure as the hormones in your body.

What about ‘bio- identical’ hormones?

These are hormones that have been compounded – or tailored – to your unique profile, as determined by a saliva test.

While that sounds good, they’re not regulated, haven’t been subject to randomised control trials and don’t get the green light for efficacy or safety from the British Menopause Society or the NHS.

Will I need to have oestrogen in a gel?

Not necessarily. While it’s usually given as a gel or a patch, to be absorbed through the skin into the bloodstream, it can also be taken via a spray or tablet.

Dr Newson warns patients that taking oestrogen as a tablet incurs a small increased risk of blood clots. All forms are available via prescription on the NHS - where supplies allow.

And I need some progesterone, right?

Yes, unless you’ve had a hysterectomy, it’s essential to take a type of progesterone to protect the lining of your womb. That’s because taking oestrogen can increase the thickness of the womb lining and increase the chance the cells might become cancerous.

Dr Newson recommends women take micronised progesterone, a body-identical hormone, as an oral capsule, or have it delivered via a Mirena coil, which doubles up as contraception.

There are also other types of synthetic progestogens available, which can be given if a patient is experiencing side effects.

What’s the deal with testosterone?

Women produce more testosterone than oestrogen and it’s an important hormone to improve mood, energy, concentration and libido. Yet, it’s not licensed for women in the UK.

It’s available privately, but only for some women via the NHS – ask your doctor for more information.

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