Why is there a shortage of HRT? UK menopause treatment supplies explained - and what alternatives are there

The number of HRT prescriptions in the UK has doubled in the last five years

Following prescription shortages that have left some women suicidal, the government will appoint a hormone replacement treatment (HRT) tsar, according to health secretary Sajid Javid.

But why is there a scarcity in the first place?

Here’s what you need to know.

Why is there a shortage of HRT?

Hormone replacement therapy (HRT) is a treatment to relieve symptoms of the menopause - which can include anxiety, hot flushes and insomnia - by replacing hormones that are at a lower level as you approach the menopause.

An estimated 1 million women in Britain are on HRT, which comes in a variety of forms, including patches, pills and gels.

Recent figures suggest that the number of HRT prescriptions in the UK has doubled in the last five years, but stocks are running low.

One manufacturer of a commonly-used hormone replacement gel has recently reported supply problems.

Conservative MP and chair of the women and equalities committee Caroline Nokes raised the shortages issue in the Commons last week.

She said pharmacies in her constituency had completely run out of HRT, “which leaves women of a certain age … without access to the oestrogen gel, which enables us to sleep and to work competently.”

Women are now also reportedly sharing their prescriptions and asking friends to buy medicines abroad for them, with some said to be made suicidal by the menopause symptoms they suffer without the medication.

The Royal Pharmaceutical Society (RPS) has said a simple law change around prescribing could help ease the treatment crisis.

Currently, pharmacists must dispense the exact product and amount of medication on the prescription, and if it is not available then a substitute cannot be given out without consulting the GP who prescribed the medication.

The RPS now wants pharmacists in England to be able to alter GP prescriptions and make medicine swaps when appropriate.

Sajid Javid told The Mail on Sunday he was "determined" to make sure supplies were meeting the high demand and would use lessons learned during the rollout of the Covid vaccine.

He said: "I will be urgently convening a meeting with suppliers to look at ways we can work together to improve supply in the short and long term.

"It’s also clear to me that we need to apply some of the lessons from the vaccine taskforce to this challenge, so we will soon be recruiting for an HRT supply chairperson."

The new role is expected to be modelled on that of Kate Bingham, who successfully led the government’s Covid vaccine taskforce.

‘We should never have been in this position’

Labour MP Carolyn Harris, co-chair of the UK menopause taskforce, said: "I welcome the secretary of state’s intervention on this. There are a lot of women relying on him to improve the current situation. We should never have been in this position."

Jo McEwan, from menopause training company PositivePause, which provides support to women and organisations, also welcomed the announcement.

She said: "What’s happened is the supply can’t keep up with the demand now, clearly.

"But this isn’t the first time it’s happened so I think, yes, let’s make somebody accountable or get someone whose got that authority to say ‘right, let’s get the big picture on this, let’s talk to the stakeholders, let’s talk to the pharma companies, and let’s ensure that women are not, as you say, trading HRT in car parks and buying it from abroad’."

Are there any HRT alternatives?

According to the NHS, there are a number of alternative ways of controlling your menopausal symptoms, including lifestyle changes and the medications tibolone and clonidine.

There’s also two types of antidepressantsselective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) – which may help with hot flushes caused by the menopause, according to the NHS.

However, these medicines are not licensed for this use, which means they have not undergone clinical trials to test if they help this symptom, but the NHS website said “many experts believe they’re likely to help and your doctor will discuss the possible benefits and risks with you”.

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