HRT: Medical leaders demand government action over shortages

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Medical profession leaders have called for an urgent meeting with government officials to discuss ongoing shortages of hormone replacement therapy.

Hundreds of thousands of women going through the menopause are on HRT either through tablets, patches or gels.

Many have suffered ill effects because their HRT product is out of stock.

A spokesperson from the Department of Health said it was working with suppliers to maintain the flow of medicines to patients.

But one manufacturer has told the BBC supplies of its product range will not be fully restored until the middle of next year.

HRT is the most common treatment for menopausal symptoms such as hot flushes and night sweats, and involves taking oestrogen to replace the decline in the body’s own levels.

Hundreds of women have been contacting the British Menopause Society each week asking why stocks of HRT are low and why they cannot get repeat prescriptions.

Some trans women who take HRT are also affected by the shortages.

The problems were first identified several months ago.

The Royal College of Obstetricians and Gynaecologists (RCOG) said manufacturers must do much more to provide explanations, rather simply blaming supply problems.

‘I felt hot and feverish’

Karen Keyte from Somerset says that after taking HRT she was able to cope with the symptoms of the menopause.

But after finding that she could not get her usual prescription, she felt low and tired and increasingly unwell as she struggled to find alternatives.

“The symptoms got worse and worse,” she said.

“Literally, I went back to the pharmacy with a new prescription to try and get that.

“I couldn’t get that – so asked for another one. So I’m then on my third prescription and at that point the chemist next door to the doctors had the script and was able to fulfil it.

“But by that stage, I was feeling hot and feverish. You get just a general feeling of being unwell at the point”.

Karen is now on an alternative treatment, but she is not convinced yet that it is effective.

Like others, she is frustrated that a problem affecting so many women remains unresolved.

‘Get these companies to be accountable’

A meeting between RCOG and the government has been agreed but the college says this must happen as a matter of urgency.

It has also called on the Department of Health and Social Care to make a stronger intervention.

Prof Lesley Regan, president of the RCOG, told the BBC: “What we have got to do is try and work together as professionals with the Department of Health and get these companies to be accountable – give us an explanation.

“Firstly, of what the problem is, and most importantly of the timelines before they will be resolved.”

Pharmaceutical company Janssen, which makes the Evorel range, said in a statement it was working closely with health authorities to provide advice for patients, but that supplies would be affected for some months.

A spokesperson said: “So far this year, demand for Evorel products in the UK has already exceeded that of the whole of 2018, depleting all surplus stock.

“As a result, we are unfortunately anticipating a complete interruption to supply across the product range from October 2019, although certain patches may stock out earlier than this date, due to challenges in maintaining our supply to meet this increased demand.

“We are working on a return to full supply by mid-2020.”

Other companies, including Mylan, have seen supply interruptions.

Demand has switched to alternatives where there are no shortages but this has put pressure on their stocks.

A Department of Health and Social Care spokesperson said: “Our priority is to ensure patients continue to access safe and effective medicines.

“We are aware of ongoing supply issues with some HRT preparations due to manufacturing delays.

“Supplies of alternative HRT products are available and any patient affected should discuss alternatives with their doctor.”

What is the menopause?

  • The menopause is when women’s periods stop and they can no longer become pregnant naturally
  • It is a natural part of ageing, which normally happens between the ages of 45 and 55, but can also be brought on by surgery to remove the ovaries or the womb (hysterectomy)
  • The body is affected by falling levels of oestrogen, and common symptoms include hot flushes, night sweats, sleep problems, anxiety, low mood and loss of interest in sex