Voices: HRT shortages are a public health catastrophe – women deserve better

·4-min read
I, like many others, am frustrated, angry and sad that we are having to push so hard on an issue that has a clear solution (Getty Images/iStockphoto)
I, like many others, am frustrated, angry and sad that we are having to push so hard on an issue that has a clear solution (Getty Images/iStockphoto)

This really is a bittersweet moment for me. The subject of hormone replacement therapy (HRT) supply is finally becoming a long-overdue topic of national conversation, but it highlights the critical point we have reached in this country, where thousands of women are suffering unnecessarily.

Prescriptions for HRT medication have doubled in England over the past five years, with manufacturing and supply issues meaning the demand cannot be met. Women across the UK end up “bartering and swapping bottles” via social media in a desperate attempt to get their hands on a treatment that they rely heavily on just to get them through their day.

I, like many others, am frustrated, angry and sad that we are having to push so hard on an issue that has a clear solution – a national formula that allows GPs like myself to prescribe all the combined HRT medication.

The menopause has been a taboo subject for decades, with a huge amount of misinformation and misconceptions about treatment options, especially HRT, spread across the media. The impact this has had on women’s health in this country is catastrophic.

Over the years, I’ve been passionate about improving education on menopause through the work I do through my non-profit organisation Newson Health Research and Education, and as an NHS Advisor on their National Menopause Programme.

Some could go as far to argue that I’ve contributed to the current HRT shortage, but I see it more as women finally waking up to the benefits of HRT and attitudes towards the medication shifting into a positive space.

The only way we can keep that conversation going is through education and encouraging positive dialogue on the topic. The desire is clearly there; looking back at when I launched my free menopause app, balance, back in 2015, we had an overwhelming response in our first week with over 14,000 people signing up, and more than 6,000 people joining on the first day alone.

Sadly, the right advice, information and support surrounding the perimenopause and the menopause isn’t readily available to everyone in the UK. HRT prescribing is still a postcode lottery and research has shown that women from low socio-economic backgrounds are less likely to be prescribed HRT.

The lack of information and support is one of the reasons why our community feature within the free balance app is so popular – it gives women a place to share their experiences, learn from one another, ask each other for advice, share words of wisdom and encourage everyone to get the help they need and deserve. Outside of the community section of the app, the unbiased, evidence-based information that balance also provides is there to reassure and inform.

This year marks the 20th anniversary of the damaging Women’s Health Initiative study that linked taking HRT to breast cancer using oral oestrogen and synthetic progestogens. When the data was reanalysed, it found that women taking oestrogen only HRT had a lower future of developing breast cancer, and also that women taking any type of HRT have a lower risk of dying from breast cancer.

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More importantly, if we look at what women want, why are they taking HRT? A lot of women, including myself, take it for health benefits. I don’t want osteoporosis and I’m scared about dementia; they worry me more than breast cancer. It’s such a shame that women are defined about their breast cancer risk. We are more than just our breasts. Most women die from heart disease and dementia. Taking HRT reduces the risk of both.

It’s important that women don’t stop taking HRT, so it’s refreshing to see the government moving in the right direction in terms of addressing the shortage and, more importantly, ensuring that this doesn’t happen again.

Menopause needs to be seen as a female hormone deficiency with health risks, and not a lifestyle change. We know the symptoms of menopause can be horrendous for many women and that there are health risks if not treated. There are alternatives to HRT but unfortunately, some of these are in short supply because the overall demand is increasing.

There is a good combination body identical tablet which doesn’t have the same clot risks as the older tablet, but it is currently only allowed to be prescribed by two clinical commissioning groups (CCGs).

Currently, many GPs are unable to prescribe this combination tablet because it isn’t on their prescribing formulary. If we had a national formulary that GPs could prescribe from, this would make it a lot easier for women to receive safe alternatives of HRT. We could then have options which would no doubt be a lifeline to thousands of women across the UK.

Dr Louise Newson is a GP and menopause specialist

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