MNHQ here: have you found it difficult to get HRT recently?

[RowanMumsnet]

Hello

As lots of MNers have already been discussing, there seems to be a nationwide shortage of some forms of HRT. (The reasons for the shortage seem a little clouded in mystery, although there's a partial explainer here.)

We've noticed a few MNers talking about going abroad to obtain their usual brand of HRT, or considering buying online - which of course isn't something health professionals would generally recommend (and probably doesn't feel very good to the women doing it either).

It seems pretty scandalous to us that women are having to do this in order to be sure of supplies of essential medicines and we wanted to get a sense of how many of you are affected.

So if you've struggled to get supplies of your normal HRT, or have considered going abroad or buying online to secure your supplies, we'd be interested to hear from you - please post on this thread or if you'd rather keep it confidential feel free to PM us or email us on [email protected]

Thanks
MNHQ

@florriepack that’s really not good that they didn’t consider you needed progesterone as part of HRT! I’d normally suggest you request to be referred to a menopause clinic but given current situation you could request an alternative combination as yours isn’t available - utrogestan which is micronised progesterone taken orally (can also be taken vaginally) along with Oestrogel (transdermal gel) the dose of which you can adjust to suit which you might find helpful in reducing anxiety/tearfulness.

I understand Louise Newson is currently offering online consultations and last I heard someone managed to book an appointment for about 2 weeks later.

No my Gp has ordered six months worth for me to pick up next week hopefully my coil problems will have finished by then When I hopefully see her in six months.(long story).

Can’t believe this situation is still going on, and in my experience, it’s now worse than ever.

I’ve been on estradot for a couple of years now, it suits me very well and I need a high dose as went through sudden and early meno. I struggled to get any late last year, and had a month on progynova waiting for estradot to come back into stock - hated it as the patches don’t stick properly on me, and they’re also massive compared to estradot. Was v thankful when estradot came back into stock but only could get 2 months worth.

Went to pick up my last script last week and there was no estradot or progynova to be had, so was given (after begging for help from kind pharmacist) estraderm, but it’s shockingly bad. Huge, rustly patches that somehow manage to both not stick properly AND bring me out in a rash. They fall off after two days. I’ve got a little stash of estrogel that I can use in the short term, but how, HOW is this shortage still going on??

I know these are difficult times, but this issue has been going on for many months now. I don’t function without this stuff.

Estraderm are big, aren’t they - and I agree, the 3 months I took them for they didn’t stick On me either. Evorel are sized between Estraderm and Estradot and stick very well - they need baby oil to remove the adhesive marks left.

Estradot was most easily available at my last change (1 month immediately and 2 months ordered in) so I’m now on them - and they’re great - small and they stick. I even forget to remove them at times and end up wearing 2

Another one having problems here. I had a 3 month prescription for Elleste Duet but could only get one month's supply from the chemist. I just spoke with them and they said they can't get ED at all now and that most of the combined HRTs are in very short supply.

She suggested Femeston 2/10 which she said she can still get. Same 2 mg Estradiol but 10mg Dydrogesterone rather than the 1mg Norethisterone in ED.

Or I could go back to CYCLO-PROGYNOVA 2mg which I used to take and was okay on though I didn't like the 7 pill free days.

Any thoughts wise women of MN? I have tried patches before but was allergic to the adhesive and ended up with enormous hive like blotches all over my bum! And besides I gather the patches aren't in huge supply.

More generally, how can this still be going on, still with so little clarity about what the problem is? It's outrageous. Why isn't there more of a fuss about it - I remember last year the shortage got some attention but I've seen no coverage since and I suppose current circumstances make it unlikely that will change.

I am feeling so anxious about a change in prescription, just remembering how awful I felt in some of the brands I'd tried before.

I’ve given up for the moment. Was on Evorel Sequi. Switched to Novofem with the shortages. Didn’t get on with that. Pharmacist at that stage said he couldn’t get the alternative prescribed by my GP (I don’t even know what it was because DH went to collect and didn’t bring the script back). Apparently he could only get hold of Kliofem. Decided to go cold turkey. Feeling pretty rubbish but actually not having too many hot flushes. Just feel so tired and achey.

Does anyone know if there’s any prospect of Evorel being available again soon? Last time I checked it was meant to be available again this month but they have moved the date back several times IIRC.

Agree it’s outrageous but don’t think the issue will get any attention at the moment 🙁

A local pharmacy still owes me 5 months' worth of Evorel patches, from as far back as January.

I managed to get some Estraderm via another route, but it's really not a good situation having to schlep round pharmacies and re-contact my GP and then go back to the pharmacy to see if it's arrived. I'm on an immunosuppressive drug for arthritis so could really do without the stressful obstacle course element.

JamieLee, the Coronavirus risk was basically why I decided to give up when I did. It was at the beginning of lockdown when the GP and the receptionists seemed v stressed (understandably) and there were big queues at the pharmacy. 3 of us have conditions that make us potentially vulnerable so I decided it wasn’t worth the risk of going there again.

The manufacturer says mid-May still, I might risk a trip to the pharmacy to ask them if they can get it yet. I really don’t get on with oral forms for some reason.

@howells, just to add - I've tried ringing the pharmacy I have the 'owing notes' for, but they don't pick up so I'm guessing the phone is switched off. They did say they'd ring me when it came in, but they're very busy and it's been months ... so I'm probably going to have to go there and queue when I run out again, just to ask.

I've had my ovaries removed, and have some joint & bone issues, and definitely need the HRT.

Such a pain.

Oh dear 🙁. I hope you can get hold of them soon. I’m not in your position thankfully, just suffering from hot flushes and sleeping badly, and with lots of aches and pains.

I think there's a few reasons why certain forms of HRT are in short supply, including one company ceasing production and the knock-on effect to other products which reduced availability. Also production of Evorel being taken over by another company (Theramex). One patch made by another company stopped production I think due to adhesive issues. Then I gather Brexit had some effect. The government did stop parrallel exportation of HRT products with low availability (they couldn't be exported) - don't know if that helped.

My suggestion to @WobblyLondoner @howells and anyone wondering about alternatives, have you considered, or have these been suggested to you...Estrogel (transdermal gel used via a pump dispenser and the dose adjusted accordingly) and utrogestan (progestogen pill usually taken orally which has the added benefit of helping with sleep problems, and can also be taken vaginally if preferred). These are known to be the "gold standard" of HRT and are body identical forms of HRT as opposed to synthetic as some others are. They can also be adapted for sequential therapy.

@JamieLeeCurtains I changed to estradot last time instead of evorel as this is what they had in - I so much prefer it as it's much smaller (have to be more careful putting it on though) and doesn't leave so much residue after removal

I would continue to phone the pharmacy as they might answer in less busy periods. If anyone is living in a household where they or others are in the more vulnerable group perhaps see if there is a delivery service? I've seen so many organisations and groups offering this from mums' running clubs to Trusted volunteers to GP surgeries. Perhaps ask in a local group.

Regarding patch adhesive and reactions to it - I've found they are all different. with Evorel I once tried to pick off the residue with my nails and ended up taking the skin off too! I alway use baby oil on a cotton pad now.

It's really worth keeping updated on supply via the link given above. Also handy to be aware of alternatives that can be used here: thebms.org.uk/wp-content/uploads/2019/11/HRT-alternatives-04.11.2019.pdf

My view is, the patches are available, just might not be immediately so - on the day I ask for them. I have the Mirena coil is for the progestogen part luckily, but if I didn't I'd be taking utrogestan. If ever I couldn't get my patches I'd ask for the gel instead.

I agree it is bloody annoying, especially given that this situation has become more difficult due to the current pandemic. However I'd already learnt from my local pharmacy a couple of years ago that from handing a prescription in/sent electronically from the GP, that it might take a few days before it is available for collection if I want the full amount. Now it is a case of waiting a few days for the initial amount and longer for the rest. However I haven't had to go without...yet!!

Hi @over50andfab, thank you. I must ring back armed with a bit more information. When I first went on Evorel I always had to wait a day or 2 for them to get it in. Since the shortage he’s saying he definitely can’t it at all. However it should be back in stock this month according to Theramex.

It might be worth me asking about the gel/ utrogestan combo though, because I was starting to have a mild reaction to the adhesive 🙄. Nothing is simple it seems!

@howells I had a slight reaction to the evorel adhesive too at one point (along with what I mentioned above when trying to remove the adhesive) in that it left a rash after removal but it went away.

If you're ok with taking it everyday its' certainly worth giving the gel and utrogestan a go, especially if you've having sleep problems which the latter can help with. You're right though in it can be trial and error to see what works best, also keeping on asking helps. I'll post here if I see anything about Evorel sequi availability if posted elsewhere on SM. Hope you get sorted

I think I'll ask about the gel as well.

@over50andfab, that’s exactly what I experienced - a slight reaction which then went away. It surprised me - I expected it to only get worse once it had started.

I got some Femeston - start tomorrow, fingers crossed. This is the fifth brand of HRT I'll have tried since I started, three times because brands were not available.

Good luck, @WobblyLondoner.

Just been told by my doctor that Evorel Sequi patches will now be out of stock until the end of the year (the pharmacist had called the supplier to find out). So I’m starting on tablets next week, which I’m slightly nervous about. 🙁

After far too many sleepless nights I decided to call the doctor today to try and find an alternative.. on hold in que for 40 minutes, relentless message telling me not to come to the surgery (like anyone would right now).. Finally get to speak to a receptionist who politely tells me it's non urgent so call back Monday at 8am to join the list for a telephone conversation. I did call at 8am.. I was on hold until 8.41 and got no where. Save the NHS eh.. ffs

@LittleBoxes interesting - Theramex haven't updated their website to say this - maybe a distribution problem? www.theramex.com/wp-content/uploads/2020/03/Evorel-UK-Stock-Update-from-Theramex-April-2020.pdf

Can I ask what you've been prescribed instead? If you's getting utrogestan as the progesterone part of HRT it is the best and safest way to take it, being body identical. Then there is good availability of estrogel to go with it, also body identical.

@stoptherideiwanttogetoff that recorded message would piss me right off!! Are you having symptoms of menopause/already been taking HRT?

I should persevere with getting a phone appointment with your GP. It might not be urgent but it is important. If you have to give a reason say it is impacting on your mental health - which lack of sleep can do. Make sure you are prescribed only what is available as some women have been prescribed unavailable products which as you can imagine is really annoying.

I haven’t picked it up yet but I think it’s Novofem - the doctor chose it because it has similar components to the Evorel Sequi, apparently. Will see how it goes!

I've been happy on Elleste Duet 2mg for nearly 3 years. Had to have Femoston substituted once last year. That was fine too.

Just before lockdown I renewed my prescription. After a lot of to-ing and fro-ing between the doctors and pharmacy I was given Kliofem - assumed it was the same, but now know it is continuous, not sequential.

It's been an awful 3 months - terrible cramps for first two months followed by a three week bleed. At my HRT check up today I was assured that I was being put back on a sequential tablet, Clinorette. Just pick it up from the pharmacy - it will be there waiting. It wasn't, they can't get it. I have to contact the doctor again tomorrow for another alternative. Not feeling hopeful.

I still don't have the two months' supply owing to me (in my post a little way upthread).
I can't see how it can be right that the pharmacy has had my £18, but only supplied two thirds of my prescription.
I think it might be time for a re think of which HRT might suit me better, anyway.
I've been on the Elleste Duet 2mg for two years, and at 56 I would like to try a no bleed preparation. Also,I think that the norethisterone doesn't suit me; I feel anxious and tearful when taking it.

Hi @florriepeck. I'm in almost exactly the same boat as you. Only half of my 6 month prescription for Elleste Duet 2mg was fulfilled by the pharmacy in mid-March. I paid in full and they gave me an 'IOU' for the remainder. They rang me today to say that they've been advised by the manufacturer that it won't be available until the end of October at the earliest! I will run out of Elleste Duet 2mg by mid-August...

I'm not entitled to a refund and the pharmacist's attitude was very much couldn't care less. She told me to go back to my GP. The last time this happened (June last year) the GP put me on Kliovance conti HRT without consulting me and it drove me completely batshit, as I was taking in the norethisterone daily (albeit in smaller doses) as opposed to 12 days out of every 28 on the sequential. At least with the Elleste Duet I managed 2 good weeks out of every 4!

I probably should be on a conti HRT, as I'm now 55 but I have no idea whether I'm still having periods as I've been on bloody HRT since May 2018 (I was still having periods at 53).

No idea what to do. I can only 'see' my GP via the e-consult facility, where you fill in an online form (which I did this evening). I dread being fobbed off something that isn't suitable for me. Honestly, it's like pin the bloody tail on the donkey. So pissed off.

@ilovecardigans how about discussing taking utrogestan orally and estrogel transdermally. This can be taken sequentially so utrogestan would only be taken 12 days of the month and estrogel can be adjusted to suit. These should be readily available. Have a look at the link above for recommended options otherwise

Tbh I don't know a lot about sequential HRT - Evorel Sequi/Elleste Duet etc, but I am surprised than woman are moved to continuous HRT as an alternative.

For myself, I'm older than you, and was still getting periods when I had the coil put in which stopped them dead. A couple of years later I added in estrogen patches and went straight to continous.

I'd hope that any outstanding IOUs on meds already paid for and part fulfilled will still be honoured when back in stock without any time limit.