HRT Supply issues

[HufflepuffRavenclaw]

I'm not sure how old most of you are who are active on this board but if you even hang out on the menopause board a common theme is HRT shortages. This does seem to be mainly down to increased demand/awareness and high profile people like Davina McCall and Kirsty Wark producing programmes on the issue. HRT is something more women are asking for, and manufacturers of the most commonly used patches and gels just cannot keep up with demand. Brexit is not really a factor according to manufacturers.

The government appointed a "HRT tsar" in April 2022 to try to resolve these issues, but in August 2022, despite there still being serious issues, she was sent back to dealing with Covid vaccines. www.bbc.co.uk/news/health-62721742. Those of us who depend on HRT are often still finding it very hard to get our patches or gel, phoning round several pharmacies to get it, or being asked to accept a substitution of one product for another when we know only one really works for us.

So two points.

Firstly, if this was a medication that hundreds of thousands of men were taking, you can guarantee that someone would be taking it seriously. So many people - including medics and politicians - are not taking HRT seriously. Middle aged women are being ignored and let down, again.

Also, and I am really unsure how significant this is as finding statistics is difficult, HRT is also part of the standard treatment for men who wish to transition and live as women. (Although I'd argue that's HT rather than HRT as they never had oestrogen to replace in the first place). This increased demand for HT/HRT from males is going to impact on supply too.

I'm in the position now that despite being in Scotland and getting free prescriptions, I've just paid £55 for 3 months' supply of my preferred brand of patches from an online pharmacy in England. Also investigating how to get a prescription filled in continental Europe when I'm there next month as they are behind the curve on HRT use compared with the UK.

It really shouldn't be this hard and it makes me both sad and angry that an issue which affects so many women is being ignored.

You are right, @HufflepuffRavenclaw, that this is just one more aspect of female health that gets shoved down the list of priorities. The history of medicine is littered with such things.

I saw recently that the HT dose for TW is 6 times the dose for women, but I didn't archive that so can't prove it. It makes sense though when you think of the changes it has to work of the male body.

I never took HRT myself but appreciate how life-changing it can be

I prefer the expression Cross Sex Hormone Treatment for transgender use

It's getting worse it seems.

The supply might be there but there are so many women waiting after a pause in supply that prescriptions are all filled before they can meet need.

There also seems to be some idiotic cap on how much each pharmacy can have?

I've started going to an out of town boots where there don't seem to be 5 women in the queue ahead of me when I put my prescription in (at the moment.)

Yeah I’m about to buy mine privately. Pharmacy could only give me 2 of 6 boxes on prescription and this was 2 months ago. I have one patch left…
Agree. If men used HRT this wouldn’t be talked about as there would be no issue

Wrong sex hormone treatment.

I read some articles this week that says HRT can lower the risk of women suffering Alzheimers. I suspect this is going to further increase demand.

That is perhaps a better expression.

But at the most basic level the drugs prescribed are just the same as the patches and gels given to women who need HRT. I really don't think that the shortages are down to a flurry of transgender women hogging all the patches - not at all.

It's more that the government put zero importance on women's health issues.

Am I right that it seems to be getting worse? I was aware of, and affected by, the shortage of oestrogel last year but I've read just this last week that progesterone is now in short supply too, and also testosterone gel.

What's this HRT tsar actually doing to resolve this?

Is it an issue more generally with the NHS being unable to respond quickly to changes in requirements for various medicines? Are pharmacies even under NHS control in that way? My understanding is that they are private businesses, but do they go through the NHS to procure their stock? I must admit I have no idea how it all works.

Retail pharmacies are private businesses and they procure their stock from private wholesalers.

I wonder if Brexit has anything to do with it. Does the extra bureaucracy for licensing and importation mean some manufacturers don't bother selling to the UK now.

And yes I'm sure the drug companies don't prioritise women's health either.

I did read that besins have bought a new factory in order to increase supply but I'm still not sure it will meet demand.

Do we still have an hrt tsar?

The HRT tsar was in position from April-August 2022 and is no longer in post.

I don't think problems are getting WORSE, but they certainly aren't getting better. It seems as soon as the problem is sorted out with oestrogel, there's a shortage of Estradot, or Evorel. The latest is the utrogestan progesterone capsules which lots of people are reporting massive issues with.

From what I have heard, there is limited stock coming into the UK. The wholesalers are "rationing" stock and putting caps on what pharmacies can order - sometimes as little as 4 boxes a month. This is being done to stop pharmacies stockpiling or hoarding and all the supply going to Liverpool, or Leicester or wherever, leaving women in all parts of the UK short.

I can only get 4 weeks at a time of the gel and one box of Estradot patches prescribed at a time, again to stop women stockpiling. But all it means is that you have all this stress every 4 weeks trying to get a prescription filled.

Funnily enough, if you have the money, you can order 3 months supply online and pay for it. I have no idea what is going on, everyone says Brexit isn't really an issue with this. Have seen people saying it's the "fault" of Davina McCall for daring to speak up about her symptoms. I just want someone in government to sort it.

Yep it’s really very frustrating. There seems to be no realistic alternative to the progesterone I’m on and it’s impossible to get locally. Chasing about for it every month is such a waste of time.

The lack of Utrogestan is a serious issue as there is no real easy swap alternative.

I have a couple of boxes of utrogestan if anyone wants it? I had a coil fitted so no longer need it. It is utrogestan 100.

It doesn’t affect me but I entirely agree with the OP. What is the bottleneck in the supply? If you can get it more easily if you pay privately, it suggests it is not just down to inadequate manufacturing capacity.

To be fair it's not that you can always get what you need if you pay for it. The pharmacy I used does not have any stock at all of the highest strength of the patches I use, and no 50mcg patches in the other big brand. So it's not that supply is all fabulous privately, there are still restrictions.

Apparently the demand for HRT products in the UK is up 50% in a few years, and the manufacturers just can't keep up with demand. it is a GOOD THING that women are coming forward and realising that HRT might help with their brain fog, aching joints, insomnia and sleeplessness. No woman should have to suffer. But this problem is going nowhere unless manufacturers step things up.

Every single woman in the UK is going to go through the menopause. A fair number are going to seek help with managing their symptoms. And there is nobody apart from celebs like Davina McCall or Mariella Frostrup shouting about the supply problems.

There were some really desperate posts on threads in the meno section.

It's really awful as that element of hrt specifically is incredibly important for bleeding.

I'm off to count my own as I'm on twice what I was now.

Hufffle, it's irritating though as supply issues have been problematic for a number of years and nothing has changed.

All women's health should be centralised, in specific clinics, as I heard a particularly astute woman (I believe who's advised the government) suggesting on woman's hour in the summer. She was discussing the state of women's health care around a wide ranges of issues, hrt and smears in particular. You could train people up to specifically cater for all these over lapping aspects of womens health, stream line services and presumably be more on top of what medication is needed and potentially supply it.

One of the good things that started under Boris Johnson (there has to be an exception that proves the rule) was a government women’s health strategy. What happened to that? It ran a big consultation then… silence.

that would have been a perfect vehicle to sort out these issues. Replaceable specialist Tsars don’t seem that useful. I want a robust system that actually works for women instead. No special personality figureheads required.

When the NHS is this stressed and inaccessible trying to get hold of new supplies once a month is a complete tax on being a woman. It reminds me of when I was in my 20s trying to get the pill prescription renewed. I hate having to wait at the pharmacy for my HRT prescription and them saying they’re out but there could be more at another pharmacy miles away (because of course I have time for that- I’m only a woman with a job and a family…) or worse previously I have had that they need to contact the doctor for a represcription of an alternative. Then everyone is pissed off and it takes days.

Its not just HRT though my family member has been waiting for a pain medication since before Christmas, so I can’t believe it’s not Brexit-related actually. Its never been an issue with this before.

I can believe that HRT demand has gone up which is a really good thing. I just can’t believe that the Tories have taken us out of international supply chains and aren’t admitting how devastating this really is for so many people.

To HappiestHippo, I would be really so grateful if you have the spare Utrogestan 100. I could send you a stamped padded envelope?

I’m not sure how you tag someone. Sorry it is happiestHippo123

@booface you add an @ before their name

@HappiestHippo123 thanks to @WarriorN I now know how to tag! If you see the message I’d love the spare Utrogestan 100 if still available. So kind of you to offer.