Concerns rise over HRT shortages

The hormone replacement therapy (HRT) shortage crisis is pushing women to take matters into their own hands and risk their health to source their medication, according to experts.

Woman applying a hormone patch to stomach.
Prescribers should consider using equivalent preparations to those that their patients are currently using. | GETTY IMAGES

The number of prescriptions for HRT products in England has doubled in the last five years to more than 500,000 a month, according to NHS data. This has resulted in manufacturers increasingly reporting supply issues, causing stress and potential harm for women who rely on their medication. 

Professor Martin Marshall, the chair of the Royal College of GPs has warned that the shortage crisis must be resolved quickly, after learning of the measures many women are taking to access their medication. 

Sharing medication

The increase in demand is seeing many women going to great lengths to obtain their medication. There have been concerns over women sharing HRT products with others, or seeking to buy them on the black market, which could lead to serious adverse reactions.  

Dr Martin Kinsella, a hormone expert said: 'The impact the HRT shortage is having on so many women cannot and should not be underestimated. I've heard of women buying HRT on the black market and in doing so putting their own safety at risk.' 

Long-term prescribing 

The Pharmaceutical Services Negotiating Committee (PSNC) has said that the shortages are being 'exacerbated' by some patients being prescribed a 12-month supply. 

Mike Dent, Director of Pharmacy Funding at the PSNC said: 'Demand for HRT prescriptions is currently outstripping supply following the announcement of changes to HRT prescription charges and recent media coverage regarding HRT supply issues.' 

Law change

Following the ongoing shortage issue, health secretary Sajid Javid has been urged to change the law to allow pharmacists to alter prescriptions during medicines shortages.

Currently, the law in England does not allow pharmacists to amend prescriptions so pharmacists must refer patients back to their GP, or contac the the GP on the patients behalf, which can be very time consuming. 

President of the Royal Pharmaceutical Society, Claire Anderson said pharmacists should be allowed to dispense alternative medications on prescriptions without having to contact the prescriber each time. She said: 'Enabling pharmacists to do so will save time for patients, pharmacists and doctors, as well as lessening the anxiety for women waiting for medicines.' 

Alternative preparations

The British Menopause Society advises prescribers to consider using equivalent preparations if patients are experiencing difficulties obtaining their current medication. 

The BMS also advise that oestrogen and progestogen can be prescribed separately to make the closest match or to find a suitable alternative. Different brands for the same medication may vary in appearance or excipients. However, they would provide equivalent amounts of hormones when used in similar doses.

Prescribers can find alternative HRT preparations using the MIMS HRT table, which allows them to compare hormone doses, formulations and costs of all HRT products marketed in the UK.

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