The current HRT shortages remain a concern for many. While this is understandably worrying for both patients and doctors, it’s not all doom and gloom and – in fact – may be an opportunity to optimise treatment.
Why are there shortages in the first place?
The reason for the ongoing shortages remains unclear. As Professor Helen Stokes-Lampard, chair of the Royal College of GPs (RCGP), says: “…it seems as though there are several factors at play”. We are also unsure how long it will last; some of the supply issues are believed to be temporary, while others are not. The British Menopause Society (BMS) says some of the supply issues are down to manufacturing shortages, and this is also believed to be having a knock-on effect on the availability of other brands (as doctors prescribe alternatives).
Are all forms of HRT affected?
No. It is important to understand that not all forms of HRT are affected by the shortages. A variety of brands of HRT tablets and patches (both oestrogen-only and combination oestrogen-progestogen) are affected, but there appears to be less of an issue with gels (e.g. Oestrogel, Sandrena), micronised progesterone (Utrogestan) and Tibolone. Availability is changing all the time, but at the time of writing (6th September) the following information was correct:
- Besins Healthcare (UK) HRT products (Oestrogel, Utrogestan) – good stock levels
- Orion HRT products (Sandrena, Indivina, Tridestra) – good stock levels, may be some delay in delivery of orders however
- Janssen HRT products (Evorel patches) – shortage of supplies
- Novartis HRT products (Estradot patches) – variable stock levels, worth asking your pharmacist to call the wholesalers
- Mylan HRT products (Elleste Solo/Duet tablets, Elleste Solo patches, Femoston, Zumenon) – variable; Mylan has a website for health care professionals with live information about current supply mywayhub.co.uk/en-gb/range
- Estraderm MX patches – variable stock levels
- Bayer (Mirena IUS) – good stock levels
- Novo Nordisk HRT products (Kliovance, Kliofem, Novofem, Trisequens, Vagifem) – good stock levels
- Merck Sharp & Dohme Limited (Tibolone) – good stock levels
What can I do if my HRT is out of stock?
First of all, please don’t panic. In most situations a suitable alternative (and perhaps something that will suit you better long-term) can be found. As the supply issues seem to lie primarily with tablets and combination patches, a good alternative would be swapping to an oestrogen-only patch or gel together with the Mirena IUS (coil) or Utrogestan (natural progesterone tablet).
Please see this helpful table from My Menopause Doctor detailing the different ingredients, brands, and strengths of HRT: https://www.menopausedoctor.co.uk/menopause/hrt-the-different-ingredients-brands-and-strengths-available Discussing this with your doctor and/or pharmacist will be helpful in choosing a suitable alternative if your usual HRT is not currently available.
Please be assured that the Department of Health and Social Care (DHSC) are in regular contact with HRT suppliers and community pharmacists are working hard to ensure that alternatives are available for patients who need them.
If you remain concerned, please speak with your GP, menopause specialist and/or pharmacist.