HRT is a lifeline for women, so why do we tolerate such a shortage?

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A the white sticker on the outside of my pharmacy bag containing my prescription says, “Please let Alison know that Estradot is still not available.” This message from the pharmacist was relayed over the counter, and, no, there was no news on when stocks might be replenished.

The women are absolutely desperate and have scoured pharmacies, some traveling north. Others borrow from friends hoping they can pay them back within weeks, and doctors struggle to prescribe alternatives when their patients contact them to say what they usually use isn’t in stock.

This is a very serious problem for women. It is estimated that there are up to 600,000 Irish women in the age bracket who could be affected by peri-menopause or menopause. Not everyone will be on HRT, or need to be, but demand is certainly growing.

In Britain there are similar problems with chronic shortages of HRT. Their Health Secretary, Sajid Javid, has just announced he is appointing a new HRT Czar, modeling the role on that of the government’s Covid vaccine task force, to address the shortage, particularly of vaccine patches and gels. estrogen.

In Ireland we are still awaiting an official announcement regarding anything that is being done specifically to help women.

If you want first-hand accounts of how awful it is for many of those involved, listen to RTÉ Lifeline of March 31, when so many women spoke of their frustration and despair at the lack of availability of HRT.

Corkwoman Jessica Ní Mhaoláin, who is struggling to find some HRT drugs, pictured with Sinn Féin at the launch of their menopause paper in March this year.

The official explanation is that demand has increased so much that there is no way to keep up with it in the short term. Indeed, according to the Ministry of Health, drug shortages have become increasingly common around the world over the past decade and are a feature of modern healthcare systems around the world.

The Health Products Regulatory Authority (HPRA) strives to prevent, where possible, and manage drug shortages when they occur. She is in regular contact with the companies concerned, according to a spokesperson.

According to a response from the Ministry of Health, the supply of a range of HRT patches has increased by 77% to 117%, for the three most used strengths, compared to 2020.

Additionally, based on demand over the past few months, the affected company expects a similar increase in demand for all forces in 2022. This would mean that the usage of this patch in Ireland would be around 4.5 to 7.5 times higher in 2022 (depending on strength) compared to 2019.

The supply of HRT patches, according to the department, has already been increased this year and companies are “working to find solutions to immediate supply issues.”

The HPRA has also told the companies it is willing to provide expedited regulatory approval to supply a product originally intended for other markets, if available.

So, as women become more aware of HRT’s overall safety and health-protective properties, demand has steadily increased. Indeed the succession of Lifeline programs focusing on the experience of Irish women going through menopause last year – who heard incredible stories from women about how their symptoms had been ignored by GPs, or their doctor simply wouldn’t prescribe any THS – undoubtedly contributed to this increase in demand.

A GP I know told me that she had prescribed more HRT in the past two years than in the previous 15.

But, anyway, I wrote a column in 2020 about HRT shortages and how I staged a drug deal at the school gate between a desperate mother for a month of patches and another woman who had a spare. .

Other issues

If you have been on HRT for a few years, you will know that shortages and the need to find substitutes are a common experience. So we feel there are other issues at play, not just increased demand, or that HRT availability may not be the priority it should be.

During a debate in the Dáil on March 31 on the government’s action plan for women’s health, a number of MPs raised the issue of the shortages, including Sinn Féin Health spokesman David Cullinane. But it was Cork TD Mick Barry who best expressed the frustration that so many thousands of women feel at what is happening.

“Why does this society tolerate an extreme shortage of an essential medicine for women?… Would the same tolerance be demonstrated if, for example, the medicine in extreme shortage was Viagra?” Hot flashes, joint pain, anxiety, insomnia, pain and discomfort caused by menopause have, when left untreated, caused women to give up their jobs and do other unnecessary sacrifices,” said Solidarity TD.

I couldn’t have said it better myself and somehow it seems to have more validation when it comes from a man, especially one who speaks in the Dáil.

Not all women suffer from the symptoms of menopause, but many of us do and HRT drugs are a lifesaver.

Mariella Frostrup, MP Carolyn Harris, Penny Lancaster and Davina McCall with protesters outside Parliament in London last year.
Mariella Frostrup, MP Carolyn Harris, Penny Lancaster and Davina McCall with protesters outside Parliament in London last year.

Back to Britain where some well-known women started the Menopause Mandate website. These include Davina McCall, Mariella Frostrup and Penny Lancaster, wife of Rod Stewart, who spoke out in favor of solving the HRT shortage this week.

As they point out on the site, menopause has become, thanks to the campaigns, the biggest female problem of the moment.

Yet the supply of menopause in Britain remains shockingly poor. Unsurprisingly, they have a petition. “We say enough is enough. This is not a feminist issue or a niche issue. This affects our whole society because women represent more than half of the population. There could be over 50 symptoms of menopause, and the majority of women will experience at least one…

Ensuring that women are seen by qualified doctors and nurses and receive the latest and best advice is not a luxury, it is a human right.


OWe have had some significant improvements in Ireland, but all from a desperately low base.

As in Britain, health professionals are not systematically trained on the subject and health advice is often outdated.

Family doctors in Ireland are making considerable efforts to “educate” themselves about menopause, although these efforts are clearly hampered by these HRT shortages.

To be fair, Health Minister Stephen Donnelly has shown serious intention when it comes to women’s health. He recently launched the government’s action plan for women’s health. It includes four menopause clinics, several new gynecology clinics across the country, breastfeeding supports, women’s mental health, and free birth control for women ages 17-25.

But a bird has never flown on one wing. If a crucial part of women’s health care — hormone replacement therapy — is not available, then this plan of action is seriously undermined. It’s not the same as Covid vaccines, but what happened there showed us how political pressure can make a difference.

“I sorted your HRT” would be a good enough campaign slogan when the time comes.

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