Nationwide shortage of hormone replacement therapy causing concern

Many women rely on HRT to battle menopause. Photo / 123RF

By Eleish Foon of RNZ

An Auckland woman is desperately worried that she - and others who rely on hormone replacement therapy - will soon be without their usual supplies.

Tens of thousands of New Zealand women are on some form of hormonal replacement treatment known as HRT.

For more than 15 years, Julie (who only wants to be referred to by her first name) has been using HRT to battle ongoing symptoms of menopause - the stage in life where a woman stops having regular periods.

She had been told to cut the patches she uses in half but she's afraid the delicate balance of hormone treatment will be altered to inefficient levels.

After following up with her local pharmacy, Julie discovered her 25mcg dose of Estradot patches and the 50mcg patches were almost out of supply, and she was advised to cut her patches in half to balance her levels.

"If I have to now start mucking around with new formulas and new doses, it could take ages. I'm going to turn into an absolute nightmare overnight ... be hot and sweaty and just the hormone levels would just fluctuate and I've managed to keep them even for years. It is really bad - just terrible."

She was frustrated to be dismissed by pharmacies and "had a big ring around" to see if there was more HRT supply across Auckland city.

They told her: "No, there is nothing in the country and it is a big problem," she said.

The global shortage of the hormone estradiol is also causing a shortage of some contraceptives.

Earlier this month, thousands of women were forced to change oral contraceptives because supplies of some pill brands ran out, including Brevinor, Brevinor 1/28, Norimin and Necon.

The pharmaceutical company Pfizer did not expect them to be back in stock until mid-February 2021.

Pharmac has confirmed the reason for the delays of HRT prescriptions were due to the pandemic.

In a statement, Pharmac director of operations Lisa Williams said: "The supplier of our funded oestradiol patches (brand name Estradot), Novartis, has advised Pharmac that, due to Covid-19 related delays, they don't expect to have Estradot patches back in stock until December.

"To ensure patients can continue treatment with hormone replacement therapy we are funding some alternative brands."

Seventy-five per cent of menopausal women suffer from a variety of symptoms including night sweats, poor sleep quality, vaginal dryness, itchy skin, mood swings, anxiety, depression, poor memory and weight gain.

HRT helps about 95 per cent of women with these symptoms.

Wider impact

College of General Practitioners president Dr Samantha Murton said the shortage was also affecting New Zealand's transgender population.

"I have a very small number of people who are the transgender population using HRT. When there is a shortage of supply or we have to change things, it can be quite disturbing for a lot of people and will also have quite a significant impact on their life."

Julie was concerned that if her HRT supply did run out she could run the risk of facing major depression and experience other tough symptoms.

Murton said widespread delays for some medication was a costly reality for doctors, patients and pharmacists which would only worsen in the months to come.

"It is difficult all around, not just for patients but also doctors too having to write alternative prescriptions. It is costly and tricky for a lot of people."