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Home / New Zealand

Perimenopause and the importance of a consistent HRT provider

RNZ
27 Nov, 2024 09:08 PM4 mins to read

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The offered alternative HRT patch has proven to be less efficient in regulating the hormones of perimenopausal women. Photo / file

The offered alternative HRT patch has proven to be less efficient in regulating the hormones of perimenopausal women. Photo / file

By Ruth Hill of RNZ

Helen and Chelfyn Baxter married each other in a “pagan hand-fasting ceremony” on stage at Glastonbury music festival in 2000.

“The high priest slept in so Keith Allen stepped in,” laughed Chelfyn.

“We forgot the hazel wand to place our hands on and the bottle of wine – but one of the Happy Mondays road crew stepped in with a fluoro green water pistol to replace the hazel wand, and a bottle of absinthe to replace the wine, so it all worked out.”

And it did work out.

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They moved to New Zealand, Helen’s birthplace, and started a successful digital media company.

Smart, beautiful and confident, Helen was a woman in complete control of her own life, until perimenopause plunged her into depression five years ago.

Starting HRT was the breakthrough, Chelfyn said.

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“It was like I had got my old wife back. We had about four months where Helen was really back to her old self. We went to Womad, she was no longer agoraphobic, her brain fog was clearing up, everything was working. But that was because she was getting Estrodot every prescription.”

Unfortunately, from April this year, she was prescribed an alternative.

“Her mood plummeted. She didn’t leave the covers of the bed until 5.30 had passed and there might not be any work calls to deal with.

“And that was the final three months of her life.”

“When she finally did start getting Estrodot again, she started cutting those patches in half in case she couldn’t get them again. She was so paranoid about the whole situation,” Chelfyn said.

Helen Baxter died in October, leaving a huge circle of friends and whānau and her husband utterly devastated.

“If I can save one life, if I can save one marriage just through a little bit of understanding of this, then it helps bring some kind of meaning to her death.

“Because other than that, there is none.”

For the past four years, the global shortage of HRT patches has left New Zealand women struggling to fill their prescriptions.

Pharmac’s decision to switch the brand of oestrogen patches it funds (to Estradiol TDP Mylan) – which it says will ensure a more reliable supply from July next year – has however prompted a massive backlash from women who say the alternatives do not work for them.

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More than 1200 people have already signed an online petition calling on the Government to keep funding Estrodot to treat symptoms of menopause.

One Wellington woman said with the Mylan patches, all her symptoms immediately returned.

“I was offered a pill instead, which actually brought horrendous side-effects. So it’s bad enough you’ve got menopausal symptoms, but then you’ve got headaches, nausea, dizziness, fatigue.”

She had also tried the gel – but getting the right dose involves completely coating both her arms and legs every morning.

“That’s not very convenient compared with changing a patch twice a week,” she said.

Mel had also tried the alternative and found it wanting.

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“I had to get a sticking plaster to try to make it stay on. And on the second day, all my symptoms were back so I threw them away.

“I managed to go and get some Estrodot, I paid for it actually.”

Katie said Estradot was the only HRT that did not give her migraines.

She was terrified of what would happen once it was not funded and feared it may disappear from pharmacy shelves completely if the supplier decided New Zealand was not a big enough market to bother.

“I’ve had to go to distant pharmacies, you feel like a bit of a druggie, ringing them up and saying ‘Have you got the right one?’ It’s the first time I’ve had to worry about being specific on the brand.”

Alternative will work for ‘most’ patients - Pharmac

No one from Pharmac was available for an interview today.

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However, in a written statement, director of equity and engagement Dr Nicola Ngawati said the change intended to secure ongoing supply of oestradiol patches, alongside other considerations like suitability and cost.

“A lot of people have been telling us how difficult it is to get oestradiol patches. This decision, along with funding oestradiol gel from November will mean that people can get the medicine they need.”

Clinical advisers have assured the agency the patches will meet the needs of most people, she said.

The contract depends on the supplier receiving full regulatory approval for use in New Zealand.

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