The UK is currently experiencing a shortage in the supply of hormone replacement therapy (HRT). It has been estimated that these shortages, which reportedly began in late 2018, may be ongoing for several months.

Many women in the UK rely on HRT to help with their menopausal symptoms, and so these shortages may be concerning. 

Why are there HRT shortages?

According to the European Pharmaceutical Review (EPR), in late 2018 problems emerged with the Chinese supply line regarding HRT patches. Little more is known at present about this. 

This caused certain manufacturers to stop making patches, which in turn led to higher demand for other HRT products. Manufacturers and suppliers have struggled to keep up with these rising demands which has led to shortages. 

The Royal College of Obstetricians and Gynaecologists (RCOG) has said that manufacturers need to offer more comprehensive explanations for these shortages as opposed to simply blaming supply problems. They have also said that shortages could be linked with a broader, unknown reason. 

Which HRT treatments might be affected?

The British Menopause Society (BMS) very recently updated patients about specific HRT shortages. We’ve compiled a list of affected HRT treatments below.

If you see an HRT product listed below that you take, a bioequivalent (the same medicine in the same dosage amounts) may be available as a different brand. You can read the full, comprehensive list published by the BMS here

If your treatment is affected, you may wish to consult with your pharmacist for further guidance. 

The following list may also be subject to change. We will update this list when more information becomes available. 

Manufacturer 

Brand / Product

Type / Dosage

Summary 

Orion 

Sandrena 

1.0 mg sachet

Shortages until mid-September 2019

Orion 

Indivina 

2mg oestradiol + 5mg medroxyprogesterone acetate

Shortages until mid-September 2019

Orion 

Tridestra 

2mg oestradiol + 20mg medroxyprogesterone acetate

Shortages until mid-September 2019

Janssen

Evorol®

All may be affected

Stocking out toward the end of October or earlier*

Janssen

Evorol® Sequi 

All may be affected

Stocking out toward the end of October or earlier*

Janssen

Evorol® Conti 

All may be affected

Stocking out toward the end of October or earlier*

Mylan

Elleste Duet™ Conti

2mg oestradiol + 1mg norethisterone

Shortage of supplies.

Mylan

Femoston®

1mg oestradiol + 10mg dydrogesterone

Shortage of supplies.

Mylan

Zumenon®

1mg oestradiol and 2mg oestradiol

Shortage of supplies.

Merus Labs

Estraderm MX

50 patches pack of 8

Shortage of supplies.

*The manufacturer expects these products to return mid-2020

If you are concerned about shortages of HRT, you may also wish to contact the manufacturer of the specific product you take to seek further guidance. They will be able to update you as to whether your treatment will be affected in the future. 

Are there alternative HRT treatments I can use?

Not all HRT treatments have been affected by these shortages, so there should be alternatives available. 

The BMS have suggested to doctors and medical professionals that ‘consideration should also be given to prescribing estrogen and progestogen separately to make the closest match or find a suitable alternative,’ and that, ‘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.’

However, in practice, we understand it may be difficult finding an alternative if your regular HRT treatment has been affected. 

You can find more information on alternatives here: Which HRT Treatment Should I Use?

The Australian Menopause Society also has a helpful guide on HRT equivalents. 

What should I do if my HRT is unavailable?

There are several things you can do to make sure you have access to some form of HRT treatment. However, it might be that you’ll have to try a different type of treatment. It might also be that you cannot access a new type of HRT straight away. 

Firstly, it’s a good idea to speak with your GP about the shortages. They might be able to advise you about alternative treatment options. However, it’s important to be aware that your doctor only really knows what the general public knows with regard to information about these shortages. 

It might also be worth checking with your usual pharmacist. They will be able to update you about whether these shortages have impacted their ability to supply HRT treatment. You can also read more on emergency prescriptions here

Secondly, if you are happy with your current method of treatment and wouldn’t have otherwise tried a different brand - you could try and contact the specific manufacturer of the product you’ve been taking for regular updates. This information can be found online, but there may also be manufacturer contact information on the patient information leaflet with your treatment.

Thirdly, if you have a repeat prescription or have been written a new prescription but cannot access treatment at a local pharmacy - you may wish to try and order HRT treatment online. You can have a look at our listed HRT products page here. Stocks are being affected nationally, not just by pharmacy - but we may be able to offer suitable alternatives. 

It has been reported that some people are trying to ‘bulk-buy’ HRT treatment, as to avoid being affected by the ongoing shortages. We would advise against this, not only because it exacerbates the wider problem but also because treatment regimes can change (for example if your symptoms change or if you no longer need treatment after a certain period); so you may end up with surplus treatment you do not need.

Again, if you’re unsure of anything to do with your treatment, speak to your GP.