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

0.5mg sachet

Out of stock until late October / early November 2019

Orion

Indivina

1mg oestradiol + 5mg medroxyprogesterone acetate

Out of stock until December 2019

Orion

Indivina

2mg oestradiol + 5mg medroxyprogesterone acetate

Out of stock until December 2019

Merck Sharp & Dohme Limited

Livial

Livial (2.5 mg Tibolone) (x28 packs)

Out of stock until October 2019.

Mylan HRT products

Elleste Solo™

1mg oestradiol.

Shortage of supply

Mylan HRT products

Elleste Duet™

1mg oestradiol + 1mg norethisterone acetate

Shortage of supply

Mylan HRT products

Elleste Duet™ Conti

2mg oestradiol + 1mg norethisterone.

Shortage of supplies.

Mylan HRT products

Femoston®

1mg oestradiol + 10mg dydrogesterone

Shortage of supplies.

Mylan HRT products

Zumenon®

1mg oestradiol

Shortage of supplies.

Mylan HRT products

Zumenon®

2mg oestradiol

Shortage of supplies.

Bayer

Progynova TS

Oestradiol 50 patches

Out of stock next week until end of October 2019

Theramax

Femseven conti

Oestradiol / levonorgestrel

Out of stock until end of 2020

Theramax

Femseven sequi

Oestradiol / levonorgestrel

Out of stock until end of 2021

Pfizer

Estring

Oestradiol 7.5 micrograms/24 hours

Low stock until 11th October 2019

*Updated: 01/10/2019

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.