Q&A: What are the issues with HRT supply?

HRT can help relieve most menopausal symptoms (Alamy/PA)

Women are having to deal with a shortage in hormone replacement therapy (HRT) supplies amid the rising demand for such treatment.

Here, we take a look at the issues:

– What is HRT?

According to the HSE, Hormone replacement therapy (HRT) is a medicine-based treatment used to relieve symptoms of menopause.

HRT medicine comes as tablets, skin patches, gels, and vaginal creams, pessaries or rings.

HRT can help relieve most menopausal symptoms, including hot flushes, night sweats, mood swings, vaginal dryness and reduced sex drive.

– What is the current situation with supply?

Shortages of some commonly used products, in particular HRT patches, have become a feature of women’s healthcare over the past two years.

Pharmaceutical companies have pointed to growing demand as the main cause and do not seem to be able to match this despite increasing deliveries to Ireland.

It is estimated that there are up to 600,000 Irish women who could be affected by peri-menopause or menopause.

– What is the reason for such an increase in demand?

Increased awareness of the benefits of HRT has seen more women seek help for menopause symptoms.

Rebecca Barry, supervising pharmacist of Lloyds Pharmacy in Castletroy, Limerick recently told the Irish Examiner that there has been "a massive increase in the amount of HRT being prescribed."

"Every day, for months now, there are at least two if not more HRT products unavailable," she said.

– What has been the consequence of this higher demand?

Social Democrats spokeswoman on social justice Holly Cairns said some women have not been able to access suitable HRT products at all, while the Irish Examiner has previously reported instances of women having to call  multiple pharmacies to source products.

Others are reportedly cutting patches in half to extend coverage or sharing products with others.

“The UK government is showing that this issue needs to be prioritised to help resolve it," Ms Cairns said.

"The Minister for Health, Stephen Donnelly TD, needs to step up and address this issue with a similar commitment."

– What is being done about it?

The Department of Health now plans to deliver six menopause clinics this year, up from an earlier target of four.

They recently confirmed €2.5m of the €10m women’s health fund is ring-fenced for the HSE to address menopause, postnatal care, endometritis and providing medical social workers across the maternity system.

Estradot patches, manufactured by Novartis, are currently out of stock until July.

A spokeswoman said there had been "a significant increase in demand, driven by the increased awareness of HRT and the menopause during 2021".

She said the company has “significantly increased” supply since 2021.

A spokeswoman for Besins Healthcare which makes Oestrogel gel products said they have also increased supply and expected this gel to be restocked around the end of April.

Meanwhile, at the end of April, the British Government announced that Vaccine Taskforce director-general Madelaine McTernan had been appointed to spearhead a new HRT Supply Taskforce.

– What is the HRT taskforce responsible for?

The taskforce will engage with HRT suppliers to ensure there is a good understanding of supply constraints and what is being or can be done to address them in the short and long term.

It will also work with the NHS Business Services Authority to secure access to real-time HRT dispensing data in order to improve understanding of supply, demand and what is driving shortages.