Women undergoing the menopause are experiencing profound and widespread mental health issues because of a severe shortage of Hormone Replacement Therapy (HRT) medication, experts have warned.
Treatments have become increasingly difficult to obtain since the end of last year, when supply issues that started in China forced some manufacturers to stop producing HRT patches. This led to heightened demand for alternatives, which then became scarce too.
Recent weeks have seen the shortfall become markedly worse, with around half of the most commonly prescribed HRT products now out of stock, and little improvement forecast until the middle of next year.
The majority of the 3.4 million women between 50 and 64 in the UK will be experiencing symptoms of the menopause.
The psychological symptoms include crushing anxiety, panic, loss of confidence, inability to concentrate, extreme brain fog, poor memory - with many women talking about experiencing “a loss of joy” or feeling like they are “going mad”, said Diane Danzebrink, who runs the Menopause Support network - which works with 10,000 women.
The psychotherapist, who supports women through the menopause and provides menopause training for businesses and organisations, said physical symptoms include heart palpitations, hot flushes, night sweats, urinary infections, extreme fatigue, vaginal soreness and dryness, bladder weakness, and insomnia.
Speaking about the treatment shortage, she told The Independent: “It is already chaotic. We are seeing more and more women who can’t access their brand of HRT - they are being given a different prescription but then told that is out of stock.”
The campaigner, who spearheaded the Make Menopause Matter campaign with the support of cross-party MPs in Westminster last year, added: “I do not think you can overestimate the effects of the HRT shortage. One in four women will experience debilitating symptoms that can last up to 15 years from menopause. If they stop taking their HRT, their symptoms are going to come back.”
Ms Danzebrink said: “I am very concerned about the women I interact with because their anxiety is through the roof. They use words like ‘dread’ and ‘fear’. Women are genuinely fearful. Women are worried about carrying on with jobs and looking after their children. Not having HRT is going to be life-changing and not in a good way. The shortage places some women at risk of becoming potentially suicidal. The biggest risk of suicide for women is between the ages of 50 and 54. The average age of menopause is 51. That is not a coincidence. My menopause made me suicidal - I got very close to putting my car in front of a lorry.”
Ms Danzebrink said women in the support group described HRT as their “lifeline” and one even said their blood pressure keeps rising due to the shortage. HRT replaces the oestrogen that the body stops producing during menopause. There are around 2.5 million prescriptions of HRT made in England every year.
The campaigner said she had counselled four NHS nurses in the last four months who had left the profession because they were struggling to look after patients due to their own menopause symptoms - adding that she had also supported teachers and a lawyer who had quit their jobs for similar reasons.
Ms Danzebrink argued there was a serious dearth of credible information about why there was a HRT shortage - explaining her organisation Menopause Support had contacted several pharmaceutical companies to find out which products they had in stock but had received “evasive” replies.
She said women were buying HRT, which can be administered as patches, pills or gels, from websites overseas but warned against this - saying it was dangerous as it was difficult to discern where products come from and their veracity.
One sufferer, who chose to remain anonymous, said: “I am very scared. I am only just feeling better - having been depressed and anxious for nearly three years and having been treated for depression. I don’t want to feel like that again. My pharmacy doesn’t have my patches, I don’t know what to do.”
Another said: “I’m stockpiling as I’m terrified of running out. I can’t function without my patch, I cannot stand up and teach looking like I’ve been thrown in the sea, in addition to the exhaustion from not sleeping and anxiety that would put me in a compromised position. It’s outrageous that the pharmas cannot get their supply chain organised, it’s not rocket science. And no pre-warnings at all, I only found out when I went to pick up my prescription.”
And another woman spoken to by The Independent said she was “worried sick” about the HRT shortage - explaining she had even resorted to trying to buy HRT online from Europe at heavily inflated prices but it was still not available. She said the thought of “going back” to where she was a year ago “terrifies” her.
“I’m really anxious and stressed,” she added. “I know how my symptoms will return and how even a small difference in dose affects me. I asked for my prescription early but after four weeks I can’t get the complete amount. It is terrifying.”
Dr Asha Kasliwal, a gynaecologist who is the president of the Faculty of Sexual and Reproductive Healthcare, said it was very hard to know when the HRT shortage would end as there was a lack of information.
She said: “The shortage is getting worse. It is affecting my patients quite a bit - especially the ones who are quite well-settled on HRT. It is time-consuming and frustrating for women and even for the doctors and pharmacists. If they are suffering from debilitating symptoms of menopause then it affects their home life and work life. It can lead to relationship problems. The shortage puts women’s health and wellbeing at risk.”
Haitham Hamoda, chair of the British Menopause Society, added: “We are concerned that if women are unable to obtain supplies of their HRT, this may result in symptom recurrence and this could adversely impact the quality of women’s lives. It remains unclear why there is a shortage of the treatments in the first place or when the normal supply of the products might resume. We are seeking further information and clarification as to when the matter will be resolved from the industry.”
A Department of Health and Social Care spokesperson said: “We know how distressing this shortage is for patients and it is our priority to ensure they can access the medicines they need.
“We are aware of ongoing supply issues with some HRT preparations due to manufacturing issues and are working closely with all suppliers to maintain overall flow of medicines to patients. Supplies of alternative HRT products are available and any patient affected should discuss alternatives with their doctor.”