Written by Amy Beecham
The latest announcement may solve some HRT shortages, but it creates other problems too.
Following months of widespread shortages of hormone replacement therapy (HRT) in the UK, last week the Medicines and Healthcare Products Regulatory Agency (MHRA) announced that it would be offered over the counter for the first time.
According to Menopause Support UK, one in four women will experience severe debilitating symptoms and 38% of women seek help from a GP.
The demand for HRT has increased dramatically in recent years, with around 512,000 prescriptions for HRT issued in February 2022, up from about 324,000 in February 2020.
The landmark move was hailed as a “huge step forward” for women’s health and lifeline for those experiencing menopause, with the Gina 10 microgram vaginal tablets (containing estradiol) becoming the first product available without a prescription.
Other vaginal tablets that also contain estradiol, including Vagifem 10 microgram vaginal tablets, will still be available on prescription.
Maria Caulfield, the minister for women’s health, said: “Menopause affects hundreds of thousands of women every year, but for some its symptoms can be debilitating and for many they can be misunderstood or ignored.
“Making Gina available over the counter is a huge step forward in enabling women to access HRT as easily as possible, ensuring they can continue living their life as they navigate the menopause.”
However, this isn’t the magic solution it may seem.
“This is actually a menopause tax,” Lesley Salem, founder of Over The Bloody Moon, a menopause support provider, tells Stylist.
“The recommended retail price for Gina is £29.99 for the first seven weeks of tablets, and then £29.99 for the subsequent 12 weeks. With an NHS prescription, you would receive around a three month supply for £9.35. So this change only helps those that can afford it and that means it’s not an inclusive or accessible solution.”
Particularly amid the cost of living crisis, this sets a worrying precedent about who can access essential healthcare. Salem also suggests that lack of prescription requirement also runs the risk of patients not receiving the support they need.
“When you remove healthcare professionals, you also remove people’s access to being monitored,” she explains. “More needs to be done to support them and understand their symptoms, not just a ten minute slot to discuss issues that can be very emotional or painful, such as vaginal atrophy.”
“We know that at least around 40% of women experience vaginal atrophy when they are postmenopausal, so it’s actually about prevention as much as treatment.”
So what is the solution instead? Salem says it lies in menopause clinics.
“The decision to make some HRT available over the counter is meant to reduce the pressure on the NHS, which is absolutely vital. But I think that more specialised menopause services are actually a better solution, rather than having women go to GPs who haven’t been specially trained or have experience with complex issues.”
“It’s all about getting a consistency of care for those perimenopausal, premenopausal and postmenopausal, so this decision isn’t really solving the issue at all.”
Over The Bloody Moon offers free support, advice and resources for those experiencing menopause. Visit its website for more information.
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