The HRT shortage has made me furious and terrified | Stella
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The HRT shortage has made me furious and terrified

byEmily Turner

As the HRT shortage continues, increasingly desperate women are seeing their menopause symptoms return with no idea of when their usual prescription will be fulfilled. Here, Stella’s Marketing Director, Emily Turner, shares her own experience. 

HRT has stopped my scrambled egg brain, quelled my red-hot fiery rage and enabled me to live with two teenagers in relative peace. I can’t describe the sheer panic when I was unable to fulfil my HRT prescription this month due to national shortages. I spent hours scouring pharmacies locally. What a waste of time! My part of the world has none and I’ve had to change the type of HRT I am on, which has caused some symptoms to return. I am so angry about the situation many of us women are facing right now.

I was wrong to feel smug that I’d put my prescription request in early

My doctor prescribes me three months’ worth of Sandrena transdermal gel HRT at a time, which I get fulfilled through an online service direct to my door. It’s usually stress-free and super easy. I put my last prescription in early as I was aware of the shortages. I felt confident that having a few weeks to play with would give me a greater chance of getting my HRT.

This bubble of smugness began to deflate when I got an email: “We’re sorry, but your medicine is delayed.” Over the next two weeks, I was repeatedly sent: “Your medicine is still out of stock and we’re not sure when it will arrive.” Finally, I was advised to get a refund and try pharmacies directly. The battle was on.

Everyone on HRT in my area is having the same problem

The gel form of HRT – any brand – is like gold dust where I live. Local Facebook groups are full of questions about where people can find it. There is much triumphant grandstanding when someone is successful and finds HRT – oh, the envy!

I tackled this by treating it like a major project:

  • A spreadsheet of the phone numbers for pharmacies in a 7-mile radius 
  • Included rural pharmacies that might have less demand
  • Called at different times of the day in the hope of catching a surprise delivery

I felt sorry for the people answering my calls. I could hear the weariness in their voices as they answered for the hundredth time that day: “No, we don’t have any. No, we don’t know when the next delivery will be. No, I am not telling you what equivalents we have in stock.”

I realised pretty soon that the only way I would be able to source HRT gel at the moment was to drive between pharmacies every day between opening hours and give up my job. I needed a new strategy!”

It’s a bad sign when your doctor asks you what HRT is available locally

I called the doctor and explained I could not get my prescription and asked what other HRT options were available? My doctor wanted to know from me what the pharmacists had in stock before talking about options. I explained they were not telling me, probably to prevent it from appearing on Facebook and risking people being crushed in a stampede.

I did say that one pharmacy said they had 0.5mg sachets and I needed 1mg. I asked the pharmacist if they could double up and they said they could only do that if the prescription was changed. The doctor suggested he could rewrite for 0.5mg – until I said that this was yesterday’s stock levels. It would likely be gone by now and I would be back in the same position. 

A change in the law would enable pharmacists to make small changes in doses or brands and prevent them from having to refer patients back to their doctor, a leading pharmacist has said.

We talked through options and I said I didn’t want to increase my risk profile and wanted the equivalent dose. I also wanted transdermal and not oral HRT. The doctor suggested I try patches. I queried this as I thought patches were suffering long-term shortages. The doctor reassured me that patches now had reasonable availability because everyone had been advised to use gel. Armed with a patches prescription, I got it fulfilled on the first try! Success! Or so I thought…

Different HRT preparations have different effects

I’ve been using Sandrena for about five months now, rubbing it into my thighs every night. It’s had a positive impact on some key symptoms:

  • Sleep disturbance. I got out of the routine of being awake between 3am-4am
  • Night sweats. No more mopping up a wet neck and cleavage in bed
  • Prickly skin. No longer did I feel like I was being zapped by jump leads. Read my guide to this symptom.
  • Rage, irritation, anger. I can handle the mess my teenagers leave behind without turning into the Kraken. Read how profanity embroidery helped my rage.
  • Overwhelm. The joy of a quieter mind!
  • Joint pain. I can walk 10,000 steps a day without any foot pain

The symptoms that are returning

The patches are applied twice a week. I replace them on a Wednesday and a Sunday. Either I need to get used to this new medication or the “equivalent” dose isn’t having the same impact.  I am noticing the return of:

  • Irritation. I am not at maximum on the rage-o-meter but I can feel little jets escaping. Messy bedrooms are beginning to bother me once again
  • Night sweats. I’ve had a couple of wet nights (and not the sexy kind)
  • Joint pain. My feet suddenly hurt (mind you, it could be the result of putting on a few pounds lately – let’s keep an open mind)

I’ve noticed the symptoms are worse the day before or on the day the patch is due to be replaced.

It helps when your pharmacist gives you the right information (and you read the pamphlet)

“Put the patch on below your waistline and replace it on the same days each week,” the pharmacist said. That’s exactly what I did. Except it was wrong! I put the patch on my thighs (definitely below my waistline), as this is where the gel had been before. I later found out it should have been on my stomach area.

After a seriously bad morning when I was as irritated as a wasp trapped in a jar, I decided to replace my patch at lunchtime instead of evening and read the pamphlet for the first time. It said: “Apply the patch to the lower abdomen, just below the waistline”

After checking with another pharmacist, I found out that placing your patch in the wrong area can make it less effective. Well, that might explain things! Don’t do what I did and ALWAYS read the instructions.

How I knew I needed help with my symptoms

I’ve been using HRT for a while but my journey to using HRT was not simple – I didn’t realise that this treatment could help or that I had menopause symptoms. There was a slow dawning that something was not quite right 18 months ago when I lost my shit over my son’s extremely messy bedroom and stormed out of the house for a break. I tried to unravel my mind as I lay on the beach that winter’s day, breathing deeply and counting clouds.

It took me two hours of counting clouds in a bitter north-easterly wind to calm down. This wasn’t normal for me. How had I got to a point where a messy room mattered that much?”

Perhaps the rage came from the fact that my son’s room was a visualisation of how my brain felt at the time? It was messy, chaotic and noisy – you couldn’t cover up the untidiness.

I tried antidepressants but it was perimenopause, not depression

After this happened, I called the doctor and incoherently rambled about what was happening.

“I don’t feel like myself. My confidence has packed up and disappeared overnight. My brain is overloaded with everything, work, home, all the things. I am overwhelmed. Normally I can just get on with it.” 

The doctor offered talking therapy but the waitlist was long. I knew I needed help quickly, so I agreed to antidepressants. They had an immediate effect and I felt calm. But I didn’t feel like it was depression. I was just irrationally raging with nerves a-jangling, holding my overloaded brain with the never-ending “to-do” list that is life.

Over the next 12 months, I slowly realised that I was perimenopausal. I hadn’t even heard about perimenopause until I came to work at Stella. I thought menopause was when your periods stopped and then you had hot flushes. It’s only with hindsight that I realise I’d been having symptoms since I was 45 but dealing with each one like a whack-a-mole.

My top skill is juggling everything and perimenopause stole my superpower.”

HRT helped me feel like myself again

As I became more aware of menopause symptoms and saw a correlation with what I was experiencing, I wanted to try HRT. I slowly came off antidepressants, following my doctor’s advice. It wasn’t the easiest thing to go through.

When I started HRT, I didn’t get any side effects. Within a few weeks, I noticed sleep was easier and that I felt more rested. My night sweats had stopped and, best of all, I could stare at a teenage messy room without feeling like I needed to scream. It was irritating, sure, but I could shrug it off. The alien who had inhabited my body had vacated and I was able to juggle the to-do list once again.

How have the shortages been allowed to snowball?

I am furious that I might need to go back to counting clouds to keep calm just because my oestrogen levels are fluctuating and I can’t get HRT.”

Why has this happened? It’s obvious that the conversation around menopause has been increasing, so why the surprise that demand has doubled in the past five years? Pharma is usually keen to make more money, why the slow upkeep with demand? Where are the protests? The action groups? 

It’s great the government has a new HRT tzar to tackle the shortages, but many of us are suffering right now. We can’t wait for reports and ruminating. Forget about appointing, we want anointing with HRT asap, thank you very much.

If you see us, the furious HRT-deprived women, cut us some slack. We’re doing the best we can.

Read more about menopause on our blog or in our symptoms library.