Why is There a Shortage of HRT - Latest Advice - Stella
12 mins

Why is there a shortage of HRT in the UK?

byDr. Lucy Wilkinson

Updated 31st October 2023

While hormone replacement therapy (HRT) is an effective way to treat your menopause symptoms, it isn’t always plain sailing. One increasingly common problem is medication shortages.

If you take HRT, it’s pretty likely that you’ve already been affected by this issue. Whether it’s a national shortage of your particular brand of HRT or stock issues in your local pharmacy, many HRT users are fed up with the stress and inconvenience caused by this issue. 

From wild goose chases around different pharmacies to dodgy deals over social media, some people are going to great lengths to get hold of their prescriptions, for fear of their menopause symptoms flaring up if they miss a few doses. 

Read on for Stella’s essential FAQs about HRT shortages.

What causes medication shortages?

Shortages happen with all medications, but HRT has been particularly affected in recent years. Shortages can last days, weeks or months and it is a constantly changing picture.

Broadly speaking, medication shortages (including HRT shortages) can be caused by:

  • Manufacturing issues. Factories may be unable to source a particular raw ingredient or are struggling with quality control
  • Distribution issues. There may be delays importing medications made abroad or delivering them around the country
  • Local demand. Prescribers in your area have been enthusiastic about a particular type of HRT, or the local population is more inclined to take HRT than in other areas

If you’re struggling to get your hands on your HRT, it could be for any number of reasons. This could include a surge in demand in recent years, and changes in the way doctors prescribe as they learn more about the risks and benefits of HRT.

Is there an HRT shortage at the moment?

While any product can be affected by shortages, it is unusual for all forms of HRT to be in short supply. Instead, there tends to be a small number of products affected by supply issues at any one time.

The best way to get up-to-date information about shortages is to check with the manufacturer of your HRT product. You can find out their details by checking your pack or patient information leaflet. Most maintain sections on their websites about current supply issues or can be contacted directly with specific questions.

For general information, the British Menopause Society (BMS) publishes information on HRT shortages, although this is updated less frequently than the manufacturers’ websites.

To help you stay on top of these sources, we’ll update the below list every month.

Current shortages

Supply issues have been reported with:

  • Estradot 25, 37.5 and 100mcg/24h (oestrogen-only patch). Supply expected after 3rd November
  • Ethinylestradiol tablets (UCB pharma – 10mcg, 50mcg and 1mg tablets)
  • FemSeven Sequi (combined oestrogen and progesterone patch). Supply expected by the manufacturer in early 2024
  • FemSeven 75 and 100mcg/24h (oestrogen-only patch). Listed as ‘unavailable’ by the manufacturer
  • Indivina 1mg/5mg (combined oestrogen and progesterone tablet). Other strengths are unaffected
  • Tostran 2% (testosterone gel)
  • Sylk (vaginal lubricant). Read more about this shortage here.
  • Utrogestan. Back in stock. Find out more here

Are there HRT shortages in every area?

This depends on what is causing the shortage. Manufacturing and import issues will mean that most areas of the country run short.

If, on the other hand, supply problems are down to local issues, you could find that a particular form of HRT runs short in one area while being well-stocked in another. 

At Stella, people often share stories about fruitlessly scouring their local pharmacies only to find that their HRT is readily available when they try a different area or pharmacy chain.

If you’re struggling to get hold of your HRT and it’s not due to a national issue, it’s worth checking with a pharmacy a little further from home or an online pharmacy. If just your local area is affected, you may be in luck.

Do the shortages affect every pharmacy?

Again, it depends on the cause of the shortage. If it’s due to manufacturing or import issues, most pharmacists are likely to be affected once their initial stock has run out.

Shortages caused by national distribution and local issues can vary. It’s worth calling around to check stock levels if your usual pharmacy can’t get hold of your medication.

What should you do if you can’t get hold of your HRT in time?

This is a tricky situation and one which causes enormous stress for people taking HRT. 

The best thing to do is speak to your doctor. They may be able to prescribe an alternative type of HRT which is in stock. Often this can be done by simply switching to a different brand which contains the same dose of hormones.

The trouble is, this isn’t possible for all types of HRT as there isn’t always an equivalent product available. In these cases, your doctor might advise switching to a different type of HRT. For instance, if you were consistently struggling to get hold of your usual oestrogen gel, a patch might be a good alternative.

It’s important to take your HRT as prescribed. In particular, if you are prescribed both oestrogen and progesterone, you must take both of these hormones together. Don’t stop taking one component but continue with the other, as this can cause side effects and serious risks, and may mean that your HRT doesn’t work as well.

For example, many HRT users need to take progesterone alongside oestrogen. This is because progesterone protects the lining of the womb from abnormal thickening (and in some cases even cancer) which can be caused by oestrogen if used alone. This is a good example of why both products need to be used together. Stopping the progesterone but continuing the oestrogen could have very serious consequences.

Is there a way of getting hold of HRT online? 

Yes. Online pharmacies are now widely available and popular. They have several advantages, such as not being affected by local supply issues.

If you’re consistently struggling to get hold of your HRT prescription, consider contacting an online pharmacy to see whether they have had the same supply issues. If not, this might be a good way forward for you. There is also the bonus of your medication being delivered to your door!

If you’re consistently struggling to get hold of your HRT prescription, consider contacting an online pharmacy to see whether they have had the same supply issues.

When choosing an online pharmacy, be sure to check that they are appropriately regulated and reputable. This ensures that you are receiving genuine medications with the required safety checks.

In England, pharmacies should be registered with the Care Quality Commission, which provides information on choosing an online healthcare service.

In Scotland, pharmacies should be registered with the Care Inspectorate. Equivalent bodies in Wales and Northern Ireland are Health Inspectorate Wales (HIW) and the Regulation and Quality Improvement Authority (RQIA) respectively.

Pharmacies are also regulated by the General Pharmaceutical Council.

Don’t be tempted to use unlicensed or unregulated sources of HRT, even if you’re desperate. You run the risk of being sold counterfeit or unsafe medications, and safety checks may be incomplete.

​​If you would like to find out more about your HRT options and consider using Stella’s online menopause clinic, take our free online assessment.

Is it okay to source HRT on social media?

Please don’t! You should never use any medication which has not been prescribed for you by your own doctor, and then supplied by a reputable pharmacy.

There are many reasons for this including:

  • Uncertainty around where the medication has come from. Counterfeit medications are real and can come with serious problems
  • Storage issues. You can’t guarantee that the medication has been stored properly or even if it’s out of date
  • Safety concerns. The medication may be unsuitable or even dangerous for you
  • Effectiveness. This might not be the right medication for your symptoms

If you miss a few doses of HRT, what will happen?

This depends on where you are in your menopause journey and how your HRT affects you. It also depends on how many doses you miss.

While everyone is different, you may notice:

  • Menopause symptoms returning
  • Vaginal bleeding
  • Feeling generally unwell as the hormones leave your body

If you feel unwell or have any concerns, speak to your doctor. 

Can you swap to different kinds of HRT if you can’t get the one you normally use? 

Yes. Switching your HRT is a common and sensible approach to supply problems. Your doctor may suggest:

  • Switching to an alternative brand
  • Trying a different dose
  • Changing the way your HRT is administered (e.g. switching from a gel to a patch)
  • If you’re ready to try without HRT, a trial off hormones altogether

It’s important that any changes are made by your doctor.

How many months of HRT can you ask for from your doctor? 

This depends on where you are in your HRT journey, and which type of HRT you take.

It’s normal for your doctor to prescribe just a few months of HRT when you first try it, or after any changes. This is so that they can assess how well the prescription suits you and allow for a check-up after three months.

Once you are settled on your HRT prescription, they may prescribe for longer periods. Exactly how long depends on your doctor’s local prescribing policies among other factors, although a 6-12 month prescription isn’t uncommon.

However, that doesn’t always mean you will be able to collect 6-12 months of HRT from the chemist! Pharmacists may sometimes only be able to dispense a smaller quantity of your HRT, depending on product availability, and ask you to return later for the rest.

Be aware that you may save some money with a prepaid certificate.

Exactly how long depends on your doctor’s local prescribing policies among other factors, although a 6-12 month prescription isn’t uncommon.

Is it OK to stockpile HRT?

It’s best not to stockpile. Accumulating too much HRT can lead to medications expiring before they can be used and significant waste if your prescription changes. It also contributes to the shortages and means that other people struggle to get their medication too.

Do not be tempted to give any leftover HRT to others. Even though you may feel like you are helping, only their doctor is able to give safe advice on HRT use. HRT can have serious side effects and should only be prescribed by a doctor and issued by a registered pharmacy.

Final word

HRT shortages are unfortunately a fact of life at the moment. However, there are ways to tackle supply problems. If you’re struggling to get hold of your usual HRT, consider trying an online pharmacy or discussing your options with your doctor.

Find out more about menopause on our blog or in our symptoms library.

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