The Truth About Over-The-Counter HRT for Menopause | Stella
5 mins

The truth about over-the-counter HRT

byHelen Henderson

Menopause and HRT hit the headlines for being available without a prescription. The news was welcomed by menopausal women up and down the country. But is it what it seems? Well, not quite. Read on to find out more about what it means for you when it comes to hormone replacement therapy (HRT) availability…

Is HRT available over-the-counter in pharmacies?

No. The UK’s medicines regulator, MHRA, has proposed that a specific form of local HRT should be available in pharmacies without needing to speak to your doctor or specialist for a prescription. This medication is Gina 10 microgram vaginal tablets (Estradiol). All other HRT will still require a prescription, following a consultation with your doctor or specialist, due to its associated risks. 

This is normal. The MHRA can reclassify medications and you may have seen other medications become available over-the-counter, such as Viagra and some antihistamines. However, this is the first time that a preparation of HRT has been proposed, which is brilliant for women’s health.  It’s not a done deal as we are still awaiting the outcome of the consultation.

What is Gina? 

Gina is a form of local hormone replacement therapy that is licensed to treat painful and uncomfortable vaginal atrophy. This common menopause symptom happens when low oestrogen levels cause vaginal tissues to thin, the vagina to become less elastic and mucous production to decrease. The reduced lubrication causes vaginal dryness, soreness, itching, burning and painful sex, all of which can be incredibly debilitating – think sandpaper between your legs.

To replace the hormone that your body produced previously, Gina tablets contain 10 micrograms of estradiol and are inserted into the vagina with an applicator. Only a small amount is absorbed into your bloodstream as the treatment works locally, unlike other HRT products that are taken orally or used transdermally through a patch or by spreading on your skin.

Gina is licensed for vaginal atrophy due to oestrogen deficiency in postmenopausal women aged 50 years and above, who have not had a period for at least one year.

Will you be able to buy Gina off the shelf?

Not quite! You won’t be able to pop it into your basket and go to the checkout. If Gina is reclassified as a ‘pharmacy only’ medication then you can buy it if a pharmacist is present and this is why it is called ‘over-the-counter.’ The sale of Gina will be subject to strict licensing conditions, so you will need to talk to your pharmacist first so they can make sure the medication is safe for you.

Is it safe to be able to buy this without seeing a doctor? 

Vaginal atrophy is usually diagnosed based on the symptoms you experience and an intimate physical examination is not required. You can tell your pharmacist about your symptoms confidentially in a private consultation room, so no one else in the pharmacy will overhear. 

Pharmacists are trained to understand vaginal atrophy symptoms and Gina medication. If they are worried about your symptoms, they will refer you to your doctor or specialist without selling you the drug. For example, Gina will not be sold to anyone with unexplained vaginal bleeding, unusual vaginal discharge, or changes to the look or feel of their vulva. These symptoms would need further investigation. Read more about the HRT debate.

I struggle to get HRT from my GP – can I just use Gina instead? 

Gina only treats menopause symptoms related to the vagina and won’t work for other symptoms, such as sleep issues or hot flushes. Read more about the 34 symptoms of menopause.

Benefits of over-the-counter Gina

  • If you are only having vaginal symptoms during your menopause, then using Gina may be a good option for you!
  • You don’t need to get an appointment with your doctor and can just walk into a pharmacy, which is open longer hours than GP surgeries. 

Do let your doctor know you are using Gina, as it is always helpful for them to know what you’re taking. They can still prescribe it to you if you decide you want Gina from your doctor.

Reduced prescription charges for HRT

Did you know the government is taking action to cut the cost of repeatable HRT prescriptions? NHS England has been asked to review current practice – well, it’s about time! We believe that women should not be prevented from accessing menopause treatment due to cost alone.

Final word

Some headlines were misleading to imply that HRT was going to be available over the counter. However, there are at least two great wins. First, Gina is a low-risk solution for vaginal symptoms and better access is great. Second, the relatively banal regulatory change brought loads of focus on menopause – which is also a good outcome!

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