Shortages of hormone replacement therapy (HRT) products in the UK have forced women to resort to the private sector, ration their doses and procure supplies from abroad.
Although the last five years have seen the number of prescriptions double in England, shortages of HRT products have been a problem for several years, with shortfalls blamed on manufacturing and supply issues.
Four women describe the lengths they’ve had to go to to access their medication.
‘I tried 12 pharmacies in a week’
In one week at the beginning of April, Kerri Sharp said she visited 12 pharmacies across London to try to fill her HRT prescription, with no luck. “What’s frustrating is no one could say when they were expecting to get a new batch in. If you know there will be some coming in, it takes the stress away.” The 61-year-old freelance book editor said several pharmacists told her she was one of 20 to 50 women they had seen who had been prescribed Oestrogel but were unable to get it. Sharp said one customer she met “shrugged her shoulders, saying: ‘Good luck – I’ve been everywhere’”.
Instead, Sharp was forced to buy her supply from an online pharmacy, at the cost of £42 for one month’s supply. She said she tried at least five other online pharmacies before finding one with Oestrogel in stock, and even then, the retailer was rationing it to one pack per order. “It’s the route I’ve been able to find by absolute tenacity and research – I’ve not managed it through the usual established channels.” It was meant to be a one-off, but Sharp doesn’t feel hopeful about supply returning soon: “It’s looking a bit bleak so I might have to purchase again. I’ll be back to square one in a month’s time.”
‘My sister in Spain has to send me the patches’
For some, sourcing their HRT medication has been an issue for years. Former marketing executive Annabel Bradbury said she has struggled to find Estradot patches since 2019. Instead, the 55-year-old has usually had to rely on her sister, who lives in Spain, to send over the product. “With a very significant level of effort I’ve been able to get what I need,” she said. “I’ve occasionally found supply down in Devon where my father-in-law lives. I’m pretty resourceful and was able to ring around and hustle.”
Bradbury’s local pharmacist in London said the demand for Estradot outstrips the supply he is given. “He said, ‘I’ve got one box per month and I’ve got 30 women asking for it’ – he was throwing his hands in the air exasperated,” she said, adding that he said he was “getting a lot of abuse”.
But in the last couple of months, Bradbury’s sister has reported that supplies are drying up in Spain too. “She gets me whatever she can. She goes to a neighbouring pharmacy if one doesn’t have it, so she’ll have a circuit in her town and she’ll just try them all.”
‘Is this going to get worse?’
Chloe Taylor, a 45-year-old software engineer in North Yorkshire has also found accessing HRT products hit-and-miss the last couple of years. Taylor, who is trans, has been on HRT for “a good 10 years”, and was initially on patches, before being switched onto a gel due to an allergy. But shortages have meant there have been times she’s had to use them despite the patches giving her “itchy red welts”.
Last month, Taylor was once again unable to get her prescription fulfilled. The 45-year-old usually deals with shortages by “rationing [her doses] down”. “Even then if I start to get symptoms, I take the full dose and try to play it by ear. Heavens knows what it does to my endocrine system.” She said she’s concerned about the long-term. “I’m worried about the bigger picture – is this going to get worse? Because it certainly doesn’t seem to be getting any better.”
‘I’ve gone private – not being on HRT isn’t an option’
When Elaine Kelly, a 45 year-old in Birmingham, tried to get her prescription for Oestrogel filled in February, she couldn’t find any supply locally. “I used Boots’ online prescription checker [where] you can check the stock within a five mile radius – nothing anywhere,” said Kelly, who works in the public sector. She wasn’t surprised – she had seen other women discussing the shortages in the Facebook groups she is a member of.
Kelly, who also had to resort to getting her initial HRT recommendation elsewhere, ended up having to fill her Oestrogel prescription at a private pharmacy. For three months’ supply, she has spent upwards of £250 on consultations, blood tests and prescriptions. “Long term it’s a cost implication,” she said, explaining that some of the costs have gone on her credit card. “It’s a potential debt issue for those for whom the costs of private care are prohibitive. Not being on HRT isn’t an option; I had to have a substantial amount of time off work before it. Everyone I know on HRT has had to fight for it or be forced to pay for private treatment. It’s unacceptable.”