A combination of factors is causing shortages in hormone replacement therapy (HRT) to persist for “a number of years”, according to Community Pharmacy Scotland (CPS).

The Scottish negotiator told C+D that issues in manufacturing such as “raw material shortages”, along with “distribution issues” and “an increased demand” is impacting HRT availability.

It said no single medication can be “pinpointed being affected most” but said many HRT products contain similar raw materials, and if they become unavailable, the “impact can be widely felt”.

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“To assist in alleviating supply issues with medicines availability, various Serious Shortage Protocols (SSPs) have been issued to help manage and mitigate medication shortages for prescribing clinicians, community pharmacies and importantly patients,” CPS said.

It comes as an SSP for HRT medication Estradot was extended to April 17 by the Department of Health and Social Care (DH) in January.

The Scottish government told C+D that regulations for the supply of medicines including HRT products, and any associated shortages, is “a reserved matter for the UK government”.

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“We will continue to work with the UK government to seek a lasting resolution to HRT supply issues, and to press them to work closely with the affected companies to address this as quickly as possible.”

It added that improving menopause care and support “continues to be a priority for this government” following its publication of phase two of the women’s health plan in January. It “responds to the concerns of women across Scotland and includes focused action on menopause care”.

“We want all women to have timely access to menopause support and services when required,” the Scottish government said.

Devastating

A menopause support group told The Scotsman yesterday that the shortages are “devastating” and there’s always been an HRT shortage “since 2022”.

Menopause Warriors Scotland co-founder Jacqui Dillon said “everyone suddenly wanted” HRT following the release of Davina McCall’s show ‘Sex, Myths and the Menopause’.

It led to more women wanting to access the medication but since then, availability has become limited.

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Dillon warned that changing HRT medication can cause issues for women and menopause symptoms to return and said that HRT medication is not a priority in healthcare.

CPS said that community pharmacy teams are “very experienced and adept at dealing with medicine shortages” and will “routinely engage with medical wholesalers and suppliers, liaise with prescribers, health boards, and patients to help achieve good patient outcomes”.

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In February, a House of Lords report found that HRT shortages led to “clinicians rationing prescriptions” and an increase in the “sale of counterfeit medications”.

It said patients faced “extreme anxiety” and the “return of menopausal symptoms” like “physical discomfort and psychological distress”.

It comes as the NHS Business Services Authority (NHSBSA) reported in August that it received “over 200,000” prescriptions falsely claiming to be covered by HRT pre-payment certificates (PPCs) in the last year.