Though the current shortage of synthetic hormone replacement therapy (HRT) has only been widely reported in the last six months, it’s actually a crisis that has been evident to millions of menopausal women for the last 4 years.
For the uninitiated – by which I mean those with no experience, direct or otherwise, of living with menopause – describing a shortage of HRT medication as a ‘crisis’ may seem overly melodramatic; this is, after all, a treatment that a great many women in menopause choose to go without.
But to believe, as many do, that HRT is just something that helps women to manage their mood swings and keep their internal body temperature in check is to trivialise and minimise a condition that, untreated, can have a potentially terminal impact on mental health.
A recent account of one woman’s struggle to get the medication she needed, and the suicidal depression that led to, is an all-too familiar story, describing a catastrophic lived experience that robs many women of self-esteem, confidence, and self-worth.
The impact of menopause on many women is little short of seismic. The hormonal changes that signal the end of a woman’s reproductive life can, and often do, impact every second of every waking and sleeping minute.
Much of the emotional detriment that women report experiencing as a result of symptoms such as sudden mood swings, hot flashes, loss of libido, muscle and joint pain, headaches, night sweats, and anxiety comes not from those symptoms themselves – unpleasant though they all are – but from the knowledge that they are here for the long haul.
According to the Menopause Society, the average woman spends up to 15 years in peri- or post-menopause, with most experiencing some degree of symptomatic distress.
Unless you have been through menopause, it is difficult at best to truly appreciate the scale of despair that comes from knowing that without treatment you may experience the full impact of those symptoms on each of the next 6,000 days of your life.
Most of us have experienced some sort of back, tooth or head pain in our lives. Whist it’s a fool’s errand to try to liken any common unisex health condition to a symptom of menopause, it’s worth imagining the mental anguish you might feel if you were facing 15 years of chronic back pain without access to some sort of relief or treatment.
More than this, many women say that their symptoms cause them to develop personality traits and characteristics that make them unrecognisable from the people they once were, creating a loss of identity that is highly distressing.
With that in mind, and an HRT shortage that was already deeply worrying for women who had already had a difficult enough time convincing their GP to prescribe patches or gels to begin with, it’s easy to understand why women fear the current pressure on HRT supplies.
The impact of the pandemic and, to a lesser degree, Brexit on supply chains has intensified what is fast becoming a serious problem that risks serious and potentially fatal emotional harm.
All of this makes the reluctance of public health bodies to engage with those of us involved in delivering more natural HRT treatments and remedies all the more mystifying.
Bioidentical hormone replacement therapy (BHRT) is chemically identical to your natural hormones and are made from plant estrogens. By contrast, conventional HRT treatments are made using urine from pregnant horses and other synthetic hormones.
There are now plenty of studies to show that BHRT is just as effective as synthetic treatments – a fact that many public health bodies now concede.
However, there has been a steadfast refusal by the public health establishment to be proactive in making impartial information about BHRT available to women, never mind countenancing the potential merits of supporting the referral of patients for treatment.
Remarkably, the NHS web page covering alternatives to conventional HRT even lists antidepressants and treatments such as tibolone (only suitable for women in post-menopause) and clonidine (which it admits is largely ineffectual and comes with unpleasant side effects) ahead of BHRT!
The only apparent objection that the public health community has to BHRT is that they do not clinically recognise the studies and trials that have taken place. And the reason for that? The National Institute for Clinical Health Excellence (NICE) won’t invest in those clinical trials.
NICE has never suggested that BHRT is unsafe – indeed its language and that of the NHS gives the impression that BHRT is just as safe as the synthetic alternative.
So, in a world where the health sector cannot meet demand for synthetic HRT, and where many women genuinely contemplate suicide as being preferable to living with the misery of their menopause symptoms, is it not time for the government and its health agencies to at least ensure women are actively made aware through their GPs that BHRT is an option for them?
Luckily, many GPs are beginning to share knowledge about BHRT with their menopause patients, but it is a slow process that offers no credible answer to the shortage in supplies of synthetic HRT and the new 3-month supply limit the government has placed on prescribing GPs.
BHRT is suitable for every woman and is championed by a long list of celebrities whose personal experience of it has been life-changing. If you’d like to find out how BHRT can help you, please get in touch for a confidential and informal chat.