Why is it so hard to get HRT?

I am going to start this off by saying I dont have any answers to that question, so if you are expecting me to give you the answer, and how to find the holy grail of missing patches or elusive gels, this isnt the post for you. I can however give you my experience on why it is so hard to get HRT

First of all some background.

Back in November 2018 I wrote a post (My Thoughts on the Menopause) about the documentary that Mariella Frostrup did on the BBC about the Menopause. Since then there have been many others, including a fantastic one done by Davina McCall. There has been more discussion in the media, on social media and amongst friends and it really felt like menopause was finally being discussed. Being acknowledged that the discussion was long overdue and that thousands of women were suffering, mostly in silence with what can be an incredibly debilitating condition.

Things have moved on with HRT, or Hormone Replacement Therapy, and it is no longer (thankfully) viewed as being a dangerous route to go down. Yes, women still need to do their research and make an informed decision with their health care professionals, but for many the benefits of the treatment mean it is something they can consider taking.

As I did.

Back in 2018 I realised that the headaches I had been experiencing for years were more than likely hormonal. MRIs and neurologists could find nothing wrong and painkillers (including prescription only opioids were not something I could really take long term). A chance reading of Liz Earle’s book joined up all the dots and I talked to my GP about the idea I could be menopausal.

I was ready for a fight for HRT since that was what the media at the time was suggesting would happen. Women in their thousands were being dismissed, fobbed off with “you’re too young” / “you just need anti depressants” and I was ready with a prepared speech in my head that could quote the NICE guidelines that said GPs should listen to a woman’s symptoms and accept that if she believes she is menopausal, presents with the symptoms then discuss her options for HRT.

I didnt need to do any of that as my GP agreed and gave me a prescription almost instantly. A prescription for a medication called Femseven Sequi. Four patches, one a week, with a mixture of oestrogen or progesterone. Excellent. I was on the road to being headache free, more bouncy, less itchy, irratable and boiling hot. I might finally be able to sleep for longer than two hours (unless I was on the sofa and it was mid afternoon, then I could sleep for hours).

That is, until “a supply issue” meant I couldn’t get them anymore.

Some rumours said it was due to Brexit contracts needing to be renegotiated, others said it was down to the adhesive. Either way I had to be prescribed an alternative.

An alternative that didnt stick and, crucially, didnt work. I needed to go back to the GP it seemed and start discussing an alternative, except when this was all happening so was a family emergency at the other end of the country. Our weekends were then taken up with being up north, week days with trying to work, keep an eye on granny in her care home, and with making sure the kids didn’t starve to death, whilst trying to run a home and be a f functioning member of society. Self care took a back seat for a while whilst I juggled everything else.

And then Covid hit. The NHS had better things to worry about. I had better things to worry about and quite frankly I didnt want to be anywhere near a doctor’s surgery or pharmacy, so left it all. Again.

Until this week when I decided enough was enough. I have been battling an increasingly list of symptoms, my anxiety is at a worrying level, the heat is unbearable and I spent the weekend on the sofa because I had neither the energy nor inclination to do anything. We were about to order our fourth takeaway of the week and I thought it was time to get on top of it all.

On Monday morning I filled in the e-consult form on the GP website and began the process of getting back on the HRT. The GP called the following day and after confirming a lack of a family history of high blood pressure or breast cancer suggested I go back on the original Femseven Sequi patch.

I queried this and mentioned the supply issue from a few years ago but she assured me it was resolved, freely available and I wouldn’t have an issue.

Which is strange because the 17 pharmacies I called on Thursday afternoon all told me they couldn’t get it, citing “supply issues”. A quick Google of the drug’s name came up with this on the manufacturer’s website:

If you are Googling “are Femseven Sequi patches available?” I CAN answer that one. No, they are not. And its not just a supply issue, they aren’t being manufactured and distributed at the moment. Earliest they might be available is early in 2022 but dont hold your breath.

Why did my GP prescribe them to me, telling me there was no issue? Well that is a different blog post and shows how disjointed the system is. I dont expect a GP to be able to remember the availability of every drug, and a pharmacist can only answer for their own supply chain, but surely there should be a system somewhere that joins up all the dots, shouldn’t there?

I spent four hours on the phone on Thursday afternoon, calling every pharmacy in a thirty mile radius, emailing online pharmacies, asking if anybody had it and they all said the same thing “our supplier can’t get it” which is the when I then Googled it and found the above.

Now I am somebody who works from home, in a flexible job, with an understanding employer (Narrator: its herself), I dont have young children who need entertaining, I have English as a first language, I am not battling other health conditions and I have the capacity to do the research and make the calls. Imagine women who dont have that luxury, who are holding a prescription for something they can’t get hold of? Who have no idea what to do next. How the hell do they navigate this minefield? And it is a minefield, my mentions on social media in the last 24 hours are littered with people telling a similar story.

I spent over an hour on hold to the surgery on two separate calls as I tried to get back through to speak to my GP yesterday (I even went in but was told the receptionist couldn’t help me, I would have to call) and three hours calling all those pharmacies. Apparently I need another appointment, need to speak to the GP, need a new prescription. None of it can be done quickly, or without more appointments. What a massive waste of an overworked GP’s time.

Why? Why is this the system? I am not alone. When I tweeted this yesterday I was inundated with people telling me I was not alone, they had similar issues, had gone a few weeks, or even months as they tried to get the HRT they had been prescribed.