The Queenager: Eleanor's Letter (May 14th 2023)

Dear Queenagers,

Hope you are all well! That isn’t just a polite bromide this week as this newsletter is all about the latest issues many midlife women are facing with their HRT. Last year there was a shortage of oestrogen gels, this year it’s all about bio-identical progesterone; utrogestan. I’ve had several emails this week from women who can’t get hold of Utrogestan and are feeling increasingly desperate about it. One had tried eight pharmacies none of whom had any. Another was close to despair: “It’s taken me months to get the right balance for me on the HRT, the right balance – to feel good again and now I can’t get the drugs I need. I feel so anxious.” she said. She is far from alone, check out this story from the I.

The bad news, I’m afraid, is that the supply situation is not going to get any better any time soon. A high level meeting of Pharmaceutical manufacturers and the government in parliament last week (according to my spy who was there) says “there are going to be issues until January. The company that make Utrogestan (the only bio-identical progesterone only option) are opening a new factory in Spain – but it’s not coming online anytime soon.”

Kate Muir, author of the brilliant book Everything You Wanted to Know about the Menopause (But Were too Afraid to Ask) and the producer (brains) behind the Davina McCall documentaries is also worried. “I’ve got five or six hundred women asking me on Instagram about Utrogestan and saying they can’t get it despite government assurances that all is well. It is really important that women make a fuss about this and force the politicians to act on their assurances around women’s health. And also that women understand that they can’t go on taking oestrogen without progesterone because to do that poses an increased risk of endometrial cancer.”

So what is behind the shortage? The Minister Maria Caulfield claims it is because of ‘exceptional demand’ but insiders say that the demand isn’t exceptional, it has been gently rising for the last few years and the problem is, as Carolyn Harris MP alleges, “that the government lacked the foresight to meet with manufacturers in advance and prepare for this eventuality.” Last month, April 1^st, marked the beginning of the promised HRT prepayment certificate which made HRT more accessible than ever before, to more women. But, Harris says, “Shortages of HRT have been an ongoing issue for months. After initially denying the problem, Government Ministers have now admitted that due to high demand some areas of the country are experiencing shortages of Utrogestan. Women, once again, are suffering because of the Government’s failure to prioritise this area of women’s health.’

So what should you do if you are having trouble getting progesterone? Tina Backhouse, General Manager of Theramex, one of the biggest manufacturers of HRT in the Uk, says, “Women need to ask their pharmacists for a replacement. Utrogestan now has a serious shortage protocol on it, issued by the Department of Health, which means pharmacists can replace it with something else without going back to the GP for another prescription. It’s really important other alternatives are given.”

In terms of what those alternatives can be – there is the Mirena Coil, which works as a contraceptive but also releases progesterone, which thins the lining of the womb. Or there are pills which deliver progesterone and oestrogen together called Bijuve – but these are relatively new and many GPs don’t know about it. And while they have been approved by the British National Formulry (the body which approves new medicines) our archaic NHS insists that local districts okay individually the drugs that GPs can be prescribed, so some of the progesterone alternatives are not available in some places. Campaigners are pushing hard for a National Formulary for prescribing which would get around this – expect questions from Wes Streeting the Shadow Health Minister on this imminently. As Backhouse explains, “A National Formulary would mean that all women get the same access to HRT and new medicines wherever they live ans so any subsequent shortages would have iminal impact as the choices would be there for local GPs and pharamcies to make replacements so new treatmnets are not just available to women who can afford private prescribing. Women shouldn’t have to fight for access to hormones like this!”

However, the good news for Queenager readers of this newsletter is that we can help. We’ve been running a partnership with Stella, an online service which helps women with menopause, which has online GPs who use exactly the same questionnaires and methodology as the NHS and who currently have a supply of Utrogestan just waiting for you lovely members of the Noon Community. To check out Stella here is the link (special discount for Queenager subscribers and if you go through Noon).

The bigger issue is that once again women’s concerns around health in midlife are being put to the bottom of the list by politicians. I bet if there was a shortage of Viagra or testosterone it would be taken more seriously!  And despite all the protestations from last year’s oestrogen shortage, depressingly, nothing has changed.

And for those of you who missed last week’s post because of the Bank Holiday weekend – Noon Book Club is back. The next event is on June 19^th at 7pm BST on zoom (book your free spot here on eventbrite).

Paid Subscribers to this email can get a free book for each book club.