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MHT shortages – other options are available, say menopause experts

Health updates 25 May 2020
mid life woman sitting on step outside

Women should not be worried about the shortage of some menopausal hormone therapy (MHT) medications in Australia, as there are alternative medications available for them.

Jean Hailes endocrinologist and president of the Australasian Menopause Society, Dr Sonia Davison, says women should discuss alternatives with a health professional if they cannot get hold of their usual medication.

“There are lots of different options available and most women will be able to tolerate a different product for a short time,” she explains.

MHT (formerly known as hormone replacement therapy, or HRT) provides relief for women from menopausal symptoms such as hot flushes, sweats, mood swings, irritability, insomnia, joint aches and vaginal dryness.

The products affected by the current shortage include transdermal patches Estalis Sequi and Estradot (sponsored by Novartis Pharmaceuticals Australia Pty Ltd) as well as Climara (sponsored by Bayer Australia Ltd). There is also a shortage of the oral tablet Angeliq (also sponsored by Bayer Australia Ltd).

According to Jean Hailes endocrinologist Dr Rosie Worsley, Estalis Sequi is one of the most commonly used patches on the market. It is also on the Pharmaceutical Benefits Scheme (PBS), which means it attracts a federal government subsidy and therefore costs less than some alternatives.

“Medicine shortages seem to have become more common and doctors have become very adept at finding alternatives and, for MHT, there are always other options available,” she says.

The only possible drawback will be cost, as not all medications are covered by the PBS. Dr Worsley believes the government should consider short-term PBS subsidies for alternative products. “It would be helpful if we had some more options available under the PBS because of these rolling shortages,” she says.

In prescribing MHT, one ‘size’ does not fit all women. Some women will have trialled a number of medications before finding one that best suits them. However, Dr Davison says there are alternatives that can still be considered and women could ask their doctor about them.

A spokesperson for the Therapeutic Goods Administration (TGA) says it is actively monitoring the situation and will look to secure supply of overseas products if required. The TGA regulates Australia’s therapeutic goods including prescription medicines.

The spokesperson says the sponsors of the products blame manufacturing issues on the shortage. They have provided timelines on when the products may become available and these can be found on the TGA website.

“Multiple other HRT products remain available and patients affected by these shortages are encouraged to speak to their doctor or pharmacist to discuss whether these alternatives may be appropriate to treat their condition,” says the spokesperson.

To learn more about MHT, visit our web page on Menopause management.

Health professionals looking for alternative products during shortages can go to the Australasian Menopause Society for a guide to equivalent MHT doses.