EXCLUSIVE: Health Care Under ‘Huge Pressure’ as HRT Prescriptions Double Since Pre-Pandemic Year

Stock photo showing a woman holding a box of pills in her hand. (Dmytro Zinkevych/Shutterstock)

Clinicians are facing “huge pressure” with soaring demand for menopause treatment, a leading expert said.

It comes as the number of Hormone Replacement Therapy (HRT) items prescribed in England last year almost doubled before the COVID-19 pandemic.

Dr. Paula Briggs, chair of the British Menopause Society (BMS) and sexual and reproductive health consultant at Liverpool Women’s Hospital, told The Epoch Times that heightened publicity around menopause has pushed up the demand for medical treatment, and the long waiting list for menopause treatment is pushing women to seek private health care.

HRT is a treatment to raise the level of female hormones using tablets, patches, implants, gel, or spray.

It’s mostly used to relieve menopausal symptoms such as hot flushes and night sweats, with other applications including the treatment of premature ovarian insufficiency or cancer-related hormone deficiency, or a boosting of oestrogen levels in biological males undergoing gender reassignment surgery.

According to data obtained by The Epoch Times through a Freedom of Information request and historical data published by the NHS Business Services Authority (NHSBSA), almost 11.4 million HRT items were prescribed in England’s primary care settings in the financial year 2022–2023, almost doubled the amount prescribed in the year 2019–2020 (some 5.8 million items).

The total net ingredient cost of the prescribed items was £1.66 million, more than double the amount in the last pre-pandemic year (£81 million).

The numbers have steadily risen during the last decade, but the increase has become faster following a dip during the COVID-19 pandemic.

The number of prescribed HRT Items in England by financial year. (Data source, NHSBSA Copyright 2023 /  Contains public sector information licensed under the Open Government Licence v3.0)

The net ingredient cost of HRT items prescribed in England. (Data source, NHSBSA Copyright 2023 /  Contains public sector information licensed under the Open Government Licence v3.0)

Patient Numbers Rise Across Most Ages

Most prescribed items could be attributed to identified patients by their NHS numbers.

In the year 2022-2023, the number of patients identified in England’s HRT prescriptions has also increased across most age groups compared to the last pre-pandemic year, with menopausal-aged patients being the biggest contributor to the increase.

The age group 50–54 had the most number of identified patients in last year’s prescriptions, at around 0.6 million people, 99.1 percent up from three years ago.

But the biggest jump in patient numbers was seen in the age group 45–49, around 103.1 percent more than that in the year 2019–2020.

Some 91.3 percent more patients aged 55–59 and 70.5 percent more patients aged 40–44 were prescribed HRT than three years ago.

There were also significant rises in the number of patients aged above 60, smaller increases among those aged between 25 and 39, and a slight rise in patient numbers in the age group 0–4.

But in general, fewer young people (5–24) were prescribed HRT in the year 2022–2023 compared to the year 2019–2020.

HRT prescriptions England: the number of identified patients by age group. (Data source, NHSBSA Copyright 2023 /  Contains public sector information licensed under the Open Government Licence v3.0)

Previously published figures based on population estimates by the Office for National Statistics (ONS) suggested that a small part of the previous increase may be owing to changes in the population size. The ONS is yet to publish its mid-year population estimates for the years 2022 and 2023.

More HRT items are expected to be prescribed in the future as the UK government launched a new scheme in April, allowing annual prescriptions of HRT instead of shorter-term prescriptions. According to the BBC, the measure can cut prescription costs by between £90 to £200 per patient per year.

Clinicians Under ‘Huge Pressure’

Attributing much of the increase in HRT prescriptions to the raised awareness and publicity around menopausal symptoms, Briggs told The Epoch Times said the publicity is a double-edged sword.

While it’s “always good to have raised awareness,” the risen demand “has put huge pressure on medical services,” she said.

“I know in my own trust we have about a year’s wait and inevitably then women are almost obliged to go privately if they want treatment. And that’s not right.”

Briggs said medical services were managing things well when there was a “balanced narrative in relation to managing menopause, which is a ... normal life stage” but amplified publicity has made the demand “really difficult to manage.”

Some patients had symptoms that are “clearly identified with menopause” and can benefit from HRT. Still, there were others who were “lead to believe that they have to have HRT for cardiovascular protection and to maintain their bone mineral density,” which can be achieved by other means such as “regular exercise, not smoking, not drinking too much, [and] eating the right things.”

Earlier this month, ministers had to restrict the dispensing of one of the drugs amid soaring demand.

The government issued a serious shortage protocol (SSP) for Utrogestan 100mg capsules on May 19, meaning pharmacists across the UK can only dispense up to two month’s supply per prescription.

The Department of Health and Social Care (DHSC) said the drug was frequently delivered by the manufacturer but it still struggled to cope with rising demand.

The Department also said Utrogestan is expected to be in intermittent supply until late 2023.

Since April 2022, the government had to issue 22 SSPs for HRT products, although only one other SSP for Progynova 100 microgram patches currently remains in place, the DHSC said.