HRT alternatives during the Utrogestan shortage in the UK

What is HRT?  

Hormone replacement therapy (HRT) is a treatment aimed at alleviating symptoms associated with menopause by replenishing hormones that naturally decline during this stage.  

The primary advantage of HRT is its ability to alleviate a wide range of menopausal symptoms, including:

• Hot flushes 
• Night sweats 
• Mood swings 
• Vaginal dryness 
• Decreased libido 

While many of these symptoms may naturally diminish over time, they can be uncomfortable, and HRT can provide relief for numerous women.  

Additionally, HRT can help prevent the onset of osteoporosis, a condition that becomes more prevalent after menopause, and can contribute to weakened bones.

Menopause without HRT 

Menopause without hormone replacement therapy (HRT) involves the natural decline of hormones and can lead to various symptoms, including hot flushes, mood swings, vaginal dryness, decreased sex drive, sleep disturbances, changes in menstruation, urinary symptoms, bone density loss, cognitive changes, and emotional adjustments. Managing these symptoms without HRT usually involves lifestyle modifications and seeking support from healthcare professionals. 

How long after starting HRT do you feel a difference?  

As most HRT medicine is a hormonal treatment that is very similar to the hormones in your body, you may notice minor changes within days of using HRT, while it may take up to 90 days to feel the full effects of HRT. Factors such as commitment, consistency, healthy diet, and lifestyle habits can have an impact on the time and effectiveness of HRT. 

Why is there a shortage of HRT? 

Medication shortages (particularly HRT shortages) can be caused by a variety of factors, such as, manufacturing difficulties as factories may be unable to obtain a specific raw component or may be experiencing quality control issues, and problems in distribution.  

However, a unique issue has caused the HRT shortage in the UK as in some way we have become a victim of our own success. We are ahead of the rest of the world when it comes to HRT. We have raised women's awareness in the UK, and demand has increased. That is the source of the shortfall.

Is there a shortage of progesterone? 

As of the 19th of May 2023, the department of health and social care

issued a serious shortage protocol (SSP) across the UK for Utrogestan, currently the only progesterone only oral capsule licenced for the treatment of HRT in the UK.  

The new SSP will limit amount a pharmacist can dispense on the NHS no more than 2 months’ supply. (1) 

What is progesterone?  

So, what does progesterone do? Progesterone, a steroid hormone belonging to the group of progestogens, is primarily secreted by the corpus luteum in the ovary during the end of the menstrual cycle. Its role is significant in both the menstrual cycle and early pregnancy. However, during menopause, progesterone is also needed for the following reasons:

1. Hormonal balance: Progesterone helps maintain a balance with oestrogen, which decreases during menopause. It restores hormonal equilibrium in the body. 
2. Protecting the uterus: Progesterone thins the lining of the uterus, reducing the risk of abnormal growth that can lead to endometrial cancer. 
3. Symptom relief: Progesterone can alleviate menopausal symptoms such as mood swings, anxiety, sleep disturbances, and vaginal dryness. 
4. Bone health: Progesterone supports bone density and helps prevent osteoporosis, a condition that becomes more common after menopause. 

Progesterone is often used in hormone replacement therapy (HRT) to address these needs. Consultation with a healthcare professional is important to determine the appropriate use of progesterone HRT options based on individual circumstances.  

Menopause without progesterone can have several effects on the body. Progesterone is one of the hormones that naturally declines during menopause. 

What is Utrogestan? 

Utrogestan is a female hormone called progesterone that is used in conjunction with another medication called oestrogen. The combination of utrogestan and oestrogen is a type of medicine known as hormone replacement treatment (HRT).  

Utrogestan, in combination with oestrogen, is used to alleviate menopausal symptoms. It is only used in women who still have a uterus (womb). Utrogestan is not a contraception pill. 

The amount of the female hormone's oestrogen and progesterone in your body decreases as you approach menopause. HRT replenishes these hormones and helps to alleviate menopausal symptoms. 

Utrogestan HRT alternatives  

 Bijuve 

This combined oral therapy was created for women who have an intact womb (i.e., who have not had a hysterectomy) and whose last menstruation was at least a year ago, contains 1 mg of oestradiol (oestrogen) and 100 mg of progesterone.  

Marina coil

The Mirena is an intrauterine system (a "coil" that is inserted inside the womb) that releases progestogen into the womb. It can be used as the progestogen component of HRT for four years for women who are taking oestrogen tablets or using the patches or gel. The Mirena can help to reduce the negative effects of menopausal PMS symptoms. You will need to speak with your regular doctor if you would like the Mirena coil.  

Body identical HRT vs Synthetic HRT

Bioidentical hormones are derived from plants, whereas synthetic hormones are derived from synthetic compounds. There is no evidence that bioidentical hormone therapy is any safer or more successful than synthetic hormone therapy.

Where to get alternative HRT from?

At Oxford Online Pharmacy, Hormone replacement therapy is one of our most popular treatment categories, we are helping to relieve hundreds of women from symptoms associated with the Menopause. We offer a vast range of HRT products, from oestrogen only patches to combined progesterone and oestrogen therapy we may have the treatment you’re looking for. Get in touch today with one of our healthcare professionals to find a treatment that’s suitable for you. 

We also accept the HRT prescription payment certificate for licenced HRT medicines. To find more information on how to apply for a HRT certificate, see our dedicated HRT prepayment blog here. 

References: 

1.      Department of Health and Social Care, Supply update: hormone replacement therapy medication Utrogestan, Maria Caulfield MP, Published 20 May 2023