A study has shown that SOME healthcare providers are prescribing “twice the recommended dose” of HRT, putting women at risk of deadly cancer.
Hormone replacement therapy (HRT) is a treatment that uses synthetic estrogens and progesterone to relieve the symptoms of menopause.
These include issues such as anxiety, mood changes, and trouble sleeping.
However, a recent investigation by Pharmaceutical magazine (PJ) found that women attending private menopause clinics were given “unorthodox” prescriptions.
In some cases, women receive HRT with very high levels of estrogen, which can lead to an increased risk of certain types of cancer and bleeding.
NHS states that the risk of developing breast cancer may increase if the body is exposed to too much estrogen.
Experts on Cleveland Clinic also state that cancers such as ovarian cancer and endometrial cancer depend on the development of hormones.
This is because HRT prescriptions in England have risen by more than a third in just one year as symptom awareness has become more widespread.
Increased demand for life-changing drugs means shortages have continued since 2018.
Several pharmacists and nurses have stated that they have encountered patients receiving very high doses of estrogen as HRT.
Speaking to PJ, Brandon Jiang, an Oxford-based clinical pharmacist, said his team is increasingly receiving letters from private clinics asking them to prescribe estrogen doses that are not recommended by NICE, the body that informs the NHS.
“The worst thing I’ve seen is double – that is, 200 micrograms – a maximum of 100 micrograms of Evorel patches,” he added. “And that was in addition to vaginal estrogen and topical gel use.”
Nuttan Tanna, consultant for hospital pharmacists in London, said she received similar feedback in her region: “[We have] referral for a bleeding study and then discover that the patient has taken very high doses [of oestrogen] previously prescribed by private providers.”
British Menopause SocietySAM), told the SP that he was aware of the problems associated with prescribing by private providers and was addressing the issue “as a matter of priority”.
Are you in danger?
For most women, HRT is a safe option, with small risks that are often outweighed by the big benefits it can bring, says the NHS.
These risks include a very small increased chance of getting breast cancer.
But it is important to remember that some of these small risks can be reduced simply by changing the way a woman is given HRT.
For example, administering estrogen through the skin instead of ingestion reduces the risk of blood clots.
While there may be small long-term risks, there are long-term benefits as well.
These include a reduced risk of osteoporosis, as well as potential benefits against bowel cancer, osteoarthritis, heart disease, and cataracts.
If you have been prescribed HRT at a private clinic and are concerned, talk to your doctor, nurse, or pharmacist to see if the dose you are taking is safe for you.
In a joint statement, Dr. Paula Briggs, Chairman of BMS, and Dr. Haitham Hamoda, former Chairman, said the public is “very well aware” of the problems associated with “unorthodox appointments” by private providers.
“We have been contacted by a significant number of members, non-members and women questioning regulations that do not comply with national licensing guidelines and recommendations.
“We are working with other specialized societies and colleges that share our concerns to address this issue as a matter of priority,” the letter said.
Debra Holloway, a gynecological nurse, said it’s “unusual” that you’ll need higher doses of estrogen than recommended.
She said that if you give someone higher doses of estrogen and don’t counter it properly, you put the patient at an increased risk of hyperplasia and cancer.
Responding to concerns, Magnus Harrison, chief medical officer of Newson Health Group, the UK’s largest private menopause clinic, explained that some women require higher doses of estradiol because estrogen absorption through the skin is “variable”.
For young women with premature ovarian failure, studies have shown that higher doses of estradiol are needed to achieve a physiological response, Magnus said.
He said that low levels of estradiol at menopause are associated with an increased risk of diseases such as cardiovascular disease, osteoporosis, type 2 diabetes and dementia.
He added that data on the actual dose of progesterone to provide adequate endometrial protection is “unreliable.”
Just this year, some HRT pills became available without a prescription for the first time.
The move is part of a campaign to improve women’s health by improving access to HRT.
The government was forced to act on access to HRT after supplies of critical drugs ran out in the spring and patient concerns were exposed by The Sun Fabulous Menopause Matters campaign.
Fabulous menopause issues
It is estimated that one in five people in the UK currently suffers from it.
However, menopause is still whispered in a low voice like it’s something to be embarrassed about.
The stigma attached to the transition signifies that women have suffered in silence for centuries.
The Sun is determined to change that by launching the Fabulous Menopause Matters campaign to kick-start the taboo and get women the support they need.
The campaign has three goals:
- Make HRT free in England
- Ensure every workplace has a menopause policy to support
- To break taboos around menopause
The campaign was supported by many influential people, including Baroness Karren Brady CBE, celebrities Lisa Snowdon, Jane Moore, Michelle Heaton, Zoe Hardman, Saira Khan, Trisha Goddard, as well as Dr. Louise Newson, MP Carolyn Harris, MP Jess Phillips. , MP Caroline Noakes and MP Rachel McLean.
An exclusive study commissioned by Fabulous, which surveyed 2,000 British women aged 45-65 who are going through or have experienced menopause, found that 49% of women suffered from depression, and 7% experienced suicidal thoughts during menopause.
50% of respondents said that menopausal women are not getting enough support, which is simply not enough. It’s time to change that.
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