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Ongoing shortages of HRT and contraceptives remain unacceptable and continue to harm women, say professional bodies

7 February 2020

For the past year many women in the UK have been unable to access their hormone replacement therapy (HRT) due to ongoing manufacturing and supply issues, causing distress for clinicians, patients and pharmacists.

More recently we have become aware of a shortage of contraceptives. As well as this affecting the physical and mental wellbeing of women and girls, we are concerned this situation may lead to a rise in unplanned pregnancies and abortions, whilst inadvertently affecting the most vulnerable in our society.

Today our three organisations - The Royal College of Obstetricians and Gynaecologists, The British Menopause Society and The Faculty of Sexual and Reproductive Healthcare - have written to the Secretary of State for Health and Social Care, Matt Hancock, calling for a working group to be set up to address these ongoing supply constraints.

Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:

"We understand the HRT supply situation should begin to improve from February 2020 as the range of products which supply 70% of the HRT patch market will be re-introduced to the UK market. However a number of HRT medications and contraceptives remain unavailable, some until the end of this year, and some with no timeline as to when they will be back on the market.

"While we are grateful to the Department of Health and Social Care (DHSC) for working closely with suppliers to re-introduce some of these products to the market, it remains unclear why there is a shortage in the first place or when the normal supply of the products might resume. The lack of transparency around why these shortages have occurred is extremely frustrating.

"Thousands of women and girls have been adversely affected by this ongoing situation and they deserve better. We are calling on the DHSC to set up a working group with industry, regulatory agencies and our organisations to get to the root of why shortages in both HRT and contraceptives have occurred. This working group must work together to ensure that this situation is prevented from happening again."

Mr Haitham Hamoda, Chair of the British Menopause Society (BMS), said:

"We are continuing to provide advice to prescribers on alternative products available and we are keeping our website updated on what treatments are available based on information from the manufacturers. For the majority of women, supplies of alternative HRT products are available and women affected should discuss alternatives with their doctor."

"It is very frustrating that we still do not know why these shortages are happening, and why they seem to be unique to the UK. While we understand the DHSC is working with suppliers, we remain concerned about these shortages which need to be addressed urgently."

Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare (FSRH), said:

"We are very concerned by the continuing reported shortages of contraceptives which may inadvertently lead to a rise in unplanned pregnancies. We have received queries from our members who are finding it increasingly hard to prescribe contraception.

"We are aware that women are sent away with prescriptions for unavailable products and end up lost in a system that is frustrating to navigate. This is causing utter chaos for patients, clinicians and pharmacists.

"For some contraceptive methods, a truly equivalent alternative just does not exist. This is the case of Sayana Press, a self-injectable contraceptive. Women who use Sayana Press now have to see a healthcare professional to access a non-self-injectable alternative, which is undoubtedly an extra burden for them, increasing demand in busy GP practices and sexual and reproductive healthcare clinics. At the moment, the resupply date for Sayana Press is unknown.

"These shortages disproportionately affect the most vulnerable in our society, for example a woman struggling to access clinics, or a transgender patient, who is already under psychological distress, and for whom changing contraceptive preparations could cause further difficulties."

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