Mental Health Declines, Relationships And Jobs At Risk Without HRT, Survey Results Show

A nationwide survey that canvassed over 2000 hormone replacement therapy (HRT) users has proven how critical hormones are to general health, productivity, and mental wellness.

Almost 2300 women, alongside a small number (1%) of other HRT users, filled out an online survey in June and July. Led by Hawke’s Bay GP, Dr Samantha Newman, the group responsible for the survey say they were frustrated at the lack of action taken by Pharmac, who had failed to plan for ongoing HRT patch shortages, leaving New Zealanders without vital medication and not knowing where to turn. “It was important someone listen to our people who were struggling and that their experiences were documented, validated and shared,” Dr Newman says. “The survey has gifted us new knowledge, proof that HRT is not a lifestyle choice but an essential and life-giving medication, and the perspective to prioritise hormonal health.”

Newman, who runs clinics for women facing perimenopause and menopause, along with other women’s health concerns, says despite hearing worrying stories daily from patients desperate to find the medicines they need, even she was surprised at the results.

“The survey – which we think is the first of its kind in Aotearoa New Zealand – drew responses from people who feared for their jobs, their relationships and their lives. 95 percent had had difficulty accessing their prescription. Almost all had experienced worsening symptoms without access to HRT – 84 percent reported a negative impact on their wellbeing, 65 percent reported physical decline, and over half said their relationships had been impacted.”

Many of the experiences shared were heartbreaking, says Dr Newman.

“I am feeling anxious and depressed,” wrote one respondent, “and I find it hard to function.” Another: “I am less capable at work, particularly in stressful situations where I previously would have thrived.”

And a third: “For me, the HRT is the difference between a liveable and unliveable life.”

Productivity has also been adversely affected, with a third stating that the shortages have affected their ability to perform in their job. 20 percent of teachers and another 20 percent of nurses surveyed have had to skip work due to their worsening health. “And that’s a huge issue for our country when - even when fully staffed to current levels - our hospitals, medical facilities and schools are stretched,” notes Dr Newman.

Other interesting findings were reduced reliance on other medications, such as pain or anxiety medications, when HRT was prescribed. “This excites me as it is what I see every day. And now I have some statistics to back up my experience. There are many health concerns that don’t tick the traditional ‘menopause’ box, but actually are impacted by hormones. We need more research in this area to ensure women access the right medication for their diagnosis.”

HRT patch shortages have placed users under significant financial strain as they spend more money on travelling to alternative pharmacies searching for medication, switching to unfunded medications or paying for additional medical appointments. Over half of respondents had shelled out for extra prescriptions during the shortages.

One user described the lack of medication, information and support as “shocking and frightening. It's as dangerous as heart medication or stroke prevention medication not being available,” and Dr Newman says the comment is typical of the confusion and concern hormone users have felt since the shortages began. “Many expressed anger that the government had not predicted the shortage and responded sooner. A common theme was that this neglect from Pharmac would not happen with a medicine that primarily treats men,” she says.

She also notes the toll the shortages have taken on users who have tried almost everything to keep themselves well.

“Many have resorted to DIY solutions because they are not able to access the medication they need. This includes lowering doses and borrowing from others. One person wrote that they felt like a drug dealer, having to ask others to share their patches, or paying people online to get their supply.”

Pharmac recently opened consultation on a proposal to fund an estrogen gel, news that Dr Newman wholeheartedly supports. “Women have the highest rates of suicide in mid-life, and finding ways to get them the medication they require is of utmost importance.”

Newman recently developed and delivered an education session for primary care providers on issues related to HRT and the shortage of medicines. The full day online course was attended by more than 400, “demonstrating there is an eagerness within the medical profession to understand hormones and support our wāhine” she says.

Following the training day, Dr Newman says she was increasingly questioned by patients, pharmacists and healthcare professionals about how to navigate the patch shortages. “So I spent every evening one week, plus my weekend, developing an advice leaflet. It was arranged at short notice due to the lack of support given at a government level to primary care around these particular issues – there’s such demand and it shouldn’t really be an exhausted GP who is taking on this role on top of a fulltime job!”

Now, she’s hoping insights from the HRT users survey, which will be presented to government health officials, will help spearhead change. “I feel if policy makers more deeply understand how life-giving estrogen is, it will become obvious that this isn’t just about hot flushes. It’s not a supplement or a lifestyle choice. It’s vital medication and continued access needs to be a priority.”

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