Women living in England’s most disadvantaged areas are much less likely to be prescribed hormone replacement therapy (HRT) to help them cope with menopausal symptoms. I can reveal.
An analysis of NHS prescribing data revealed large disparities in access to HRT in England.
It happens after I Earlier this month it was reported that women in the UK are finding it difficult to access HRT due to a new wave of shortages.
The shortage has forced many women to seek HRT from private clinics, while others travel across the country or abroad to get prescription drugs.
Now I can show how access to HRT, currently used by about two million women in the UK, varies by postcode and socioeconomic status.
An analysis of all NHS HRT prescriptions in England up to June 2022 using a tool developed by data collection firm GPrX found that GPs in the least disadvantaged parts of England spend three times as much on HRT per patient compared to practice to the most disadvantaged areas.
The tool models NHS prescription data with government indicators for multiple deprivation measures that rank neighborhoods according to 39 different indicators covering things like employment, education and health.
Practitioners in the poorest parts of England spent an average of £4,251 on HRT per thousand patients aged 45–60, while practitioners in the poorest areas spent £12,845 per thousand patients aged 45–60.
Meanwhile, additional analysis of NHS data I found that women living in the south of England were most likely to receive HRT from the NHS.
The three combined health authorities with the highest proportion of patients taking HRT per registered woman over 40 are Gloucestershire (12.5%), Dorset (11.86%) and Surrey Heartlands (11.84%).
North East London (4.96 percent), North West London (5.8 percent) and the Black Country (6.02 percent) had the lowest proportion of patients taking HRT.
How access to HRT is changing in England
Five comprehensive care tips in England with the highest proportion of HRT patients per woman over 40:
Gloucestershire: 12.50% Dorset: 11.86% Surrey Heartland: 11.84% Devon: 11.66% Cornwall and Isles of Scilly: 11.63% The five United Health Boards in England with the lowest proportion of HRT patients per woman over 40:
South East London: 6.97% Central London: 6.59% Black Country: 6.02% North West London: 5.8% North East London: 4.96%
There are also large differences in access to HRT across regions. For example, GPs in the wealthiest areas of North East London spend more than five times more on HRT than GPs in the poorest areas.
In West Yorkshire, general practitioners in the least disadvantaged part of the region spend an average of £17,900 on HRT per 1,000 registered patients aged 45-60, while general practitioners in the most disadvantaged areas spend only £3,400.
Dr. Louise Newsome, a menopause specialist, said part of the reason for the disparity in access to HRT is due to a lack of knowledge about menopause among both women and family physicians.
“One of the problems is that women have been told for years that menopause is a natural occurrence, it just brings on a few hot flashes and you just have to get through it,” she said.
“[Women] “It’s not always taught that joint pain, poor sleep, memory loss, fatigue, hormone levels, depression, anxiety, restless legs, tinnitus, and dry eyes can be caused by their hormone levels,” she added.
Why is there not enough HRT in the UK?
In recent years, there have been serious waves of HRT shortages in the UK.
Last year, after a major nationwide shortage in the spring, the government created an HRT task force, but it was abolished a few months later. Since January of this year, women have been reporting difficulty refilling prescriptions.
Increased media attention and high-profile celebrity campaigns surrounding HRT have led to an increase in demand for the treatment. NHS data shows a 35 percent increase in HRT prescriptions between 2020/21 and 2021-2022 alone.
The supply could not meet the demand. HRT vendors say they need to improve their engagement with government to scale, while other issues including Covid and supply chain issues have also been cited as reasons for the shortage.
In addition, not all HRT products are approved in certain regions, which could exacerbate shortages when approved drugs run out.
According to the British Menopause Society, this is due to “an increase in approved formulas due to the COVID-19 pandemic, changes in the boundaries of prescribing committees to comprehensive care and a lack of prioritization of women’s health issues.”
Demand for HRT in the UK has been on the rise in recent years due to a shift in public discussion of menopause, fueled in part by celebrity campaigns such as Davina McCall.
However, Dr. Newsom said that often women from more privileged backgrounds can arm themselves with the knowledge to ask their GP about HRT.
She said “cultural differences” and “stigma” remain when it comes to seeking treatment for menopause-related symptoms.
“Many people think that HRT is a lifestyle drug used by middle-class women because they want to look like Davina or have beautiful skin and hair, which is absolutely wrong. We use HRT because we want to improve our health in the future and reduce the risk of disease,” she said.
Women also have difficulty accessing HRT because general practitioners are not aware of the symptoms of menopause and the benefits of hormone-based treatments. Newsome added.
“In my career, I have seen hundreds if not thousands of people suffer from dry eyes, joint pain, heart palpitations, urinary problems, decreased libido, depressed mood and anxiety. I never thought about her hormones because I didn’t know there was a connection between them,” she said, referring to her time as a general practitioner before becoming a menopausal specialist.
I spent £500 on private HRT after getting ‘wrong advice’ from my GP.
Lisa Austin, 50, from Hertfordshire, first saw her GP for HRT a few years ago after a hysterectomy.
She was prescribed a small amount of HRT and told not to take a higher dose as it would increase her risk of breast cancer. Ms. Austin’s mother died of breast cancer at the age of 40.
Two months ago, Ms Austin went to a private clinic because she was feeling “very ill” with symptoms such as rapid heart rate and poor vision.
When she visited a private clinic, she was told that there was no increased risk of breast cancer because she was taking estrogen-only HRT, as opposed to combined estrogen-progestogen HRT.
According to the NHS website, combination HRT may be associated with a slight increase in breast cancer risk, but breast cancer risk doesn’t change much when you take estrogen-only HRT.
Ms. Austin, who is a personal trainer, has now increased her HRT prescriptions and started taking testosterone after visiting a private clinic.
“I am like a 25-year-old woman. I get up again, there is no fog in my head, my heart palpitations have completely disappeared, my vision has improved. I wake up rested in the morning,” she said.
It cost her £500 for a consultation and six months of testosterone and she still receives a prescription for estrogen from the NHS.
Ms Austin said she understands that GPs are under a lot of pressure, but said education about menopause needs to be improved.
“This is menopause. We are not talking about a very unusual disease that no one knows about,” she said.
Ms Austin helps many of her PT patients access HRT through her GP and said it is “a guess” whether her own doctor will prescribe the treatment.
“They told me they had joint pain, palpitations and couldn’t sleep. They go through 10 different symptoms of menopause, go to their GP, and get away with being offered antidepressants,” she said.
Alyn Boblin, leader of the transition organization Transformation in Action, says women from wealthier families have easier access to HRT because they have the resources to talk to private menopause specialists who “can solve your problems and give you the opportunity to do so in order to qualify for treatment.” decisions”. . “.
She said health experts may also stigmatize women living in highly disadvantaged areas where obesity, diabetes and other health problems are more common.
“Unfortunately, often the first recommendation is that you should lose weight by doing nothing,” she said.
Dr. Newsom, who runs a private menopause clinic, says 17 percent of her patients see their GP three times a year before seeking private care.
“In our clinic, we also see people from all socioeconomic backgrounds. We see people with the lowest levels of deprivation, but they are desperate to leave and get their jobs back, and that terrifies me. You don’t have to pay for hormones,” she said.
Previous research has also shown that women living in disadvantaged areas are much more likely to be prescribed oral forms of HRT, as opposed to patches or gels, which dr. Newsom is “safer” because they pose no risk of blood clots.
Not all forms of HRT are currently available in all regions of the UK due to delays in local approval of new drugs.
Dr. Newsom said GPs are usually limited by what their region allows them to prescribe, and many areas still require GPs to prescribe pills as “first line.”
“Even if you know you want to prescribe a patch, you may not succeed as a GP, which I really hate. So women are not getting help again,” she said.
NHS England and the Department of Health and Human Services asked for comment.
Source: I News
I’m Raymond Molina, a professional writer and journalist with over 5 years of experience in the media industry. I currently work for 24 News Reporters, where I write for the health section of their news website. In my role, I am responsible for researching and writing stories on current health trends and issues. My articles are often seen as thought-provoking pieces that provide valuable insight into the state of society’s wellbeing.