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No HRT, no problem

No HRT, no problem

I’m not going to make sarcy comments about the current HRT shortage furore. I’m not a sexist, misogynist dinosaur, so it would be entirely unlike me to make cheap and ill-informed points about how various patients have in the recent past faced various quite serious medication-based shortages without them getting that hot, bothered, flushed and sweaty about it.

Also, I’m not going to point out that the great HRT shortage seems to have given Ukraine a run for its newsworthy money, possibly because the whole topic of women’s health seems politicised, media-worthy and over asserted (compared to, let’s think, men’s health) and yet the drum bangers somehow still seem to insist that the subject is under-represented, stigmatised and mocked. Mocked! It would be ridiculous to say that, so I won’t. Though re-reading that last para, I realise I have made one mistake, which is that I’ve just remembered I am, in fact, a dinosaur.

Being Jurassic, I can remember a long way back. And I can honestly say that the Government’s reaction to the great hormone deficiency treatment deficiency has been unprecedentedly speedy, clever and pragmatic. By simply rationing the usually lengthy prescriptions to three months, it has ensured that everyone shares and plays nicely.

But if the answer to a, er, health crisis is to decisively impose a system of rationing, aren’t we missing an open goal here? After all, flush-busting oestrogens aren’t the only things in short supply in the NHS, are they? GPs are at a premium, too. And if perimenopausal women can be noble enough to accept restrictions on personal supplies of HRT for the greater good of womankind, then patients should man/woman up for the benefit of the general populace. By which I mean, restrict themselves to seeing the GP only three times a year, tops. This doesn’t just mean less demand. We know that 10% of our list create 90% of our work – if we could spread those consultations around a bit to the less frequent attenders then everyone gets a go, diagnoses aren’t delayed and everyone’s happy.

So menopausal women, you may have suffered – but you might have achieved something marvellous, and can be very proud. No wonder you’re blushing.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at



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Patrufini Duffy 10 May, 2022 4:19 pm

Don’t show this to Davina or the new Tsar of HRT. First world problems. I saw a gynaecologist talk recently and the last slide said “If all else fails, change your husband”. That kind of sums this up. The UKs inability to create a generic factory on the doorstep of the elite in the countryside, is like any other inability, embarrassing. Let’s not start on insulin and PPE. Big business is HRT. Probably will bring General Practice to its knees alone at this rate of disproportionate somatisation. Dishing out testosterone to a woman is always a questionable trendy activity, that makes even a Dinosaur frown or laugh, a good money seller though for all these pop up nurses flouting on the internet. If men aren’t getting some so ubiquitously, you do wonder, what’s exactly is going on here? I think this is going to turn out like Botox and Fillers, a free for all market making a quick buck and augmenting reality. And you’re right. Contraception and pill checks are a big bug bear blocking clinical time, and now menopause will hog even more. The NHS doesn’t realise what it’s conjuring here. A massive storm. And I bet you they don’t give it GUM or gynaecology, just dump it on your lap. But Davina said women aren’t taken seriously. I think that needs some evidence base which is easily extractable by data and attendance across primary and secondary care. **Let’s just hope the UK sertraline supply chain is impenetrable, because that certainly would trump HRT, and be truly cataclysmic. I suggest stock up in case.

Dave Haddock 17 May, 2022 4:39 pm

We seem rationed to zero GP consults per year currently.
Telephone fob-off don’t count.