top of page

High bridges and low moods

I have had to change my HRT, against my will. For months now, it has been difficult and sometimes impossible for women to find their usual HRT prescription. My usual prescription is Estradot oestrogen patches, applied twice a week continuously, plus utrogestan micronised progesterone, taken for 12 days a month. A few months ago, Estradot suddenly became difficult to find. I wrote to its manufacturer Novartis to ask why, and they sent me a boilerplate response that there were no manufacturing issues, but because a manufacturer of a generic oestrogen product was having issues with its glue, many people were switching to Estradot. They advised me to tell my pharmacist to phone them. I did. No patches, no supply date. I spent a couple of days phoning around pharmacies in Leeds, after my GP's pharmacist gave me the tip that independent pharmacies have different wholesalers, and someone might have some Estradot. 20 phone calls later: I found a box here and a tube of gel there, but nobody could supply me with three months of 200mcg estradot patches twice a week. I read the updates from the British Menopause Society about this mysterious shortage. They didn't call it mysterious but I think it is. It is a shortage denied by its manufacturer. Dr. Louise Newson, whose clinic I sometimes attend, posted a helpful guide to the various products. But what bothered me about this was that it seemed they were interchangeable. In the end, I found a supply of oestrogen patches in a pharmacy in Manchester, that someone had tipped me off about. It was ludicrous: I felt like a bootlegger, phoning desperately to find not whisky but an essential medication that I require to keep me sane and stable and functional. Estradot wasn't perfect, but the patches always stayed on, and I had achieved a mostly stable life on them, with the odd bad day.


But now, against my wishes, I had to switch, to Evorel. These shouldn't have provoked any difference in my body: the oestrogen is the same - beta 17 oestrodiol -- and Evorel, like Estradot, uses plant-based oestrogen. But the patches are huge, and for the first couple of weeks they routinely fell off. And I noticed that my moods were plummeting more frequently than usual. I was back to the time of having at least one day a week where I sat at my desk wanting to weep.


I know that it is not solely the HRT that makes me like this. I know that it is a combination of factors. But I know that menopausal me is a different person to pre-menopausal me, and that I have lost resilience, confidence, vigour and many other things. I find it hard to be curious or enthusiastic. I am numb, and deadened. I find it extremely difficult to write anything, which is a problem when you are a freelance writer and you want to write another book, because you love writing books, but you can't summon up enough love for a topic to write about it.


I'm sitting at my yellow desk writing this in a sort of frenzy. But when I stop, the numbness and bleakness will descend, and I will wonder how I will get home. And what tomorrow will be like.


My chosen hobby is endurance running. Daily life is also endurance, in this menopause. But where is the outcry that millions of women can't get their vital medication? It is not there because they are women and we cope. And because menopausal women are too busy trying to stay sane and above the parapet for outcrying. Crying, though: we manage that.


I wrote this essay a while ago for a new issue of Post-Reproductive Health. It's edited by Dr Hannah Short, an excellent menopause GP, and for once, here is a journal that concentrates on menopause and mental health, still far too neglected, though mental ill health is why many women end up seeking help (and far too many women don't get it, as I know from all the emails I still receive). The essay is called High Bridges and Low Moods. The whole issue is open access until October 28th, and I recommend it.


As for my HRT: like the reality of being a functional menopausal woman, it is a work in progress.

2,920 views8 comments

Recent Posts

See All

Meltdown

8 Comments


Wow. This is exactly me (also in Leeds). Only it's 2022 and there is STILL a "supply issue". I don't like Evorel - I feel like I am back to square one. I was just getting somewhere with Estrodot... Thank you for your post. It's good to know that we're not making things up (although that's a handy gift as a writer) but it's a very real problem

Like
Rose George
Rose George
Mar 19, 2023
Replying to

Same here. I only just got my prescription of Estradot which was submitted on 2 February. The Serious Shortage Protocol was lifted on March 17 and I got my prescription on March 17. Funny that.

Like

Your candor and beautiful writing are a constant gift to us all. This time in our lives presents a real challenge, or rather challenges, considering the shifting and evolving nature of symptoms. I was never much of a drinker, but now any amount of alcohol brings the near certain promise of a migraine. That was easy enough to fix. Initially, I wasn’t so lucky with hot flashes, which began in the early evening and tormented me relentlessly all night, leaving me soaking wet and exhausted every morning. Fortunately, my doctor suggested Relizen, which (after about six weeks) works like magic. I don’t know what other nasty tricks menopause has in store for me, or any of us, but I appreciate…

Like

I’m so grateful for your story. I am in a VERY similar situation here in the US. It took me YEARS to finally figure out that my particular suite of issues is related to estrogen deficiency (tendinitis, tinnitus, vertigo, FEAR, sadness, overeating....). last November my (new) doctor/naturopath wanted me to try a different product since I had complained that my (wonderful and life saving) HRT seemed to not be working as well anymore. she gave me something different (even though the sauce I had been using for 3 years was perfect). I ended up using twice as much as prescribed because it wasn’t working at all. When I ran out too quickly, she refused to see me for 2 WEEKS!…

Like
Rose George
Rose George
Mar 19, 2023
Replying to

So sorry I didn't reply, all those years ago. I finally realised that Wix doesn't inform me when comments are posted, so I don't see them. I hope things improved for you Betty.

Like

Tracey Dooley
Tracey Dooley
Nov 14, 2019

Your story is eerily similar to mine; although I am still searching for a suitable alternative to my usual HRT prescription. Worryingly, my GP decided to prescribe Estraderm MX25, which has HALF the oestrogen dose of my usual HRT prescription and NONE of the progestogen, which is crucial to any woman with a womb! Worse, my GP just ignored my plight for a week or so, while I phoned around various chemists, all to no avail.


I agree: "where is the outcry that millions of women can't get their vital medication?" If men had to rely on HRT, there may have been a revolution! There is a fair amount of secrecy surrounding reasons for the shortages (evidence is hidden because…

Like
Rose George
Rose George
Mar 19, 2023
Replying to

I'm so sorry I never replied to this, I've just realised Wix doesn't inform me when comments are posted, so I don't see them. Three years on, and there are still shortages.

Like
bottom of page