Hormone replacement therapy may soon be available over the counter without the need for a consultation – however, could there be unintended downsides?
At the Menopause Clinic, we are experts in bioidentical hormone replacement therapy and so must express a clear interest in this proposed change.
You might also assume we are against it as it is a change that could impact our business. If people can get hormones over the counter, they won’t visit a specialist clinic.
However, this does not concern us. Our business thrives through word-of-mouth recommendation, there will always be other options a woman can choose – other clinics, other treatments, other advice.
Our concern is that a one-size-fits-all approach can so obviously not equal a properly prescribed solution.
An over the counter treatment and a prescribed treatment administered only after a sample has been analysed are very different.
At our clinic, you would consult with an expert and also have a blood sample taken, this then sent away from analysis. From this, a fully tailored set of bioidentical hormones will be created, bioidentical meaning they are matches of the hormones produced by the body, rather than synthetic approximations.
These hormones are matched to that individual patient and how their hormonal balance has changed.
There would also be follow-up conversations to ensure the impact of the hormones was as expected, and we could use our expertise to make any small changes as required. Then, after a year a new sample would be taken, this capturing how hormones have changed over the last 12 months. A new prescription is created.
Details of the over the counter alternative are still to be ironed out, but it is likely to be similar to how you might get a pain killer.
You would go up to the service hatch and say you wanted hormone replacement tablets – after a couple of cursory questions, the option vaguely closest to your needs would be chosen – perhaps an option for women experiencing severe menopausal symptoms in their mid 40s.
This might have some impact and so could be considered a success but, importantly, it won’t have the maximum impact. It might make menopause a little less of a concern, but still not great.
Libido might improve a little, the headaches might lessen, but still be there.
It is so different from treating a temporary source of pain. If you need painkillers for a headache then, in all likelihood any will do a passable job. The headache will lessen and then it will disappear of its own accord quite naturally over time regardless of the medication.
But the menopause will not just disappear, if the treatment is suboptimal it will go on being sub-optimal.
Announcing the changes, A Department of Health and Social Care spokesperson said: “We understand that for some women menopause symptoms can have a significant impact on their quality of life, and we are committed to improving the care and support they receive.”
This is all completely accurate, but it fails to address the fundamental fact that not every treatment might be equal.
Visiting a clinic or your GP for more specialist advice might seem burdensome, but it is a one-off appointment for ongoing benefit. Offered only for reference, it is worth noting that our appointments typically take less than an hour and after that the process is remote – the prescription is sent to your door follow-ups are via Zoom.
It is actually less of a burden than walking to Boots to collect an over-the-counter treatment (not to mention the fact that you don’t run the risk of them being out of stock).
If the proposed changes lead to greater awareness of perimenopause and menopause then they are of huge benefit, nobody should suffer in silence or through lack of knowledge that treatments exist.
However, it also needs to be accompanied by an information programme that makes it clear to women that more tailored approaches are available and that the over the counter option might not deliver the level of change they might wish for.
If you are interested in further information about BHRT therapy, or would like to book in a consultation with specialist Deborah Vines, please contact us at Menopause Clinic – one of the few clinics to offer this important form of treatment.
Please call us today on 01706 691 683 or via email to book in an initial consultation.