There’s an unwritten rule at the chemist that you try not to overhear what the person in front of you is discussing with the pharmacist at the “scripts in” counter. This is hard because you are often barely three feet away.
Earlier this week a woman in front of me flashed her e-script at the pharmacist and asked quickly for estradiol patches. The tone of her question sounded as if she already knew the answer would be no. The pharmacist replied that no, they didn’t have any patches. She started walking quickly away. I stepped in. “Excuse me, did you know that you can also maybe use the gel with the current shortage of patches?”
The woman was understandably alarmed at my unsolicited intervention.
What on earth was I doing? Firstly, only a medical practitioner or pharmacist should be talking to a person about medication. Secondly, I had broken the aforementioned rule of the chemist “scripts in” counter.
Transdermal estradiol patches are sometimes prescribed by doctors for perimenopausal, menopausal and post-menopausal symptoms as part of menopausal hormone therapy (MHT). Hormone replacement therapy is also used during gender-affirming hormone therapy. The patches are applied to the skin and deliver oestrogen directly into the bloodstream.
As Associate Professor Ada Cheung wrote in an article in March this year, Oestradiol is important for bone health, heart health and maintaining mental health and wellbeing. Interestingly, post‐menopausal MHT is also approved for the prevention of bone mineral density loss. A fun fact is that oestradiol is derived from soya beans or sweet potatoes. For more than 12 months there have been serious shortages Australia wide (of the patches, that is, not the vegetables).
The reason I spoke to the woman in the chemist this week, is because I have become quite desperate in my search for these patches. Every week I ring or visit 10 -15 chemists to see if any patches have come in. The answer? No. No. No. No.
The pharmacists always tell me they have no idea when supply will come in. My GP equally has no information about when the patches will be available again. I have been to my GP several times for advice. Most recently she gave me literally 10 different scripts to help me get the required level of estradiol I need, including in the more expensive gel.
Would it be cheaper to eat a tonne of sweet potatoes? Unfortunately that wouldn’t work and I much prefer a little sticker on my bum.
For me, these little patches have been life changing. Before I started on Menopausal Hormone Therapy (MHT) I was a cross between Cruella De Vil and the Sadness character from Inside Out. I was not sleeping. I was depressed. I had horrible hot flashes. I had insane skin crawling that feels like ants and spiders and running all over my skin. A couple of times I literally slapped myself in the face thinking there was a spider there. It was embarrassing and deeply unpleasant.
When I started on MHT my symptoms literally vanished within two days. They do not work this effectively for everyone, but for me they are little angels of saneness.
The Australian Medical Association (AMA) submission to the current senate inquiry into the issues related to menopause and perimenopause initiated by Senator Larissa Waters, has identified that while some Australians have few or no symptoms, many will have symptoms that can be prolonged and severe.
Australia is not currently doing anywhere near enough to make sure we have a regular and secure supply of oestradiol patches.
The TGA, Australia’s medicines and medical devices regulator, is not treating this with urgency and seems to be doing little to ensure regular supply.
Meanwhile our New Zealand neighbours appear to be taking this seriously. The New Zealand medicines regulator, Pharmac, has a clear and long list of actions they are undertaking including:
- Tendering for the supply of patches
- Called for proposals (RFP) from suppliers for oestradiol gel.
- Funding a range of alternative brands of the patches
- Exploring if there are other presentations or products NZ can secure and fund
- Asking suppliers and wholesalers to limit patches they send out trying to make distribution of the limited stock as fair as possible
- Supporting suppliers to speed up delivery of stock into New Zealand and out to wholesalers and suppliers
Why can’t I see a list this extensive on our TGA website? Can we please try as hard as New Zealand?
Right now tens of thousands of Australians are unable to access these potentially life changing medications. Australia pushed hard to get a good supply of Covid Rapid Antigen Tests (RATs) when we needed them. Now the Australian government needs to work harder to get a good supply of these medications.
Or is “women’s” health still not important enough?
- Picture at top: Daisy Gardener. Credit: Pru Aja
Daisy is a writer, campaigner and ratbag feminist. She has 20 years experience working on gender equality and human rights advocacy programs.
