There are 34 menopause symptoms, which can be as specific as a hot sweat or as utterly vague as insomnia, irritability, anxiety and itching. Photo / Getty Images
There are 34 menopause symptoms, which can be as specific as a hot sweat or as utterly vague as insomnia, irritability, anxiety and itching. Photo / Getty Images
Thousands of people have signed a petition headed by a Bay of Plenty doctor to make more menopause treatment options available to New Zealand women.
Estrogen is one of the main hormones used in menopausal hormone therapy. But in New Zealand, only one way to take transdermal estrogen is publicly funded.
It comes as Pharmac has announced it was experiencing supply issues with oestradiol (Estradot), the estrogen patches currently on allocation in pharmacies. Pharmac made the decision to fully fund the patches without restriction in June 2016.
“I started this petition because New Zealand is lagging behind other developed countries because we only approve one type of transdermal estrogen here, in the form of patches,” Dear told the Bay of Plenty Times.
Dear said transdermal patches delivered medication through the skin.
“This is the safest way to take estrogen, because it does not carry the small increased clot risk that oral estrogen does.
“Many women can’t take oral estrogen because they are at high risk of clots or because they have certain types of migraines that also make it less safe for them.”
GP Dr Linda Dear has launched a nationwide online survey to gather data on menopause.
However, Dear said estrogen patches did not work for all women.
Some had allergic reactions to them or found the patches would not stick on their skin.
“There are also often global supply issues with patches, so we need to have an alternative option more easily available.”
Pharmac last week released a statement advising of “supply issues” affecting oestradiol (Estradot) estrogen patches.
According to the statement, 100 microgram and 75mcg patches were out of stock.
“The most recent shipment [of 100mcg patches] cannot be supplied due to a problem that occurred in transit. We are working to list an alternative brand, Estraderm MX,” the statement said.
“Globally, suppliers are reporting extraordinary increases in demand for oestradiol patches. As a result, they are building up their production capabilities. Disruptions in distribution have also occurred due to global and local supply chain issues caused by Covid-19.
Dear said New Zealand women deserved the same level of transdermal estrogen products as women in other countries.
“There are estrogen gels available, and also a spray. At present, the gels are only available here as an off-licence prescription and are totally unfunded.”
Estrogen gels such as Sandrena and Oestrogel cost between an estimated $22.00 and $32.50 per month.
Dear said she hoped the petition would highlight the need for “these sorts of products” to become licensed and more readily available in New Zealand.
“The companies that manufacture them will then be motivated to approach Medsafe to ask for their products to become fully licensed here.
“This process can often take several years, so the sooner it starts, the better.”
Eventually, once licensed, Dear hoped the products could then also become funded in some way for people who did not get good results from the patches.
“This petition is urging Pharmac to avoid another decade of delay and give New Zealand women fully funded access to more options for the safest form of estrogen.”
By 2030, the world population of menopausal and post-menopausal women is projected to increase to 1.2 billion. Photo / 123RF
Dear, who set up a clinic dedicated to the treatment of menopause in early 2022, previously launched a survey aiming to reduce the stigma around the condition. More than 4000 people took part, with results due to be released this month.
Dear said menopause was an inevitable phase in every woman’s life, and by 2030, the world population of menopausal and post-menopausal women was projected to increase to 1.2 billion.
“Menopausal hormone therapy is a highly effective treatment for all menopausal symptoms,” Dear said.
“When started before the age of 60, it also reduces the risk of heart disease, osteoporosis and leads to a longer lifespan.
“[It] is, therefore, a key aspect for the health and quality of life for many women, particularly those who are plunged into an early or sudden menopause through surgery or medical treatments.”
Pharmac director of operations Lisa Williams said a funding application for alternative presentations of estrogen such as gel would be welcome.
“However, the two gel products the petition asks to be funded - Sandrena and Oestrogel – have not been registered through Medsafe,” Williams said.
“We would need this to happen before we consider a new funding application.”
Williams said that, unlike similar organisations in other countries, Pharmac works within a fixed budget.
“We need to make difficult choices about which items to fund within the available budget. Therefore we cannot guarantee if, or when, a medicine may be funded.”
Williams said to achieve the best health outcomes, Pharmac needed to prioritise its decisions.
“This prioritisation is dynamic, and we must take the time to consider various ways in which funding or not funding a medicine or device would impact New Zealanders. Because of this, we cannot provide a definitive timeframe for if or when treatments will be funded – something we know can be difficult to hear.”
