Australia 

Patch Shortages

There are a number of MHTs that are currently unavailable. Please note that the TGA has approved some unregistered products under Section 19A and some substitute doses are currently in supply in Australia.

Pharmacists are encouraged to contact suppliers Medsurge Healthcare Pty Ltd on 1300 788 261 for orders of Estramon and Sandoz on 1800 726 369 for orders of Estradiol Transdermal System.

Oestradiol patches

Combined patches

All doses of Climara have been deleted from the market and there will be a reduction in supply until supply is exhausted.

The AMS Guide to MHT Doses (Australia only) provides a guideline to approximately equivalent doses of the different MHT/HRT products in Australia.

The Australasian Menopause Society (AMS) provides education to health professionals to improve the healthcare of women at perimenopause and after menopause.

The AMS welcomes discussion of menopause and efforts to improve access to appropriate care. However, we have recently become aware of spurious claims being made about menopause and hormone therapy by some health professionals on social media and in opinion pieces. These claims are presented as mainstream expert opinion, but some of them do not accord with current evidence-based guidelines.

The concerning content includes:

• Promotion of menopausal hormone therapy (MHT) for treatment of a wide variety of symptoms that may not be related to menopause.

• Promotion of MHT for primary prevention of cardiovascular disease and dementia prevention for women at the usual age of menopause. This is not supported by evidence or current guidelines.

• Not using agreed definitions of the perimenopause, leading to patient treatment with MHT outside of accepted indications. Perimenopause is defined as beginning when menstrual cycle changes occur as per the STRAW +10 criteria.

• Promoting testosterone as a routine component of MHT and promoting testosterone for non-specific symptoms such as fatigue or ‘brain fog’, or to improve general wellbeing. The only evidence-based indication for testosterone currently is hypoactive sexual desire dysfunction in postmenopausal women. Evidence for testosterone to treat any other symptom or for disease prevention is lacking.

• Minimising risks of MHT and making overly simplified statements regarding the highly emotive area of MHT use and breast cancer risk. Much more research is needed before it can be said that any of the available forms of MHT are risk free with regards to breast cancer.

• Suggesting that breast cancer survivors can routinely be prescribed MHT. There are very occasional circumstances when women with breast cancer may be prescribed MHT but it should be a careful decision involving multidisciplinary discussion.

MHT is the most effective treatment for menopausal symptoms and has a role in preventing osteoporosis and fracture. It can be offered to women who are medically eligible, along with an individualised discussion of the benefits and risks. AMS promotes a balanced, evidence-based discussion of the benefits and risks of hormone therapy.