How to survive the HRT shortage

For the majority of women who take HRT, the effects can be life-changing, alleviating a range of menopausal symptoms from brain fog and hot flushes to depression and lack of libido.

However, due to supply issues, there is currently a shortage of HRT and, for many, being without their prescription is a terrifying prospect. So are there any alternative ways to manage the menopause that work? I put the question to Dr Samantha Brown, a GP, menopause specialist and co-founder of The Bronte Clinic (, an all-female health centre in London. ‘Nothing will replace your hormones like putting back your hormones,’ she says. However, there are things you can do, she adds, to help manage symptoms if you can’t get your HRT, or have chosen not to take it, as is the case for many women – for example, if they’ve had breast cancer.


First up, advises Samantha, ‘do everything you can to look after yourself. This means reduce alcohol, stop smoking, cut out caffeine, do weight-bearing exercise and focus on getting better sleep.’

Next, up your supplement intake (whether you are taking medication or not). Her first recommendation is magnesium, which 75 per cent of women are deficient in, as increased levels can improve sleep. She also suggests a good omega-3 supplement, which is important for optimal brain function in middle-age, and 400 IU of vitamin D daily, which can help reduce the effects of osteoporosis. Meanwhile, vitamin B12 has been shown to lower the risk of heart disease and alleviate brain fog.

Dr Geoff Mullan – co-founder of bespoke vitamin company, which, through blood tests, tailors supplements to your needs– would add vitamin E to the above list. ‘This vitamin is crucial to the removal of free radicals from the body and tackling the stress and anxiety that is all too familiar to those going through menopause. It works best when consumed in the right dosage of 800 IU per day.’

A specialist in nutraceuticals (targeted nutrition), Dr Mullan says that changes in diet can also optimise women’s health now and beyond the menopausal years.

He suggests increasing your intake of foods that are rich in phytoestrogens, which replicate the effects of oestrogen. These include soya-based products, oats, beans, pulses and cruciferous vegetables (kale, cabbage, cauliflower, spinach). He also points out that the newest bioidentical HRT uses yams, which mimic the oestrogen in our bodies (though at the last look they were nowhere to be seen in my local Sainsbury’s).

There is a buzz around other supplements containing black cohosh and maca root, which have been linked to improving mood and sex drive. Dr Mullan explains that, while they may work for some, there are conflicting views on their effectiveness.

Ultimately there is no magic bullet to solve the HRT shortage, but there are other drugs being trialled. One, set to launch in the near future, could be especially important for women who have had hormone-dependant cancer: it tackles our NK3 receptors, which are widely distributed in the central nervous system and are key to the chemical pathway that leads to hot flushes. During the menopause NK3 receptors can be overstimulated. It’s claimed that in trials this new drug suppressed the pathway, reducing flushes and sweats. There are signs it can possibly improve mood too.


Chinese medicine sees menopause as a positive experience. Known as ‘the second spring’, it is seen as a time of deep energy shift and transformation. Chinese medicine practitioner Katie Brindle recommends the following, which she also used to manage her own symptoms:


By moving your awareness out of your head and into your breath, your heart rate slows, your mind is calmed and your blood oxygenated.


This combination of meditation, movement and breathing exercises is a fundamental pillar of Chinese medicine. Whatever your health issue, it will help to balance it.


Tapping your body with bamboo is an ancient Chinese therapy that works wonders for your general wellbeing, allowing the free flow of circulation, supporting lymphatic drainage and improving energy.

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