Do women need HRT in menopause? HRT shortages and testosterone in menopause
In the latest episode of the Zing Wellbeing Podcast, hosted by Rhian Allen, listeners are treated to an enlightening conversation with Dr. Ceri Cashell, a Sydney GP with a special interest in women’s health, including hormones and menopause.
The episode delves into critical topics surrounding menopause management, including the potential use of testosterone for treating menopause symptoms and the ongoing shortage of Hormone Replacement Therapy (HRT) patches affecting countless women across Australia.
Zing Wellbeing is a holistic health and wellness platform founded by Rhian Allen, former owner of The Healthy Mummy. The platform is dedicated to empowering women to thrive through every life stage, with a particular focus on hormonal health, menopause, and overall wellbeing.
Over the past year, a significant shortage of HRT patches has left many women without essential treatment. Rhian shares her personal experience, stating, “I was given patches over a year ago, and they went out of stock. I haven’t had any for 12 months, so I stopped HRT.”
Dr. Cashell discusses the complexities behind this shortage, pointing to our healthcare system’s reliance on large pharmaceutical companies, and she expresses concern about the supply chain's future.
“The companies that manufacture natural estrogen patches view this product as a small part of their portfolio, and the off-patent status means there's little financial incentive to prioritise production. The much-loved weekly patches were divested in 2022, and that same year, they reduced their budget for female research and development. There is little incentive for pharmaceutical companies to improve that supply chain,” Dr. Cashell explains.
“We’re relying on businesses to provide healthcare solutions, but the reality is that their focus is primarily on profit. There is a significant disconnect in our system that does not serve people well,” she adds.
Despite the challenges, Dr. Cashell offers hope: “If you’re on patches, you can use the gel instead.”
The conversation also explores the underutilised option of testosterone therapy for women in menopause. Dr. Cashell notes, “Testosterone levels decline as women age, and those with low levels may experience a range of symptoms, including loss of libido, fatigue, and cognitive issues.” She emphasises that testosterone is currently only licensed in Australia specifically for women with Hypoactive Sexual Desire Disorder, but its benefits may extend beyond libido to mood, energy, and overall well-being.
“Seventy-five percent of studies into testosterone have looked into low libido, which is where most of our evidence is. While that’s a limitation, there is some evidence that testosterone can positively impact bone density, energy, and even joint pain,” Dr. Cashell states.
“It’s important to remember that we are all different. This is where art meets science; it’s not about targeting blood levels, but how the individual is feeling and what else is going on. It’s never just one thing,” she explains.
Testosterone therapy may be appropriate for some listeners as part of a comprehensive approach to menopause management, particularly for those who have not found relief with traditional estrogen and progesterone treatments.
Inspired by the discussions on the podcast, Rhian Allen is contemplating further advocacy for women impacted by the HRT patch shortage, highlighting the urgent need for better access to hormonal treatments in Australia.
Tune in to this episode of the Zing Wellbeing Podcast to explore these vital issues and gain valuable insights into menopause management.
You can also see the Zing Wellbeing menopause diet plan and program here
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