Analysis

Too HRT to handle? First the ‘pill’, now HRT – how OTC brings us a step closer to making choice a reality for women’s health

Ramona Aning

Could the announcement this week that hormone replacement therapy might become available over the counter signal a dramatic change in women’s health? Having worked in women’s health for the last three years, hear what our new Account Director Ramona Aning has to say.

There has been a lot of buzz lately around women’s health and with the impending arrival of the government’s Women’s Health Strategy it’s fair to say that it seems that women’s health is finally getting the attention it deserves.

While there’s undoubtably a lot to do, and the actual implementation of changes which will improve and sustain women’s health will take time, there is a sense of optimism that we’re at least on the way.

This week’s announcement by the MHRA, the UK medicines and healthcare products regulator, that it’s considering reclassifying a hormone replacement treatment (HRT), making it available over the counter (OTC), could signal a dramatic change for women who are dealing with the symptoms of menopause.

At a time where primary care is stretched, providing more options and choice to women to actively manage their health is a welcome step, however with choice also comes great responsibility.

In the call to evidence public survey for the government’s Women’s Health Strategy, “only 9% of respondents felt that they had enough information on the menopause, and many had not learnt about or been educated on the menopause until they were experiencing it.” So, while HRT might be more readily available, do women feel confident in knowing when to seek it out?

When reforms are considered to give women more choices to manage their health, it’s imperative that this is underpinned with a full programme of education, including unbiased and clear information about any treatment choice, to equip women to make fully informed decisions.

Let’s not be down about however, because we have seen bigger strides in making choice a reality for women’s reproductive health over recent years, with campaigns tackling period stigma, an influx of ‘femtech’ gear for menstrual cycle tracking and family planning, and not to forget, the revolutionary change of making the ‘mini pill’ available over the counter. However, less focus has been given to improving choices for the millions of women entering, or are in the midst of, post-reproductive age.

It’s no secret that women’s health needs change over time. However, what has transpired is that there are common threads of needs and experiences that span across the different stages of our health journeys, with choice being instrumental to improving our health experiences and outcomes. Whether it’s freedom of choice due to advances and technologies providing more options, the power of choice giving women agency to choose the best care for themselves, or information which arms women to be able to make informed choices – the reality is that every aspect of choice is linked.

However, tackling the broader elements of ‘women’s health’, to make choice a reality for women, is made up of a multitude of different aspects and touchpoints across women’s life cycle; acknowledging the conditions themselves, tackling institutionalised behaviours, treatment development,  improving the ability to access services and solutions, and investment and commitment to developing broader innovations. And, as highlighted in the Vision for the Women’s Health Strategy, as well as other research such as the Global Women’s Health Index, it’s imperative that any reforms must adopt a ‘life course approach’ to truly close the gap in women’s health experiences and outcomes, regardless of the stage of live they are in.

It’s also not just simply about providing women with information, but consideration must be given to the way the information is communicated, who communicates it and most importantly, it must be inclusive, so it speaks to all women. For too long conversations about menopause have been taboo and normalising conversations about menopause through a consistent drumbeat of proactive communications, using different tactics, will be key to move the conversation forward.

Data shows, that many women do not feel as comfortable talking about menopause with friends, family and healthcare professionals as they do about other topics such as pregnancy, which is why it’s been welcoming to see public figures like Davina McCall and others openly speak about their experiences. Tackling stigma and moving the conversation about menopause out of the shadows into the open will be crucial to the spread of information and education, and maybe the introduction of over the counter HRT can play a part in this, bringing us one step closer to making choice a genuine reality for women’s health.