The October issue of Endocrine news (1) carries an article that once again tackles the complexity of bioidentical hormones.

The freelance US writer highlights the confusion surrounding "bioidentical hormones" and more specifically the compounded formulations that are promoted as "natural".

The 2015 study by Santoro and Pinkerton (2) estimated that 1 million to 2.5 million U.S. women aged 40 years or older are using compounded hormone therapy. This may mean that custom-compounded products represent a quarter to a third of the market for hormone therapy products. Custom-compounded products lack protections of purity, controlled manufacturing processes, and evidence from clinical trials that products from less-regulated compounding pharmacies do not.

Santoro is quoted as recognising “Maybe 1% of people will have a reaction to all forms of hormone therapy and might do better with compounding” but emphasises the availability of "government-approved bioidentical hormone therapy".

The “Compounded Bioidentical Hormones in Endocrinology Practice: An Endocrine Society Scientific Statement” published in The Journal of Clinical Endocrinology & Metabolism in April 2016 (3) is worth a read or review along with Bioidentical Hormones for Menopausal Symptoms. 

20 April 2017: 

Fairfax through The Sydney Morning Herald and The Age, has published a story about the current shortage of oestrogen patches, a hormone replacement treatment used to manage menopausal symptoms.

With so many questions being raised about the shortage, Jean Hailes Medical Director Dr Elizabeth Farrell AO and Jean Hailes endocrinologist Dr Sonia Davison, were asked for some further advice.

With Jean Hailes for Women's kind permission, the advice is as follows:

If I use oestrogen patches such as Estradot (oestrogen only) and Estalis (combined oestrogen and progestogen), what does the shortage mean for me?

While these products are unavailable you might need to consider alternative HRT products.

How do I decide what alternative HRT I should use?

There are different options available, including a topical gel or substituting with another patch, but it's best to make an appointment and talk to your health professional to work out what's appropriate for you.

When are supplies expected to return to normal?

According to an official statement on the website of Novartis, a pharmaceutical company that supplies some oestrogen patches: "Novartis is currently undergoing a disruption in supply of Estradot, Estalis Continuous and Estalis Sequi in Australia. We apologise for the inconvenience this has caused and are working to resolve the fluctuations in supply. We anticipate a return to stable supply in Australia by mid-2017."

I'm a health practitioner, where can I find reliable information on HRT products? 

The Australasian Menopause Society has an excellent guide to MHT/HRT equivalent-dose products (Aus) and MHT/HRT equivalent-dose products (NZ) and should be consulted for further guidance as to other products that may be used.