This Women’s Month, as I celebrated women’s strength and discussed health issues that affect us, I found myself on a personal quest for my menopause medication. For months, my hormone replacement therapy (HRT) patch had been a lifeline, improving my sleep, clarity, memory, patience and overall presence.
Then one day, it simply vanished from pharmacy shelves. It was unavailable. As a doctor, I understand that medicines can “disappear” for many reasons – manufacturing problems, supply chain issues, regulatory hurdles or procurement failures. Yet, knowing the intricacies behind the shortage doesn’t make the medicine any more accessible.
I started calling around and managed to get a higher-dose patch to maintain continuity, but it caused severe headaches. I even considered cutting it in half, an instinctive act of desperation.
It struck me how easily a patient can be nudged away from a carefully planned treatment plan into a world of makeshift solutions.
Fortunately, I have gynaecologists on speed dial, a privilege many women don’t have. Awareness of menopause is improving, but access to treatment remains a challenge. Even with a prescription, women may struggle to obtain the necessary medication, and a patch is a user-friendly option.
During my search, I spoke with pharmacists from two major pharmacy groups in South Africa (SA). I posed a provocative question: “What happens when medicines for erectile dysfunction are unavailable?” One pharmacist chuckled and said: “Men complain loudly; they fight. We make sure we have stock.” While I can’t generalise from one anecdote, it does make you ponder – whose grievances does our healthcare system prioritise? This isn’t to downplay the importance of erectile dysfunction medications for those who need them.
The larger issue is why women’s suffering, such as that caused by menopause, often goes unnoticed, and is expected to be endured in silence. Menopause affects half the population, yet it’s frequently dismissed as merely a natural part of ageing. Of course, women will manage and survive.
Still, strength shouldn’t equate to the absence of need, and resilience shouldn’t be an excuse for unnecessary suffering. Imbokodo is the woman who carries the weight of her world and knows that taking care of herself is not a sign of weakness.
A prescription is not access.
HRT access
HRT treatments are personalised, and when appropriate, we must ensure reliable access. Merely having a prescription doesn’t equate to receiving care. Instead, it often leaves women hopping from pharmacy to pharmacy, searching online, joining WhatsApp groups, and grappling with whether to ration their dwindling supplies.
Consider the teacher who suddenly seems a bit more short-tempered. The nurse who’s become unusually irritable. The executive who struggles to maintain focus in a crucial meeting. The woman who whispers, “I just don’t feel like myself anymore.”
Women’s health doesn’t just impact individuals; it ripples through families, workplaces, communities and economies. Unmedicated women might be labelled as not coping, “difficult” or moody, affecting their self-esteem.
This Women’s Month, let’s move from awareness to action. The pressing question we should be asking this month is: is HRT adequately recognised as an essential medicine in both public and private healthcare sectors?
Eventually, my patch returned, but when I learned that a pharmacy had only three boxes in stock, I took all three. It may seem like hoarding, but to me it’s continuity-of-care anxiety. My confidence in the supply chain has been shaken.
Shaping health policy
I’m grateful, but gratitude alone doesn’t shape health policy. This Women’s Month, let’s dig deeper: Are we genuinely building systems that work for women? We can’t keep encouraging open conversations about menopause while leaving women to cope with medication shortages.
Manufacturers and distributors must be transparent about disruptions; pharmacies need to improve stock tracking and communication; healthcare professionals should receive timely updates when products become unavailable; and regulators and policymakers need to treat these recurring shortages as a significant public health concern.
Menopause care is essential healthcare and a prescribed minimum benefit across all medical schemes. It shouldn’t depend on luck or privilege.
This Women’s Month, let’s make sure the health system is listening. DM
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