Plans to sell vaginal HRT tablets over the counter

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Vaginal oestrogen tablets - a type of hormone replacement therapy (HRT) - could be available in chemists depending on the outcome of a consultation.

Under the proposals, women would be able to get them without a prescription instead of going to see their GP.

HRT is used to treat menopause symptoms - and 150,000 women have prescriptions.

Doctors caution that pharmacists and women need to be well informed on the choice of treatments available.

The UK medicines regulator, the MHRA, is proposing to reclassify a product called Gina10, or estradiol - which treats vaginal dryness caused by lack of oestrogen - as a pharmacy medicine. This change would make it available to buy in chemists.

The tablets, which are inserted into the vagina, are for women aged over 50 who have not had a period for at least one year.

Pharmacists will have access to training materials and a checklist to help them identify women who can be offered the treatment, the MHRA says.

The regulator is now asking GPs, pharmacists and the public for their views on the proposal as part of a consultation, external which is open until 23 February 2022.

Minister for Women's Health, Maria Caulfield, said menopause support was "a key issue" which the government needed to do more to address.

"This consultation is another step forward to ensure women's voices are being heard loud and clear on how they want to access HRT to reduce the impact of the menopause on their lives," she added.

As part of its Women's Health Strategy, the government has set up a UK-wide taskforce to focus on the menopause.

In October, it was announced that the cost of repeat prescriptions for HRT would be significantly reduced in England, but the changes have yet to be brought in.

'Very safe'

HRT replaces the hormones that are missing during the menopause - particularly oestrogen - and relieves symptoms, such as hot flushes, night sweats, sleeping problems, brain fog and mood changes.

It is available as tablets, skin patches, gels and pessaries.

Some types of HRT slightly increase the risk of breast cancer and blood clots in some women, but the risks are small and usually outweighed by the benefits,, external NHS advice says.

The Royal College of Obstetricians and Gynaecologists (RCOG) said they welcomed improved access to HRT, but stressed that women should still feel able to talk to a doctor about their symptoms and discuss all treatments available.

Dr Edward Morris, RCOG president, said "every woman will experience the menopause differently" and that meant treatments needed to be tailored to individual needs and symptoms.

Menopause specialist Dr Louise Newson called the vaginal tablets "a local hormonal treatment" which could treat irritation and also help combat urinary symptoms.

According to Dr Newson, 80% of women going through the menopause experience those symptoms, but only 8% access treatment.

"It's different to HRT and it doesn't reduce the health risks of the menopause, but it is very safe," she said.

Dr Paula Briggs, a consultant in sexual and reproductive health at Liverpool Women's Hospital, said that making HRT available over the counter would be "a good thing to do". But she said it needed to be done carefully, by ensuring education for pharmacists and women on how to access the right treatments.

She also said pharmacists should be able to look at patients' medical records to check their history before advising on a treatment.

Thorrun Govind, from the Royal Pharmaceutical Society, said the proposal was "an important step in the right direction" and would particularly benefit those who struggle to access healthcare, while also helping busy GPs.

She said the Society supported scrapping prescriptions charges for HRT products altogether in England.

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