Written by Thy TranHoang
What does Hormone Replacement Therapy (HRT) look like outside the United States?
Women all around the world experience menopause. While hormone replacement therapy may be common in the United States, some women in other countries do not refer to hormone replacement therapy to treat menopause symptoms. The availability of hormone replacement therapy products is also dependent on the country’s demand for these products. So, what does hormone replacement therapy look like outside the United States?
Estradiol hormone skin products are licensed in most parts of Europe, North America, Australia, and Asia. Hormone replacement therapy products were approved by Health Canada in 2003 for treatment of menopause symptoms. Estrogen only and estrogen + progestin pills are the two most common hormone replacement therapy products in Canada. A study conducted by the National Institute of Health as part of the Women’s Health Initiative concluded that estrogen + progestin pills are not ideal for long term usages in postmenopausal women due to increased risks for heart disease, stroke, breast cancers, and blood clots.
Middle Eastern countries do not have many hormone replacement therapy products available because a very small percentage of women in the Middle East use hormone replacement therapy. China is the Asian country that has the most hormone replacement therapy products available, but access to these products is very selective. Menopause in Japan is considered to be a natural life occurrence and women in Japan do not experience severe menopause symptoms compared to Western women. As a result, they do not refer to hormone replacement therapy.
Furthermore, women in Asia prefer to use herbal or alternative medicines to relieve menopause symptoms. Pharmaceutical companies in the United Kingdom have discontinued the most products due to commercial reasons. This decision paired with increased demands in the past decade has led to a hormone replacement therapy product shortage in 2018. Up until 2022, the United Kingdom had to ship hormone therapy products from other European countries. Products that were not licensed in the United Kingdom needed to be approved in order to be prescribed. There are also products that are licensed, but cannot be used due to formula restrictions.
Hormone replacement therapy products in countries outside the United States seem to not be as common due to licensing requirements or low demands, while shortages in products are due to sudden increase in demands.
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Sources:
- Chandler, J. (2021). Menopause around the world. Mindset Health. https://www.mindsethealth.com/matter/menopause-around-the-world
- Hamada, H. (2020). Availability of menopausal hormone therapy products worldwide. Maturitas, 141, 87-88. https://doi.org/10.1016/j.maturitas.2020.02.002
- Reed, B. (2022). HRT products could be sent to UK from mainland Europe next week. The Guardian. https://www.theguardian.com/society/2022/may/13/hrt-products-could-be-shipped-to-uk-from-europe-next-week
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