| Physician Samantha Newman is blunt when it comes to the severe shortage of hormone replacement therapy here in New Zealand: "Women are desperate. I fear for their lives." Newman, who runs a women's clinic in the coastal city of Napier, is particularly concerned about the depression and anxiety that could come on when patients are forced to abruptly discontinue taking estrogen and other hormones. "I've had an email from one woman who is frightened for her life," she told me. "She was suicidal before her doctor prescribed HRT and now that she can't get it anymore, she is panicking. The stories I hear almost hourly are terrifying. I'm deeply worried for the mental, emotional and physical health of HRT users. Will it take a death before the government acts?" HRT is used to treat the symptoms of perimenopause and menopause, including hot flashes, body aches, brain fog, anxiety and depression. Perimenopause is when the body starts producing fewer hormones. It usually begins between the ages of 45 and 55, although some women experience it in their 30s or younger. Menopause occurs when a woman hasn't had a period for 12 straight months. The global supply of transdermal estrogen patches, which sit against the skin and release hormones into the body, began running low almost two years ago. New Zealand's drug buying agency Pharmac was slow to act while it had the opportunity and failed to ensure that alternatives to patches — gels, tablets and sprays — were approved for use and readily available, according to Newman. Pharmac is doing all it can to ensure people continue to get the treatment and has sourced another brand that will be available in coming months, Geraldine MacGibbon, Pharmac's pharmaceuticals director, said in response to my request for comment. Insufficient supply is likely to continue into 2025 amid global shortages and a more than doubling in domestic demand, she said. Frustrated by a lack of information about the shortage here in New Zealand, Newman started her own survey to establish data on the numbers of women affected and the impact it's having on their lives. More than 2,000 people have responded since it launched on June 14, with 13% saying they've been denied medication and 18% saying they've had to take time off of work due to the shortage of HRT.
Some 17% of respondents even said they've swapped or borrowed the medication from a friend. "The survey is already showing us that women are unable to work and parent effectively while their hormone levels are impacted," Newman said. "They're getting sick – mentally and emotionally with anxiety, depression and suicidality, but also physically, with sweating, heart palpitations, severe fatigue and joint pain." Other nations have managed the shortage better, she said. Australian authorities have approved alternative patches until their stocks of the popular brand Estradot are replenished. In the UK, the government has worked to maintain a reliable estrogen supply. "We need the government to understand that this medication is not a nice-to-have or a lifestyle choice – it's not a supplement, or a vitamin," Newman said. "It's vital medicine and without it, people are in agony." —Ainsley Thomson | 
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