Shortage of estrogen medication and increased demand for treatment in perimenopause

Current news regarding price increases and shortages of preparations like Lenzetto are causing uncertainty. Gynecologist Julia Hoge reflects here on the challenges of switching preparations, clinical diagnostics, and the importance of a thorough individual assessment.

Managing medication shortages and switching preparations

Recently, there have been challenges related to the supply of estrogen spray (Lenzetto) and certain types of patches. While this may feel unpredictable for the patient, from a medical perspective, there are good options for maintaining stable treatment. In the event of a shortage of one preparation, we can usually transition the patient to an equivalent dose in the form of a gel or patch. The key is a clear dialogue between doctor and patient to ensure correct dosage when changing the form of administration.

The need for individual assessment over standardized treatment

Today, we see a significant increase in demand for menopause hormone therapy (MHT). While increased awareness is positive, it is important to emphasize that hormone therapy is not a standardized solution. A responsible initiation of treatment requires a thorough review of the patient's medical history and an individual risk assessment. The goal is to identify who will benefit significantly from treatment and who should be considered for other measures.

Limitations of hormone testing in diagnostics

A frequent issue in my practice is the interpretation of blood tests. Many find that their symptoms do not align with "normal" hormone levels. During perimenopause, hormone levels fluctuate significantly from day to day. A single blood test, therefore, only provides a snapshot and is rarely a definitive guide for diagnosis. It is the clinical picture—the patient's actual symptoms—that must form the basis of the medical evaluation.

The importance of sufficient time for guidance and risk assessment

Menopause medicine is a complex and rapidly evolving field. To ensure a safe patient journey, it is necessary to dedicate sufficient time to provide information about both benefits and potential risks. By prioritizing an extended initial consultation, we facilitate a thorough conversation that builds the necessary confidence before starting treatment. This also ensures better compliance and closer follow-up of the patient over time.

A holistic approach to women’s health

The discussion regarding subsidized prescriptions and increased accessibility is important for an equitable healthcare service. At the same time, we must recognize that treating menopausal symptoms requires a holistic approach. For many, hormone therapy will be indicated, but counseling related to lifestyle, preventive measures, and non-hormonal alternatives are equal components of a comprehensive treatment plan.