Last updated: 21 July 2022

The British Menopause Society has issued an update on HRT supply to provide guidance to BMS members and clinical practitioners on the current availability of HRT products.

The UK continues to experience shortages in supplies of Oestrogel. Besins have indicated they are receiving deliveries of this product on a regular basis and acknowledge that the current supply is sometimes insufficient to meet the continuing extraordinary demand. Besins have delivered significant volumes of Oestrogel into wholesalers recently, which is approaching double the amount supplied in the same period January to April last year. The company is working to increase and expedite supplies to wholesalers and pharmacies across the country. In addition to the increases described above, Besins Healthcare plans to further increase production capabilities to enable further supplies of this product into the UK market in the longer term.

The BMS advises women who are experiencing difficulty in obtaining Oestrogel to consider equivalent alternative HRT preparations. This could include patches, Sandrena gel (0.5mg or 1mg) or Lenzetto spray preparations.

Prescribers should consider using equivalent preparations to those that their patients are currently using. If an exact match is not possible, prescribers can seek guidance available on the BMS website to clarify equivalent doses:

BMS HRT preparations and equivalents

BMS HRT – practical prescribing

Consideration could also be given to prescribing estrogen and progestogen separately to make the closest match or to find a suitable alternative. Different brands for the same medication may vary in appearance or excipients. However, they would provide equivalent amounts of hormones when used in similar doses.

Besins have recently released a new Testogel sachet (40.5mg/2.5 ml). The new 40.5 mg/2.5ml sachet could be administered off-label over 8 days (1/8th of a sachet will deliver 5 mg) and this is contained in a smaller volume of gel.

Alternatively, Testim (off-label use), Tostran (off-label use) or Androfeme could be prescribed as referred to in the update.

The ongoing challenges brought on by the COVID-19 pandemic have resulted in many women experiencing difficulties in obtaining their HRT supplies. We appreciate that continuing HRT is likely to help many women control their often difficult menopausal symptoms, particularly relevant given the additional stress some women may be under in view of the strains of the current situation on society. In addition, General Practitioners’ surgeries have been under ongoing additional pressure as a result of the pandemic.

We recommend that Healthcare Professionals and prescribers follow the joint guidance issued by the BMS, RCOG, RCGP and FSRH which recommends that General Practitioners and healthcare providers consider advising women about menopause issues through telephone and virtual consultations where possible to reduce face to face engagement, and with easy access to repeat prescriptions of HRT supplies (especially to women who have been on HRT and have not been experiencing any problems with their use). This will help to avoid the need for many women to visit their GP surgery to discuss these issues and assist with obtaining repeat prescriptions. This can be accessed through the following link:

Framework for restoration of menopause services in response to COVID-19

Signposting is also provided to resources on the BMS website as well as Women’s Health Concern (WHC) website, Menopause Matters and the Primary Care Women’s Health Forum (PCWHF).

BMS members can post prescribing queries on the BMS forum if any clarifications are required.

The information on stock availability and supplies below was obtained from the pharmaceutical companies manufacturing these products. We are not in a position to comment on availability at wholesale suppliers’ level and appreciate that availability from wholesale suppliers may lag behind and thus sometimes vary from the information provided by the manufacturers.

Besins Healthcare (UK) HRT products

Information for the public from Besins Healthcare (UK) Ltd regarding Oestrogel® (estradiol (0.06% w/w)) Pump-Pack 750 micrograms/actuation Gel supply status:

As a result of the extraordinary demand we are experiencing for Oestrogel in the UK, we regret that the current supply is sometimes insufficient to meet demand. However, we can assure you that we have supplied, and continue to supply, significant volumes of Oestrogel into wholesalers. From January to end of June 2022, we have delivered almost double the amount of packs into wholesalers as the same period last year.

Besins Healthcare has increased manufacturing capacity in the short term and are seeking further ways to boost supplies in the medium and long term by looking at a range of manufacturing options.

We are committed to communicating any significant changes of supply with patients, healthcare professionals and other stakeholders.

Utrogestan (micronised progesterone) 100 mg in continuous combined regimen and 200 mg in sequential regimens. Available
Testogel 50 mg, gel sachet (sachet over 10 days to provide 5 mg a day). Available
Testogel 40.5 mg gel sachet – a new sachet preparation – is now available. Sachet over 8 days to provide 5 mg a day.
Off-label use for female testosterone replacement (5 mg a day).
Imvaggis vaginal 0.03 mg estriol vaginal pessary. Available

Gedeon Richter


Gedeon Richter is the Marketing Authorisation holder of Lenzetto 1.53 mg/spray, transdermal spray, solution, MA number PL 04854/0130.
Lenzetto is available in the UK, in x1 and x3 pack since 2020. After a period of unusually high demand experienced from early 2022, Gedeon Richter UK have been working with our Gedeon Richter global team to allocate more product to the UK market than that which was originally forecasted for 2022. As a result of this our supply to the market has grown significantly compared to the 2021 levels and previous trends and we estimate Lenzetto’s market share to be around 5% of the UK topical estrogen market in the UK in May and June 2022. As further expansion of our production for the UK market requires several months of preparation time, we are able to keep the current level of supplies in the next 5-6 months, after which we will be in the position to double our current supply volume per month. During this period, we shall focus on the production of 1X pack size and will make sure that the same volume is being sold on the market every month to assure equal supply in the coming months. We are also working on further expansion of ours and our suppliers’ capacities to be able to follow the current growing market demand of the UK in the long run.

We are acutely aware that the current supply level along with disturbances in other products’ supply will impact the availability of Lenzetto to our patients in the coming months. If you are experiencing significant difficulties in obtaining Lenzetto we advise you speak directly to your Dr or Pharmacist. We will continue to work with the BMS and other relevant organisations to ensure our communication remains up to date on this topic.

Vagirux 10 micrograms vaginal tablets. Available

Orion HRT products

With regards to supplies of Sandrena Gel, we have experienced challenges fulfilling orders for the unprecedented increase in demand over recent months. We continue to receive frequent supplies of all HRT products from our European parent company and are doing everything we can to manage and increase supplies for the UK. This heightened demand means that we go out of stock very quickly.

We are sorry about this situation and understand how distressing this is for patients unable to obtain supplies of our products.

We are working hard to secure additional supplies and we hope that this situation will resolve in the coming weeks. We are sorry for the impact this situation is having and we are endeavouring to minimise inconvenience to pharmacies and patients.

Indivina 2mg x 5mg – unavailable with supplies expected mid-August.

Theramex HRT products

Product Availability
Bijuve (estradiol/progesterone) Available – Fully in stock
Evorel® Conti (estradiol/norethisterone) Available – Fully in stock
Evorel® Sequi (estradiol/norethisterone) Available – Fully in stock
Evorel® 25 (estradiol) Available – Fully in stock
Evorel® 50 (estradiol) Available – Fully in stock
Evorel® 75 (estradiol) Available – Fully in stock
Evorel® 100 (estradiol) Available – Fully in stock
FemSeven® Conti (estradiol/levonorgestrel) Available – Fully in stock
FemSeven® Sequi (estradiol/levonorgestrel) Expected September 2022
FemSeven® 50 (estradiol) Available – Fully in stock
FemSeven® 75 (estradiol) Available – Fully in stock
FemSeven® 100 (estradiol) Available – Fully in stock
Intrarosa® (Prasterone) Available – Fully in stock
Zoely® (nomegestrol acetate/estradiol) Available – Fully in stock

Theramex will continue to keep health care professionals informed of any changes. We would like to thank both patients and prescribers for their continued patience.

Note to pharmacists

For pharmacists and healthcare professionals who wish to place orders, please contact Alliance Healthcare via your usual channels.

Novartis pharmaceuticals

Novartis UK is not experiencing any Estradot supply issues at present. However, we have been working very closely with the Department of Health and Social Care (DHSC) to identify solutions to address the increased demand as shown in overall market data.

Our patients and customers are our number one priority and we aim to ensure a fair and equitable access to our medicines, both in the public and private market; for patients in need, no matter where they are and what their background.

If you are a healthcare professional and would like further information, please contact the Novartis Pharmaceuticals UK Medical Information Services by email ( or by phone (+44 1276 698370).

Norgine UK – Estraderm MX patches

  • ESTRADERM MX100 1X24 PATCH GB – out of stock
  • ESTRADERM MX100 1X8 PATCH GB – in stock – good availability
  • ESTRADERM MX25 1X24 PATCH GB – in stock – low availability
  • ESTRADERM MX25 1X8 PATCH GB – out of stock
  • ESTRADERM MX50 1X24 PATCH GB – in stock – good availability
  • ESTRADERM MX50 1X8 PATCH GB – in stock – good availability
  • ESTRADERM MX75 1X24 PATCH GB- in stock – low availability
  • ESTRADERM MX75 1X8 PATCH GB in stock – good availability

Viatris UK Healthcare (previously Mylan)

For stock updates on the Viatris HRT range, you can also visit
Viatris HRT stock can be obtained through AAH, Alliance and Phoenix, if you need assistance from us please contact

Femoston® Range – all available
• Femoston® 1mg estradiol + 10mg dydrogesterone. Available
• Femoston® 2mg estradiol + 10mg dydrogesterone. Available
• Femoston®-conti 1mg estradiol + 5mg dydrogesterone. Available
• Femoston®-conti ultra-low dose 0.5mg estradiol + 2.5mg dydrogesterone. Available

Zumenon® Range – all available
• Zumenon® 1mg estradiol. Available
• Zumenon® 2mg estradiol. Available

Elleste™ oral Range – all available
• Elleste Solo™ 1mg estradiol. Available
• Elleste Solo™ 2mg estradiol. Available
• Elleste Duet™ 1mg estradiol + 1mg norethisterone acetate. Available
• Elleste Duet™ 2mg estradiol + 1mg norethisterone acetate. Available
• Elleste Duet™ Conti 2mg estradiol + 1mg norethisterone acetate. Available

Elleste™ transdermal Range – discontinued
§ Elleste Solo™ MX patches 40mcg transdermal estradiol No longer available (discontinued) (contact Viatris for more information)
§ Elleste Solo™ MX patches 80mcg transdermal estradiol No longer available (discontinued) (contact Viatris for more information)


Currently there are no supply issues with any Pfizer HRT products.

Novo Nordisk HRT products

No shortage of supplies of any of their HRT products:
Kliovance 1mg estradiol + 0.5mg norethisterone acetate. Available
Kliofem 2mg estradiol + 1mg norethisterone acetate. Available
Novofem 1 mg estradiol + 1 mg norethisterone acetate. Available
Trisequens 2mg/2mg/1mg estradiol + 1mg norethisterone acetate. Available
Vagifem 10mcg topical vaginal estrogen. Available
If difficulty obtaining supplies, the company suggested contacting their customer care on:; or telephone 0800 023 2573., to guide them to their wholesale suppliers.


Progynova 1mg estradiol tablets. Available
Progynova 2 mg estradiol tablets. Available
Progynova TS estradiol 50 patches. Available
Progynova TS estradiol 100 patches. Available
Mirena IUS. Available
Qlaira. Available

Endo Pharmaceuticals

Testim testosterone gel. 50 mg tube. Unavailable – due back in stock September 2022.
Off-label use for female testosterone replacement (5 mg a day).
Medical Information Direct Line 0800 069 8421, +353 1 268 2000


Ovestin. Estriol topical vaginal cream. Available but there may be some local shortages until the July.


Estriol 0.01%. Topical Estriol vaginal cream. Available

Flynn Pharma Ltd

Blissel 50 micrograms estriol vaginal gel. Available

Shionogi BV

Senshio (ospemifene) 60mg 28 tablet pack – Available
Shionogi UK has decided to discontinue commercial support behind Senshio (ospemifene). However, Shionogi Europe will continue to support existing and upcoming formulary applications through the EU Med Affairs and Senshio remains available to prescribe in the UK for patients who need it.

Any supply issues, medical information enquiries or questions regarding formulary applications should be addressed to the company on 020 3053 4190 or

Kyowa Kirin Ltd

Tostran 2% Gel. Available
Female testosterone replacement (10 mg per measure to take 2-3 times a week).
If difficulty obtaining supplies, the company suggested contacting their customer care on:; or telephone 01896 664 000.

Lawley Pharmaceuticals

AndroFeme 1 testosterone 1% cream (Specials unlicensed supply). Available
AndroFeme 1 remains available in the UK with no shortages anticipated and the UK ‘specials’ status remains.
On 23rd November 2020 Australia’s regulatory granted AndroFeme 1 full marketing authorisation and registration on the Australian Register of Therapeutic Goods.
The approved indication for the management of hypoactive sexual desire dysfunction (HSDD) in postmenopausal women.

Organon Pharma (UK) Ltd

Livial (2.5 mg Tibolone) (x84 packs). Available
Livial (2.5 mg Tibolone) (x28 packs). Available

GPs and Pharmacists should be able to provide guidance on suitable alternatives.

Paula Briggs, Chairman, British Menopause Society