"At-risk women in England must be supported, not penalised with HRT prescription charges"

29 October 2021
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Today, the Government pledged to lower repeatable HRT prescription costs and provide better support for women going through menopause in England, after MPs met to debate the landmark Menopause Bill. Women in England currently face years of multiple prescription charges, unlike their neighbours in Scotland and Wales. We explain why the news is a step in the right direction for women with a high genetic risk of ovarian cancer, who currently receive above-average HRT costs when taking steps to cut this risk. 

What was the Menopause Bill?  

Despite HRT being free of charge to women in Scotland and Wales, those wanting to access HRT in England have remained subject to NHS prescription charges. Women were being left behind, which is why we supported Carolyn Harris MP's Menopause (Support and Services) Bill. It proposed providing better menopause support and granting women in England to access free HRT to relieve the physical, emotional and psychological symptoms of menopause.  

What happened?

Today the Government announced that total cost of HRT prescriptions will now fall in England, thanks to the passion and support behind Carolyn Harris's campaign. Although the Government have not agreed to abolish HRT prescription charges, they have said that women will only have to pay a one-off prescription charge for HRT each year. A new cross-government Menopause Taskforce will also be established, led by Carolyn Harris MP, to consider how education and training, workplace policies, and peer groups can support women through menopause.

Why does free HRT matter to women with a genetic risk of ovarian cancer? 

Today's outcome will make a positive and tangible difference to women living with a genetic predisposition to ovarian cancer in England, who may need to access menopause support and HRT from as early as 35 years old.  

1 in 400 women carry a BRCA1/2 gene mutation and 1 in 270 women have Lynch syndrome – genetic mutations that increase a woman’s risk of ovarian cancer to 9-60%. The only option to reduce their cancer risk is to have surgery to remove both ovaries between the ages of 35-45. This triggers the immediate and early onset of menopause symptoms - hot flushes, low energy, difficulty concentrating, anxiety and depression, to name a few - which are often more severe than those in natural menopause.  

HRT can be a life-changing and essential treatment for women who face surgical menopause in exchange for a lower risk of cancer. But they are advised to take HRT until at least the age of 51 following risk-reducing surgery at their own cost. This can be from as young as 35 years old, which adds up to 15 years and (up until now) £1,100 of HRT prescription charges by the time they reach the average age of menopause.   

Removing the NHS prescription fee for HRT and improving access to menopause support would make a huge difference to women like me. It would remove the worry and burden of paying for multiple prescriptions for the next 15 years and would have made the first months of menopause much easier for me as I had to pay for private advice and treatment

Carla from Chester, a BRCA mutation carrier who had risk-reducing surgery aged 38

We’re determined to end the postcode lottery in women’s health 

At-risk women in England must be supported, not penalised with high HRT prescription charges, when taking potentially life-saving steps to lower their risk of ovarian cancer. We hope this Bill will help pave the way to better menopause support services, which we know vary greatly across the country. Our research revealed that 31% of those who had gone ahead with risk-reducing surgery felt they were not fully informed of their HRT choices. Elsewhere we’ve heard patients are waiting up to six months after surgery to attend one of the 29 NHS menopause clinics, when symptoms of the menopause hit from day one.  

Women facing sudden menopause deserve immediate access to expert menopause services and treatment. That’s why we urged the Health and Social Care Secretary to back the Bill and joined with campaigners outside Parliament today to celebrate the fall in HRT costs.

Jo Stanford, OCA’s Cancer Prevention Officer: “As a BRCA mutation carrier I’ve taken all the risk-reducing action I can, including having my ovaries removed last October at age 36. There are so many women struggling with surgical menopause and they deserve real support. Although we are lucky enough to understand and act on our genetic risk of cancer, we also need help to deal with the fallout of risk-reducing  surgery.” 

What’s next? 

The Government is now holding discussions with NHS England to put their pledge into practice. 

Today's news is a positive step forward for women facing a natural and early menopause, even it is not the leap we had hoped for. Women with a BRCA mutation and Lynch syndrome must still pay a price for having risk-reducing surgery unlike those in Scotland and Wales. We'll keep pushing until all women are granted free access to HRT. Because women don't just deserve better, they deserve the best.