Dr Michelle O'Driscoll: Free HRT for women... what it will really mean

Menopause is something that will affect about half of the population directly, and the other half will need to be able to support family members, friends or colleagues that are going through it at some point in their lives.

Women are living longer, and we’re living without the supply of hormones that our body needs to function properly. Oestrogen, progresterone and testosterone have very specific and important jobs in terms of bone, cardiovascular and neurological health, but their levels plummet in perimenopause and menopase.

Because we’re living longer, for about a third of our lives we’re making do with vastly diminished levels of these hormones, and suffering the consequences.

There have been many articles included here over the years about menopause – the physiological reasons for it, the symptoms that may present, the impact that these symptoms have on women’s physical, mental and emotional health, and the potential benefits of hormone replacement therapy for those women whose quality of life is affected by perimenopausal or menopausal symptoms, and for whom such treatment might be clinically appropriate.

More and more women are reaching out for advice on this type of support for their health, particularly when struggling with daily life.

Against this backdrop of increasing need and desire for support, it was reported that the Government are considering giving Free Hormone Replacement Therapy for women in Ireland. This would be an incredibly impactful move towards supporting women’s health.

A free contraception scheme has been initiated by them in recent years, and this is gradually increasing its eligibility criteria.

Now it looks like the government are planning on expanding the scope of their women’s health support offerings by supporting the later years in their hormonal decline through free HRT, that has only previously been available to those with a medical card.

And when we say “later years” this doesn’t mean that menopause is an “old woman’s game”. We know that the average age of menopause (one year post last period) is 51, but we also know that symptoms can start eight to ten years before this.

Perimenopause can be debilitating and challenging, and isn’t the always the easiest thing to diagnose. But it can and does affect some women from their mid-thirties, and occasionally even in their twenties.

This government plan for free HRT is forward-thinking, putting the needs of half the population on the agenda, and saving millions of euro in future years thanks to the protective effect that this will have on women’s health. 

Two-thirds of women in the age bracket that are most affected by symptoms are still at work. This will help to keep them there, rather than being unable to cope with debilitating symptoms should they occur.

While that’s certainly not to say that HRT is appropriate for everybody, removal of the financial barriers will unlock previously inaccessible options for some women.

This would be very exciting and promising, although the exact details are yet to be confirmed, but are expected to be in the weeks ahead. We don’t yet know for definite whether there will be any exclusion criteria, e.g. age, or means? It seems that there won’t be, and the hope is that nobody will fall between the cracks in this initiative.

Something else to bear in mind is the ongoing HRT drug shortages. Patches in particular have an unreliable supply history, due in part to the lack of generic options available, a problem also potentially attributable to the increase in demand in recent years, as the myths around the risks of HRT have begun to be put to rest, and public awareness of menopausal symptoms and HRT benefits has grown.

While there are many questions left to answer, these plans can only be seen as positive. Watch this space for more updates as they’re released.