Contraception shortage affecting vulnerable women

Shortages of contraception could lead to a rise in unplanned pregnancies and abortions, health professionals have warned.

The Royal College of Obstetricians (RCOG) - along with the British Menopause Society (BMS) and the Faculty of Sexual and Reproductive Healthcare – have called on the UK government to investigate supply constraints in relation to contraception and hormone replacement therapy (HRT).  

A shortage of HRT has affected women for the past year due to manufacturing and supply issues. Whilst the HRT shortage is expected to improve from February 2020, the reason for contraception shortages remains unknown, with doctors unsure when the situation will improve.

One such product affected by the shortage is Pfizer’s Sayana Press – a self-injectable contraceptive and for which no alternative exists.

Dr Asha Kasliwal, president of the Faculty of Sexual and Reproductive Healthcare (FSRH), said: “For some contraceptive methods, a truly equivalent alternative just does not exist. This is the case of Sayana Press, a self-injectable contraceptive. Women who use Sayana Press now have to see a healthcare professional to access a non-self-injectable alternative, which is undoubtedly an extra burden for them, increasing demand in busy GP practices and sexual and reproductive healthcare clinics. At the moment, the resupply date for Sayana Press is unknown.“

Dr Kasliwal warns that the shortages are disproportionally affecting the most vulnerable people in society, such as women struggling to access clinics or transgender patients who require constant access to HRT or contraceptives. 

Dr Edward Morris, president of the RCOG, added: “We understand the HRT supply situation should begin to improve from February 2020 as the range of products which supply 70% of the HRT patch market will be re-introduced to the UK market. However a number of HRT medications and contraceptives remain unavailable, some until the end of this year, and some with no timeline as to when they will be back on the market.

"While we are grateful to the Department of Health and Social Care for working closely with suppliers to re-introduce some of these products to the market, it remains unclear why there is a shortage in the first place or when the normal supply of the products might resume. The lack of transparency around why these shortages have occurred is extremely frustrating.”

The RCOG has called on the Department of Health and Social Care to set up a working group with pharmaceutical companies and regulatory agencies to understand why the shortages are occurring.

The BMS is providing advice to prescribers and patients about the alternative products they can access, though warn patients that they should discuss any medication change with their doctor.

Mr Haitham Hamoda, chair of the BMS, said: “It is very frustrating that we still do not know why these shortages are happening, and why they seem to be unique to the UK. While we understand the DHSC is working with suppliers, we remain concerned about these shortages which need to be addressed urgently.”