Calling on NHS Lothian to ensure and enable GPs to prescribe micronised progesterone (Utrogestan) as part of HRT to ensure equity and equality across Scotland in the support of perimenopause and menopause symptoms. And for the Scottish Medicines Consortium (SMC) to remove the need for Peer Approved Clinical System (PACS) for this licensed micronised progesterone. 

Progesterone is needed as part of HRT for women who still have a uterus to protect the lining of the womb. Micronised progesterone (Utrogestan - a body identical hormone) is the safest way to take progesterone as part of HRT, when taking oestrogen and progesterone separately, and is not available in all NHS Scotland regions. The Mirena coil is the only other progesterone alternative offered (licensed for 5 years as part of HRT) and is synthetic. A choice of the form of HRT is essential in the joint decision making between a woman and her doctor in accordance with NICE guidelines. Transdermal (through the skin) body identical HRT is the safest way to take Hormone Replacement Therapy and with Utrogestan not on the NHS Lothian formulary, many women living in this area do not have access to the safest form of HRT. 

I also believe this decision has been influenced by cost: Utrogestan is approx. £59 per patient per year versus £21 for Mirena coil per patient per 5 years. There are many long term health benefits for the women who would like to take HRT including a reduced risk of dementia, osteoporosis and heart disease potentially saving the NHS money.

https://d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/457/Micronised%20Progesterone%20or%20Utrogestan%20v21-02.pdf