"I am a BRCA carrier - the shortage of hormonal therapy endangers my life"
After choosing to undergo an oophorectomy to reduce the risk of cancer, I discovered that the hormonal therapy I need has become an ongoing struggle to obtain medication. Phone calls to pharmacies, searches in online groups, and recurring shortages that harm thousands of women. This is not how treatment recommended by the healthcare system should look.
How is it possible that in the Israel of 2026, where hundreds of thousands of women are in menopause, there is still no continuity in the supply of hormone replacement therapy? How is it possible that women are forced to trek between pharmacies, travel from city to city, and search for medications in WhatsApp or Facebook groups? In the last half year, there have been ten instances of marketing cessation and shortages of hormonal preparations, and there are still not enough alternatives or generic preparations to ensure treatment continuity. Many women have been forced to chase after obtaining the medication, and in some cases, to stop vital treatment.
For many women in menopause, this shortage harms their quality of life. For women who entered surgical menopause following a risk-reducing oophorectomy, it can also harm their health. I am a carrier of a mutation in the BRCA gene; like me, there are thousands of women in Israel who know they are at high risk of developing ovarian cancer, an aggressive disease that is often discovered only at advanced stages. The medical recommendation for many of us is clear: finish childbearing at a young age and undergo a risk-reducing oophorectomy. This is not a simple decision, but it is the decision that saves our lives from deadly cancer.
When doctors recommend that BRCA carriers undergo a risk-reducing oophorectomy, they explain that hormonal therapy will help prevent some of the secondary morbidity caused by the sudden cessation of ovarian activity, will maintain bone and heart health, and will help maintain quality of life. However, in the last half year, this promise has repeatedly clashed with the reality of shortages. To our regret and astonishment, women find themselves in an exhausting pursuit of the medication that is supposed to be available to them, calling pharmacies, exchanging information in social media groups, and sometimes forced to switch between different preparations only because the treatment that was tailored for them does not exist.
This is not an inconvenience. Hormone replacement therapy is not a luxury, and it is not a cosmetic treatment. For many women, and especially for BRCA carriers who underwent oophorectomy at a young age, this is vital medical treatment intended to reduce the consequences of sudden estrogen deficiency: to maintain bone health, reduce the risk of cardiovascular diseases, assist in cognitive function, and alleviate dozens of symptoms that affect quality of life.
Yana Wasserman, a doctor of clinical pharmacy and a volunteer at the 'Good Genes' (Ganim Tovim) association, explains that the shortage of medications does not stem from a lack of estrogen, but from a limited number of preparations and manufacturers and the lack of a sufficient variety of alternatives in Israel. While in other countries there are additional preparations, generics, and regulated mechanisms for switching treatment during periods of shortage, in Israel the options are much more limited. In the UK and Australia, for example, there are mechanisms that allow for regulated switching between preparations during periods of shortage, alongside the publication of professional guidelines for doctors and pharmacists. The limited variety in Israel in this field quickly turns any shortage into a crisis for thousands of women.
Moreover, the problem does not end at the pharmacy. Even women who manage to obtain the medication sometimes struggle to receive the medical support they need. The number of doctors specializing in menopause is still small, appointments are long, and not every doctor is deeply familiar with the unique characteristics of surgical menopause. Women who have made a dramatic medical decision to save their lives deserve a complete medical envelope, not just the surgery, but also everything that comes after it.
The State of Israel recommends this surgery and even funds it, and rightly so. But its responsibility does not end in the operating room. It must ensure that even on the day after, there will be available treatment, a variety of preparations, alternatives in times of shortage, more doctors specializing in menopause, and a medical envelope that will allow women to continue living healthy and full lives. It is impossible to encourage women to take the bravest step to save their lives on one hand, and on the other hand, leave them to fight alone for the medication that allows them to live the day after. It is time for the State of Israel to ensure that this sentence is not only medically correct, but also correct in reality.
Libi Margolin is the CEO of the 'Good Genes' (Ganim Tovim) association.
