Theramex has been censured over HRT failures that regulators said jeopardised patient safety.

The UK producer of HRT drugs, including Evorel and Intrarosa, was found to have breached fundamental compliance standards.

These included not updating crucial prescribing information, in some cases for several years, and not making clear that one drug must not be used during pregnancy.

The Prescription Medicines Code of Practice Authority issued the public reprimand after Theramex staff blew the whistle over what it described as “alarming” compliance issues and incomplete prescribing information for Evorel and Intrarosa that “jeopardise patient safety”.

Evorel patches, which contain estradiol, are among the most prescribed forms of transdermal HRT, meaning hormone treatment delivered through the skin. More than 250,000 items were issued in the last financial year, according to NHS Business Services Authority figures.

Overall, nearly 10m items of estradiol, including gels, were prescribed in the 2024/25 financial year.

The employees’ concerns included failing to provide comprehensive side-effect information in Evorel’s prescribing information, and not updating Intrarosa’s product information since 2019.

The PMCPA also reprimanded the company over failures to specify in advertising at a reproduction and advertising conference that Yselty, used to treat uterine fibroids, should not be taken during pregnancy.

In total, the PMCPA found Theramex had breached the Association of the British Pharmaceutical Industry’s code of practice 21 times.

The panel said the breaches not only jeopardised patient safety, but that Theramex had “brought discredit upon, and reduced confidence in, the pharmaceutical industry”.

The PMCPA also condemned Theramex’s decision to leave the regulator’s jurisdiction.

“By leaving the self-regulatory framework and requiring the Medicines and Healthcare products Regulatory Agency to assume full responsibility for regulating it, Theramex has inevitably delayed any regulatory action and oversight,” it said.

Dr Amit Aggarwal, medical director of the ABPI, said: “Theramex has fallen seriously short of the standards expected under our strict ABPI code of practice, and it’s right that the PMCPA took action.

“It’s also disappointing that as a result, the company has decided to leave the pharmaceutical industry’s self-regulatory system, which holds companies to standards above and beyond the law.”

Julian Beach, MHRA’s executive director of healthcare quality and access, said he was disappointed Theramex had left the PMCPA, but that the MHRA would take any necessary steps to ensure patient safety.

He said: “Leaving the jurisdiction of the PMCPA does not mean a company escapes scrutiny.

“The MHRA has legal powers to investigate and act on concerns about medicines that may impact public safety. Breaches of regulations can amount to criminal offences.”

A spokesperson for Theramex said: “Upholding ethical standards, compliance, and patient safety is very important to us. We acted promptly to address these historical matters as soon as we became aware of them.

“We take these matters seriously and have undertaken a comprehensive review of our compliance framework, including commissioning an independent external audit and implementing a broad programme of enhancements.

“As part of this process, we concluded it is most appropriate to be regulated with respect to UK medicines legislation by the MHRA, while continuing to uphold the spirit and principles of the EFPIA and ABPI codes of practice.

“Therefore, we withdrew from the PMCPA’s jurisdiction in January 2026. This approach allows us to focus our resources on maintaining high standards of ethical and compliant behaviour, with patient safety.”

Resistance training improves hip strength, balance and flexibility during menopause and may also improve lean body mass, research suggests.

A study of 72 active women aged 46 to 57 found those who completed a 12-week supervised programme saw greater gains than those who kept to their usual exercise routines.

None of the participants were taking hormone replacement therapy.

The supervised, low-impact resistance exercise programme focused on strength at the hip and shoulder, dynamic balance and flexibility.

Participants used Pvolve equipment, including resistance bands and weights around the hips, wrists and ankles, and also lifted dumbbells of varying loads.

Women in the resistance training group showed a 19 per cent increase in hip function and lower-body strength, a 21 per cent increase in full-body flexibility and a 10 per cent increase in dynamic balance, meaning the ability to stay stable while moving.

Those in the usual activity group did not show any significant improvements.

Previous studies have assessed the decline in lower limb strength and flexibility during menopause, but this is said to be the first study to compare the effect of resistance training on muscle strength and mass before, during and after menopause.

This was done by including participants in different phases of menopause rather than following the same participants over a long timeframe.

Francis Stephens, a researcher at the University of Exeter Medical School in the UK, said: “These results are important because women appear to be more susceptible to loss of leg strength as they age, particularly after menopause, which can lead to increased risk of falls and hip fractures.

“This is the first study to demonstrate that a low-impact bodyweight and resistance band exercise training programme with a focus on the lower limbs, can increase hip strength, balance, and flexibility.

“Importantly, these improvements were the same in peri- and post-menopausal females when compared to pre-menopausal females, suggesting that changes associated with menopause do not mitigate the benefits of exercise.”

Although one of the researchers sits on Pvolve’s clinical advisory board, the researchers said the company did not sponsor the study or influence its results.

Stephens added that any progressive resistance exercise training focused on lower-body strength is likely to yield the same results.

He said: “The important point is for an individual to find a type of exercise, modality, location, time of day etc., that is enjoyable, sustainable, and improves everyday life.

“The participants in the present study reported an improvement in ‘enjoyment of exercise,’ and some are still using the programme since the study finished.”

Kylie Larson, a women’s health and fitness coach and founder of Elemental Coaching, who was not involved in the study, said the results were compelling.

She said: “This is particularly exciting for those that tend to think of menopause as ‘the end’. The study proves that if you incorporate strength training you can still make improvements to your muscle mass and strength, which will also have a positive ripple effect to your ability to manage your body composition.

“In addition, staying flexible and being able to balance are both keys to a healthy and functional second half of life.”

Participants in the study did four classes a week for 30 minutes each session, but Larson said even half that amount of strength training can go a long way, particularly if you emphasise progressive overload, which means gradually increasing muscle challenge through more weight.

Larson said: “Gradually increasing the challenge is what drives real change.

“Lifting heavier over time is what builds strength, protects your bones, and keeps your body resilient through menopause and beyond.”