Having Trouble Getting Your Estrogen Patch? Here’s How to Navigate Shortages

Increased demand for hormone therapy treatments and intermittent supply disruptions have created what experts say is a perfect storm that is leaving many women frustrated at the pharmacy counter.

Transdermal estrogen patches — a commonly prescribed form of menopausal hormone therapy — can be hard to find these days.

“We’re getting the phone calls from our patients who are calling to say that their pharmacist says that the estradiol patch that they’re using is on back order,” says Dr. JoAnn Pinkerton, an obstetrician-gynecologist at UVA Health and emeritus executive director and past president of the Menopause Society. “It has been very frustrating and very inconvenient for women who rely on their patches.”

Without the patches, menopausal symptoms — such as hot flashes, night sweats and brain fog — can return, she adds.

Though estrogen (estradiol) patches are not included in the Food and Drug Administration’s (FDA) drug shortage database, the American Society of Health-System Pharmacists listed 10 different estrogen patch products on its drug shortage bulletin as of Feb. 19.

The patches, typically worn on the lower abdomen, deliver estrogen through the skin. This form of hormone therapy supplements the body’s declining estrogen levels during menopause and can help ease common symptoms.

Rising awareness, interest in treatments play a role

A growing awareness of menopause, shifting attitudes toward hormone therapy and changes in FDA recommendations have contributed to the shortage, women’s health experts say.

“Women are saying they’re learning more about hormone therapy, that it is not something to necessarily be avoided. There’s a greater comfort level with it, and they’re going to their doctors and they’re asking for it,” says Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine.

The FDA’s recent removal of black box warnings from menopausal hormone therapy products is also a contributing factor. Since the early 2000s, hormone therapy products have carried warnings about increased risks of cardiovascular disease, breast cancer and possible dementia, leading to a sharp decline in their use.

Recent research, however, has found these risks have been overstated, and that the benefits of hormone treatment outweigh the risks for many women.

“This has led many women to want to reconsider hormone therapy, when before they or their providers might have been fearful,” Pinkerton says. Couple that with manufacturers that may not have anticipated a surge, Pinkerton says, and the result is empty shelves at some pharmacies.  

The good news: “Manufacturers tell us that they’re working to meet this demand,” Pinkerton says. However, the intermittent shortages could continue through the year.