Estrogen patches face shortage as more women seek hormone therapy

Geoff Bennett:

More women are seeking treatment for symptoms of menopause and perimenopause, driving a shortage of estrogen patches, one of the most commonly used forms of hormone therapy.

As Stephanie Sy reports, manufacturers are struggling to keep up with demand, leaving many women to manage a range of difficult symptoms with little relief in sight.

Stephanie Sy:

Geoff, while there are multiple reasons for the shortage, rising demand is at least partly to blame. The popularity of estrogen patches has been surging for several years.

And awareness has grown since last year, when the Food and Drug Administration lifted a 20-year-old black box warning on estrogen that overstated the risks of hormone therapy. We spoke to women across the country who are impacted by the shortage. Here's some of what they told us.

Nicole Stark, Patient:

Hi. My name is Nicole Stark, and I have been on a HRT patch since April of 2025. I had originally talked with my doctor, like I said, back in April. She thought it was a good idea for me then to try something out as a very low dose.

The very first time I put that prescription through, no issue, totally fine. She had put me through for a three-month trial, kind of, and I checked back in with her. It was at that second, I guess, refill, or the first refill at that point that I kind of knew that something was going to be up.

Trevia Mantz, Patient:

My name is Trevia Mantz, and I have only been using the patch for six months. Because the patch is new, for me, missing was a problem, and I actually ended up missing two doses.

Michelle Pearles, Patient:

My name is Michelle Pearles. I have been on the patch for less than one year.

When I started getting these particular patches, which are twice-weekly patches, there were delays in being able to get the medication, and I was not able to get three boxes at a time, which is what we're supposed to be getting pursuant to our insurance policy through Aetna.

Sometimes, I was able to get one box.

Nicole Stark:

So, as of right now, I have actually been without the patch for the last month. The night sweats have been intense. My irritability is definitely not in check. I have been a far less pleasant person to be around, and I know that, but I can't stop it, and it's really unsettling.

Trevia Mantz:

There was panic. There was -- they -- when they said, oh, it's on back order, and then you have to wait, they're like oh, every day, every day. But because I have a clotting disorder, I didn't have the option of creams or lotions, because you can't gauge the dosage as well.

Michelle Pearles :

So I called up Wegmans. They were wonderful. They were very helpful. And they said, yes, we can get you this medication. We can get you three boxes worth tomorrow. But then they called me back and said, by the way, your insurance is not going to cover this.

Nicole Stark:

At this point, I think it's been pretty much weekly that I have checked back with my local pharmacy, and it's the same answer. So -- and they just kind of throw up their hands of, we're not sure when, sorry, is their answer. So I'm not sure what that's going to look like.

Trevia Mantz:

What we ended up having to do was go with a different manufacturer, which, of course, requires different -- going through your insurance and prior authorization. And then I was able to get the patches through them.

Michelle Pearles :

I still had to pay quite a bit more than I would have through my insurance. It's a fair amount more. It's a fair amount more. And right now I'm a full-time student. I'm not working. So it is impacting us. But my quality of life is worth this sacrifice for me at this time.

Stephanie Sy:

For more on this, we turn to Dr. Lauren Streicher, a professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine.

Dr. Streicher, thanks for joining us on the "News Hour."

You heard all those women scrambling for these estrogen patches. Give us a quick sense of how much we have seen demand surge overall for estrogen prescriptions and when the shortages became evident.

Dr. Lauren Streicher:

Well, first of all, I wouldn't call it a surge. I would call it an explosion.

There has been an increase in estrogen prescriptions, 86 percent in the last five years, and 50 percent of those are for patches. So while we haven't had the shortage until recently, it's really the perfect storm of having supply chain issues and tariffs.

And then you put on top of that so many women are suddenly getting prescriptions for patches they never had before.

Stephanie Sy:

We're going to get to the demand in a second, but the supply shortage has no clear end in sight. What tips do you have for women who can't get their prescriptions filled?

Dr. Lauren Streicher:

Well, they have a number of different options.

First of all, sometimes, it's as simple as trying a different pharmacy. There are different distributors. And sometimes maybe CVS has something that Walgreens doesn't. So you do have to do a little bit of looking around, a little bit of footwork.

But the other thing that women are not considering that's critically important is that the patch is not the only form of hormone therapy. Now, we talk about transdermal hormone therapy being preferable for many women, because the absorption through the skin means that it bypasses the liver and it doesn't have an increased risk of blood clots and some other cardiovascular issues.

And that's why a lot of women go the patch route. But the patch is not the only transdermal estrogen. We have transdermal creams and sprays and gels. And all of them are equally safe. So that would be my number one thing is, if you can't get your patch, that doesn't mean that you might not be able to use another transdermal option, not to mention that a lot of women are candidates for a pill, for an oral option.

A lot of women have been led to believe that the only option is the through-the skin option, which has advantages. But there are also advantages to the pill for some women, and some women are perfectly good candidates. So just exploring those kinds of options are useful.

And then if you are a patch person and you want to use that patch, then you can start to do some little tips and tricks, if you will. You can get a patch that's half the dose and use two of them. Maybe you can get a higher dose patch and cut that patch in half, but you need to be aware that you cannot cut every single patch.

Stephanie Sy:

Dr. Streicher, the topic of menopause has become huge on social media, with Hollywood actresses and influencers openly talking about their symptoms and the benefits of hormone therapy. Are these estrogen product shortages an unintended consequence of all that? And how much is hype versus good health advice?

Dr. Lauren Streicher:

Well, there's no question that everyone's talking about menopause, including influencers and celebrities. And this is a good thing. We want people to talk about menopause. But along with that comes the other part, the fact that people are being talked into this idea that every single woman needs to take hormone therapy, no matter what their symptoms are, no matter what their goals are, no matter how old they are.

But the other thing that's happening is that we have a lot more doctors who are put in the position of needing to prescribe hormone therapy. And on one hand, this is a good thing. We want doctors to prescribe it to women that would benefit and that it's appropriate.

But you also have doctors that, quite frankly, are not menopause experts. So maybe they only know about the patch and they tell everyone, the patch is what you should use. The patch is safest. Bioidentical is always best.

And that's not necessarily the case. So it's a little problematic, because it's great that this has become such a topic of conversation. But we also need to keep in mind that this is individualized therapy. And if there was a doctor who prescribed the same blood pressure pill to every single patient that walked in the office, you would say, hmm, that's not a very good doctor.

Yet we have a lot of doctors that are prescribing the exact same hormone therapy to every woman who walks into their office. And that's something that I'd like to see change.

Stephanie Sy:

The FDA reversed those broad warnings about hormone therapy last year. But you have also suggested in your writing that the FDA's messaging about hormone therapy may be leading to undue demand. Can you talk a little bit about that?

Dr. Lauren Streicher:

Yes, some of the statements that were made by the representatives of the FDA, RFK and Dr. Makary, really have not been shown scientifically to be true.

As an example, they talk about how, if women use hormone therapy, that it's going to prevent dementia down the road. The science does not back that up. They talked about how it's going to decrease cardiovascular disease. The science does not necessarily back that up.

Again, it's individualized. There are certain people that are at increased risk. People who have hot flashes, for example, who are not sleeping are going to benefit from getting rid of those hot flashes and sleeping more, which in turn is going to reduce the risk of having dementia or cardiovascular disease down the road.

But we have women who are coming up to me and saying, I'm 65 years old, I missed the boat, I wasn't prescribed hormone therapy, and I feel like I'm doomed. I'm doomed to die of premature, horrible death from dementia or cardiovascular disease.And nothing can be further from the truth.

So we have an awful lot of women who are asking for hormone therapy that not necessarily are going to benefit from hormone therapy.

Stephanie Sy:

Some really important information. That is Dr. Lauren Streicher joining us.

Thank you.

Dr. Lauren Streicher:

Thank you.