Women nationwide are facing significant challenges obtaining estrogen patches for menopause relief as a nationwide shortage continues to worsen, potentially lasting up to three years according to industry experts.
The supply crisis stems from dramatically increased demand following the Food and Drug Administration’s policy shift last year. Federal health officials began promoting hormone replacement therapy as “lifesaving” treatment in July, then eliminated long-standing safety warnings in November.
Data from health analytics firm Truveta shows patch usage jumped 26% through February after the FDA’s November announcement. More than one million American women enter menopause annually, and growing numbers are turning to estrogen patches to manage hot flashes, mood changes, and sleep problems.
“When the FDA removed the safety warning in November, it created unprecedented demand that cannot fully be met at present,” explained a representative from Swiss pharmaceutical company Sandoz, which has increased shipments to help address the shortage.
The patches deliver estrogen directly into the bloodstream through the skin as a form of hormone replacement therapy.
Dr. Gillian Goddard from NYU Grossman School of Medicine noted the dramatic shift in usage patterns. “For 20 years, less than 5% of women took hormone therapy. Now those numbers are growing… and scaling up production of medications is not as easy as it might seem,” she said.
Although federal officials haven’t formally declared a shortage, women are visiting multiple pharmacies, adjusting dosages, and switching between different brands or treatment types to find available supplies, according to interviews with patients, telehealth providers, and industry specialists.
Medical experts warn that suddenly stopping treatment can cause symptoms to return, while changing brands may trigger new side effects.
Amy Satterlund, a 50-year-old product manager from Fort Pierce, Colorado, has relied on estrogen patches for approximately 18 months but recently encountered supply difficulties.
She described having to anticipate shortages at CVS locations and endure extended wait times through online pharmacy Cost Plus Drugs.
“I do get nervous if I were unable to get my prescription refilled, that side effects or that the symptoms of perimenopause would come back,” Satterlund explained.
CVS Health confirmed that manufacturers haven’t been able to provide adequate quantities in recent weeks. Cost Plus representatives said they’ve increased inventory to meet exploding demand but haven’t received information about prolonged shortages from suppliers.
Andrew Nixon, speaking for the U.S. Health and Human Services Department, said the FDA is working with companies to support efforts to increase patch availability.
FDA Commissioner Marty Makary reversed previous cautionary guidance about hormone replacement therapy last July. Through interviews and public statements, he argued that women had been discouraged from these treatments due to cancer concerns, but that scientific evidence had evolved.
The 2002 Women’s Health Initiative research had connected hormone therapy to elevated risks for certain cancers, dementia, heart attacks and strokes. Currently, the American College of Obstetricians and Gynecologists website outlines both risks and benefits of various hormone replacement therapies and recommends annual discussions between patients and doctors about continuing treatment.
Truveta’s analysis of electronic health records covering over 130 million patients nationwide found that most hormone replacement therapy forms have increased in recent years, with estrogen patches showing the steepest rise of 184% since 2023. Vaginal cream hormone therapy usage climbed 122% during the same timeframe.
By February 2026, approximately five out of every 100 women aged 45-54 had received estrogen-based hormone therapy prescriptions, nearly doubling since 2023 based on analysis of women who received medical prescriptions during that period.
Telehealth platform HRT Club, which connects patients with hormone therapies and physicians, reported patch sales increased 150% following the FDA’s November actions.
Estrogen patches are generic medications with minimal profit margins, giving manufacturers little financial motivation to rapidly invest in new production facilities or equipment that can require years to establish.
Long-term supply contracts can also prevent manufacturers from quickly responding to demand fluctuations, according to industry sources and medical professionals.
Leading patch manufacturers, including Amneal, Zydus, Sandoz, Noven, and Viatris, all have certain dosages in short supply, according to the American Society of Health-System Pharmacists.
Amneal and Viatris confirmed they’re working to increase patch production to satisfy demand. Zydus and Noven didn’t respond to requests for comment.
Dr. Mary Rosser, an obstetrician-gynecologist and director of Integrated Women’s Health at Columbia University, said the FDA has options to address shortages. These might include requiring manufacturers to maintain more diverse backup supply chains and mandating minimum stock levels with proactive monitoring systems.
The FDA declined to discuss such possibilities.
“People have waited a long time to make a decision… about whether they want to use hormones,” Rosser observed. “Then they make the decision and then they can’t get them.”
