The Rise of Estrogen Patch Demand Amid Supply Shortages
Late last year, the Food and Drug Administration (FDA) removed black box warnings associated with hormone replacement therapy, leading to a surge in demand for estrogen patches. Currently, however, these patches are facing significant supply constraints as their popularity continues to climb.
According to Dr. Robert Kaufman, a professor of obstetrics and gynecology at Texas Tech University in Amarillo, the use of transdermal estrogens has increased markedly in recent years. As a result, many physicians and patients are struggling to obtain specific doses of estrogen patches. Yet, the FDA has not yet classified these patches as being in short supply.
FDA Commissioner Dr. Marty McCully noted that demand for estrogen patches surged following the removal of black box warnings last November. Despite this spike in usage, he stated that it has not reached a level that would justify a formal shortage declaration. However, he acknowledged that manufacturers are struggling to keep pace with the growing demand and are adjusting their distribution and manufacturing processes to provide a more stable supply.
Being featured on the FDA’s shortage list is crucial, as it may prompt actions such as identifying alternative suppliers or extending a drug’s expiration date. Hormone replacement therapies are essential for alleviating symptoms like hot flashes, mood swings, and urinary track infections, and they come in various forms including estrogen-only, progesterone-only, or a combination of both hormones.
The Reasons Behind the Estrogen Patch Scarcity
The shortage of estrogen patches can be attributed to several factors. The American Society of Health-System Pharmacists (ASHP) has included 14 brands or doses of these patches on its recent shortage list, first reported in January. Michael Ganio, ASHP’s senior director of pharmacy operations, explains that their list is curated from reports by healthcare practitioners and patients experiencing shortages.
Dr. Lauren Streicher from Northwestern University noted that the absence of estrogen patches frequently arises in discussions with women about menopause. Similarly, Dr. Kathleen Jordan from Midi Health indicated that her patients are increasingly encountering challenges when trying to fill prescriptions for estrogen patches, noting that the situation has worsened since last year.
Kaufman remarked that while West Texas has experienced notable shortages, reports of similar issues are surfacing nationwide. In contrast, Alloy Health, a menopause-focused telemedicine company, claims that its patients have not been significantly affected by the shortages. However, Ganio pointed out that the FDA’s assessment of drug availability relies heavily on historical data, which may lag behind current demand trends.
Factors Driving Increased Demand for Estrogen Therapy
The landscape of hormone therapy dramatically shifted after the 2002 Women’s Health Initiative study linked hormone therapy to heightened risks for postmenopausal women. This led to a sharp decline in prescriptions, dropping from 22% to just 5%. Nonetheless, recent research suggests that starting hormone therapy earlier and maintaining it longer than previously recommended may offer additional benefits for women.
Data from healthcare analytics firm Truveta revealed a staggering 184% increase in estrogen-based prescriptions among women aged 45 to 54 between 2018 and 2026, with a 20% surge occurring between July 2025 and February 2026 alone. Dr. Jordan noted that this uptick is partly due to women now taking hormone therapy for extended periods, contrary to older guidelines that suggested a duration of five to ten years.
The evolving treatment paradigm means that more women are returning for prescription refills, particularly favoring estrogen patches due to their cost-effectiveness, substantial safety data, and greater insurance coverage compared to alternative therapies.
Outlook on Restoring Estrogen Patch Supply
The timeline for replenishing the estrogen patch supply remains uncertain. Although manufacturers are reportedly increasing production, some patches may remain scarce for an extended period. Dr. Stephanie Fabion from the Mayo Clinic mentioned the potential for the situation to improve by year-end as production ramps up.
It’s important to note that pharmaceuticals are typically produced in batches planned months in advance, which could hinder rapid increases in supply. Ganio emphasized that manufacturers are committed to boosting production in the coming months.
Alternative Solutions for Patients
For women unable to obtain their usual estrogen patch, switching to different brands or applying two lower-dose patches may serve as viable options. Dr. Fabion highlighted that estrogen is available in a variety of forms, including topical creams, oral rings, and vaginal rings. Switching between the two types of patches—one replaced bi-weekly and the other weekly—could also ensure continuity in treatment.
In cases where alternatives are sought, various options exist. Oral estrogen has been recognized for its benefits in managing cholesterol levels, while vaginal rings are effective for addressing dryness and urinary infections. All transdermal estrogen options, including gels, creams, and patches, are considered comparably safe, though coverage by insurance may vary.
