Estrogen Patch Demand Surges After FDA Removes HRT Black Box Warning, Prompting Supply Adjustments

The FDA removed the black box warning from hormone replacement therapies in November 2025, a step that FDA chief Dr. Marty Makary said in May 2026 prompted a tremendous increase in demand for estrogen patches. The estrogen patch has been in short supply amid a boom in hormone replacement therapy popularity.

Doctors and patients report difficulties getting certain doses of estrogen patches, though the FDA has not included estrogen patches on its official list of drugs in shortage. Dr. Marty Makary stated that the industry has been able to keep up with demand but barely and is recalibrating distribution and manufacturing for more robust supply.

Inclusion on the FDA shortage list can trigger actions such as identifying alternative suppliers and extending expiration dates. Hormone replacement medications are prescribed to treat hot flashes, mood swings, urinary tract infections, vaginal dryness, difficulty sleeping, and to protect against bone fractures.

They can be estrogen-only, progesterone-only, or a combination of estrogen and progesterone.

The American Society of Health-System Pharmacists includes 14 brands or dosages of estrogen patches on its current list of drugs in shortage. ASHP first started including estrogen patches on its shortage list in January 2026. “ Our list is 100% reported by either practitioners, pharmacists, physicians, nurses or patients and caregivers, ” said Michael Ganio, the senior director of pharmacy practice and quality at ASHP, which collects shortage data in partnership with the University of Utah Health.

Utilization of transdermal estrogen has gone up in the last two or three years, said Dr. Robert Kauffman, a professor of obstetrics and gynecology at Texas Tech Physicians of Amarillo. Estrogen patch shortages always come up when Dr.

Lauren Streicher speaks with groups of women about menopause. “ This was happening occasionally last year but has escalated this year, ” Streicher said. There is a shortage of estrogen patches in West Texas and colleagues all over the country are reporting them, Kauffman added.

A spokesperson for Alloy Health said in an email that the menopause telehealth company has not noticed an estrogen patch shortage affecting its patients. The FDA relies on historic demand data, so its information on current demand increases may be lagging, Ganio said.

U.S. To help pharmacies keep up with demand as of April 2026. NBC News contacted Viatris, Sandoz, Noven Pharmaceuticals and Amneal Pharmaceuticals in May 2026 about the shortage and received no response. From 2018 to 2026, the number of women ages 45 to 54 prescribed estrogen-based therapies increased 184 percent, according to a recent survey by Truveta.

Prescriptions increased 20 percent between July 2025 and February 2026 alone. Women are using hormone therapy longer than in the past, said Jordan of Midi Health. Older guidelines recommended hormone therapy for menopause for five to 10 years and stopping by age 60.

Newer studies suggest women could benefit from starting hormone therapy in their 40s and continuing into their 60s, 70s or 80s, Jordan said in an email. This means more women going to the pharmacy for refills. Estrogen patches are typically cheaper, have the largest amount of safety data, and are more likely to be covered by insurance compared with creams or vaginal rings, Kauffman said.

Pharmaceutical companies typically make drugs in batches planned months in advance. Dr. Stephanie Faubion, director of the Mayo Clinic’s Center for Women’s Health, said companies are increasing production and things should be better by the end of 2026.

Some women may be able to switch to a different brand or wear two patches of a lower dose if their regular prescription is unavailable, Faubion added. There are also other forms of estrogen including topical creams, gels, oral tablets and vaginal rings.

Patches come in two types, one changed twice per week and one swapped once per week, so changing between options can help women stay on estrogen patches even if their usual brand and dose is in short supply.