Estrogen Patches Face Supply Issues as Demand for Hormone Therapy Rises

The Food and Drug Administration removed the black box warning from hormone replacement therapies in November 2025. Since then, demand for estrogen patches, the most commonly insured form of the treatment, has increased sharply. Doctors and patients have reported difficulties obtaining certain doses of the patches.

The FDA has not included any estrogen patches on its official list of drugs in shortage. Marty Makary said Tuesday that the removal of the warning label prompted a significant rise in demand. “The industry has been able to keep up but barely,” Makary said in an interview.

” Inclusion on the FDA shortage list can prompt measures such as identifying alternative suppliers or extending drug expiration dates. Hormone replacement medications treat symptoms including hot flashes, mood swings, urinary tract infections, vaginal dryness and sleep difficulties.

They also help protect against bone fractures.

The group first added estrogen patches to its list in January 2026, according to Michael Ganio, senior director of pharmacy practice and quality at the organization. “Our list is 100% reported by either practitioners, pharmacists, physicians, nurses or patients and caregivers,” Ganio said.

Dr. Lauren Streicher at Northwestern University Feinberg School of Medicine said the issue arises frequently in discussions with menopausal women. Dr. Kathleen Jordan, chief medical officer at Midi Health, reported that patients are facing increasing problems filling prescriptions.

Dr. Robert Kauffman, a professor of obstetrics and gynecology at Texas Tech Physicians of Amarillo, said a shortage exists in West Texas and that colleagues across the country have reported similar issues. A spokesperson for Alloy Health said in an email that the company has not observed an estrogen patch shortage affecting its patients.

The FDA uses historic demand data to assess whether manufacturers are meeting current needs, which may lag behind recent increases, Ganio said. An FDA spokesperson stated that any national shortage will be posted on the agency’s drug shortage website.

Swiss manufacturer Sandoz told Reuters in April that it had shipped additional supplies to the United States. NBC News contacted four estrogen patch manufacturers in May — Viatris, Sandoz, Noven Pharmaceuticals and Amneal Pharmaceuticals — but received no responses.

Since 2018 Prescriptions for estrogen-based therapies among women ages 45 to 54 rose 184 percent from 2018 to 2026, according to a Truveta survey. Prescriptions increased an additional 20 percent between July 2025 and February 2026. Women are also using hormone therapy for longer periods.

Guidelines once recommended limiting treatment to five to 10 years and stopping by age 60. Newer studies suggest benefits from starting in the 40s and continuing into later decades, Jordan said. Estrogen patches are often chosen because they are typically cheaper than alternatives, carry substantial safety data and are more likely to be covered by insurance, Kauffman said.

It remains unclear when supplies will fully stabilize. Some estrogen patches could remain in shortage for years even as companies increase production, according to industry observers. Dr. Pharmaceutical companies manufacture in batches planned months in advance, which can delay output increases, Ganio said.

In the interim, patients may switch to a different brand, use two lower-dose patches, or change between twice-weekly and once-weekly formulations. Other estrogen delivery methods include topical creams, gels, oral tablets and vaginal rings. Faubion said no patient in her practice has been left without an alternative.

Oral estrogen can lower LDL cholesterol and raise HDL cholesterol, potentially benefiting women with high cholesterol, Streicher said. Women with a history of blood clots are advised to avoid oral estrogen because it can slightly increase clotting risk.

Vaginal rings provide localized treatment for dryness and recurrent urinary tract infections.