Estrogen Patch Shortage Has Menopausal Women Scrambling for Help

A nationwide shortage of estrogen patches used for women going through menopause is sending patients scrambling for the crucial hormone therapy. Here is a closer look at the patch, the ongoing shortage, alternative treatments, and what government officials are doing to increase production.

Estrogen Patch Shortage Has Women Looking for Alternative Treatments

Estrogen patches have been in short supply since the beginning of the year. The U.S. Food and Drug Administration (FDA) has recently stepped in to try to alleviate the shortage. While the FDA has not formally categorized the difficulty of finding these patches as a shortage, the agency could start working with the five biggest manufacturers to hopefully address the issue.

The FDA said that it will begin reaching out to manufacturers and compounding facilities to boost production should the shortage deepen. The first goal is to ensure that all of the manufacturers are running at full capacity.

In the meantime, doctors are advising patients who rely on the patch to line up alternative treatments. If patches are not available, a patient may choose to take an estrogen pill. Another option is an estrogen gel or spray. Providers are able to change forms of the treatment without necessarily changing the prescription, making these flexible options.

Unfortunately, some of these options can be more costly. For instance, while most patches run about $35 per month, the gel form can cost up to $300 monthly.

Another possible solution, if the 0.05 patches are out of stock, is to try two 0.025 patches instead. Other patients have found success cutting their patches in half to make them last longer.  

Lastly, keep in mind that stock can vary from pharmacy to pharmacy. Checking with different outlets or looking into mail-order options is another good strategy.

Health care professionals are telling women not to simply skip treatment if they cannot find the patch. Several proven alternatives may help to provide the same relief from menopausal symptoms. Just one month off the hormones can wreak havoc on the body, making it important to stick with the course.

About Estrogen Patches

According to The Menopause Society, hormone replacement therapy using estrogen along with progestin is the preferred treatment for many women dealing with menopause symptoms. These symptoms include night sweats, hot flashes, and vaginal dryness. Estrogen patches are a specific type of hormone replacement therapy that delivers estradiol through the skin, allowing the drug to flow through the skin and into the bloodstream.

The patch can be used on any area of the skin where it will stick. A benefit of a patch as opposed to a pill is that the drug enters the bloodstream slowly and continuously instead of in one large dose. The active estradiol reduces menopausal symptoms by attaching itself to receptors located in the bones, muscles, blood vessels, and brain.

An estrogen patch has different uses. In addition to serving as a key component in hormone replacement, the patch is also used to treat estrogen levels, help with low libido, improve sleep, and prevent postmenopausal osteoporosis. Estrogen patches are also being used more by trans men and women as part of a gender-affirming care protocol.

Why the Shortage?

Health officials are blaming the shortages on an increased demand for the patches after the FDA removed its black box warning label from the drug last fall. This warning had been in place for over two decades, following a 2002 Women’s Health Initiative study that linked hormone replacement therapy to an increased risk of breast cancer, heart attacks, and strokes in postmenopausal women.

The threats were later found to mostly be an issue for women who started hormone therapy at later ages. The 2002 study prompted millions of women to stop using the patch. The use of hormone replacement therapy in general fell from 40% to 5% over the last 20 years. Some doctors went so far as to stop prescribing it completely.

However, the removal of the black box warning on the heels of new data sent more women back to this form of treatment. According to health and data analytics company Truveta, prescriptions for estrogen-based hormone replacement therapy more than doubled between 2018 and 2026 as more information came to light.

Help is on the way to combat the shortage. Sandoz, one of the largest makers of estrogen patches, recently confirmed that it is working to increase capacity. A spokesperson for the company noted that patches are notorious for being more time-consuming to produce when compared to other types of treatment.

Until supply can keep up with demand, doctors are advising patients to talk with their clinicians about alternative treatments to bridge the gap.

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