Across the United States, women are encountering empty shelves at pharmacies when attempting to fill prescriptions for estrogen patches, a common form of hormone replacement therapy (HRT). The growing demand for HRT, coupled with supply chain issues, is leaving many searching for alternatives to manage symptoms of menopause, such as hot flashes, sleep disturbances, and mood changes. This surge in need comes after years of hesitancy surrounding hormone therapy, a shift driven by evolving medical understanding and a reevaluation of past research.
Marci Longnecker, an office coordinator at a Louisiana clinic and a patient herself, experienced the frustration firsthand. “Patches were a little bit harder to be able to find,” she said. “They weren’t so readily available.” After finding a patch dosage that effectively managed her menopausal symptoms, she encountered difficulty when attempting a recent refill. Her experience reflects a broader trend, as prescriptions for HRT have risen significantly in recent years.
The increase in demand for hormone replacement therapy is largely attributed to a change in perspective regarding its safety and efficacy. For decades, a degree of caution surrounded HRT, stemming in part from the 2002 Women’s Health Initiative (WHI) study. However, Dr. Gunjan Raina, a physician, explained that the initial findings of that study were “flawed, and we’ve revised it.” Current research indicates that estrogen does not cause cancer, and hormone replacement therapy is considered safe and appropriate for many women. According to an Epic Research study, HRT prescriptions increased 86% from 2021 to the conclude of 2025.
A Shift in Medical Confidence
The Food and Drug Administration’s (FDA) decision to lift the black box warning from most menopausal hormone therapy products has as well contributed to the increased demand. This change has empowered both physicians and patients, fostering greater confidence in HRT as a viable treatment option. Dr. Raina noted, “I was one of those doctors that kind of blew women off when they came in with a multitude of symptoms… And now that we know better, and the FDA has lifted the black box warning, doctors are feeling more confident and comfortable, and patients are feeling more confident and comfortable to start taking hormone replacement therapy.”
For years, many doctors were hesitant to prescribe HRT, often dismissing patients’ symptoms or lacking a clear understanding of the hormonal changes associated with menopause. This reluctance stemmed from concerns raised by the WHI study, which initially suggested a link between HRT and increased risks of breast cancer and heart disease. However, subsequent analysis of the WHI data revealed that the risks were lower than originally thought, and primarily affected women who began HRT more than 10 years after menopause. The revised understanding of the study’s findings, coupled with growing recognition of the significant impact of menopause on women’s quality of life, has led to a more positive outlook on HRT.
Navigating the Shortage
The current shortage isn’t solely due to increased demand. A popular brand of estrogen patch was recently discontinued, further straining the supply. This has created challenges for both patients and healthcare providers, who are now working to find alternative solutions.
Dr. Raina recommends that patients experiencing difficulty obtaining their estrogen patches call around to different pharmacies to check for availability. “Just as you’re on the patch, you don’t have to be married to the patch,” she said. “It’s okay to transfer the route of administration for a few weeks. And you may never know, you may like the other route better.” Alternative forms of HRT include gels, pills, and creams, which deliver estrogen through different methods.
The situation appears to be improving, according to Dr. Raina. “The last six to eight weeks were rough, but we were able to find some pharmacies in stock,” she said. “We were able to switch some routes of administration. They’re now taking the pill or the gel. And they’re really, really happy.”
Looking Ahead
Longnecker expressed hope that the supply issues will be temporary, ensuring future access to treatment for women entering menopause. “Hopefully it does obtain to a place where there will no longer be issues that when they get a prescription, they’re able to go to their pharmacy and grab care of that,” she said.
The ongoing situation highlights the importance of open communication between patients and their healthcare providers regarding hormone therapy options. As medical understanding of menopause and HRT continues to evolve, informed decision-making is crucial for women seeking relief from their symptoms. The FDA continues to monitor drug supplies and works with manufacturers to address shortages when they occur. Patients can find updates on drug shortages on the FDA’s website.
Here’s a developing story. Further updates will be provided as they become available.
Have you been affected by the hormone replacement therapy shortage? Share your experience in the comments below.
