Menopause drug demand leaves estrogen patches scarce
Prescriptions have surged as more women seek hormone therapy, while doctors say patients are spending extra time trying to fill patch orders.
By Maya Lindqvist · Senior Technology Correspondent
3 min read
Women seeking hormone therapy for menopause are running into shortages of estrogen patches, a preferred treatment for symptoms such as hot flashes and brain fog. Doctors told CNBC the squeeze is forcing patients, clinicians and pharmacists to spend time hunting for supplies or switching to alternatives.
HealthVerity data cited by CNBC shows prescriptions for estrogen patches rose 162% over the past two years. The rise accelerated after the Food and Drug Administration moved last fall to remove a more than 20-year-old black box warning that had discouraged use of hormone replacement therapy, CNBC reported.
The American Society of Health-System Pharmacists lists three types of estradiol patches as being in shortage, based on reports from health-care providers. The FDA, which uses manufacturer data and a different method, says estradiol patches are not currently in shortage.
Dr. Susan Loeb-Zeitlin, director of the Women’s Midlife Center at Weill Cornell Medicine, told CNBC the patches can still be found, but doing so takes “a lot of time and effort.” Dr. Francesca Turner, a physician in Iowa, said her office, nurses, patients and pharmacists are working on the problem nearly every day.
Demand rose as warnings eased
Doctors use estrogen to treat symptoms that can emerge when hormone levels fall during menopause. CNBC reported that estradiol, a potent form of estrogen, is often delivered through a skin patch that releases the drug gradually.
Loeb-Zeitlin told CNBC many doctors prefer topical estrogen because they consider it safer than oral treatment. Interest in hormone therapy had been constrained for years after a 2002 Women’s Health Initiative study linked it to higher risks of breast cancer, dementia and other conditions, CNBC reported.
Later analyses found the study population was older than many women who begin hormone therapy and that the risks had been overstated, according to CNBC. The FDA then said last fall it would work with companies to remove references to those risks from medication labels.
HealthVerity data cited by CNBC shows prescriptions for all estrogen products climbed 78% over two years. Patch prescriptions rose from 594,000 in June 2024 to 1.6 million in May, giving patches 44% of all estrogen prescriptions, according to HealthVerity.
Dr. Jessica Shepherd, chief medical officer of Hers, told CNBC the surge has been driven in part by women discussing menopause symptoms in their communities and on social media, along with celebrities describing their own experiences. Hers, part of Hims & Hers, said interest in its perimenopause and menopause program has tripled since its October launch, CNBC reported.
Manufacturers face limits
CNBC reported that Zydus and Noven did not respond to requests for comment about affected patches. Amneal told CNBC it is increasing production to meet demand but did not give production details or a timeline.
Sandoz told CNBC that prescribing changes have created demand that cannot currently be fully met. The company said estradiol patches are complex to make and that it is working to increase manufacturing.
Michael Ganio, senior director of pharmacy practice and quality at ASHP, told CNBC the FDA’s shortage process can miss surges in unfilled demand because the agency compares supply with historical demand and relies on manufacturers’ reports. An FDA spokesperson told CNBC all six manufacturers are producing at full capacity and that the agency is monitoring supply and offering help to increase it.
Ganio said transdermal patches are harder to make than pills, and generic manufacturers may have to wait for scheduled production windows or add batches to raise output. He estimated it could take one to two years for supply and demand to balance, CNBC reported.
ASHP has also listed several estradiol creams and progesterone pills as being in shortage, according to CNBC. Loeb-Zeitlin said she has suggested estrogen gels when patients cannot find patches, while some doctors are using compounded creams, which insurers rarely cover.
This story draws on original reporting from CNBC.