Prescriptions for estrogen patches, which ease menopause symptoms like night sweats, hot flashes, and brain fog, more than tripled in the last eight years. Now there’s a shortage that’s left patients heated and providers scrambling.
Five months ago, Jenny Lynn Walding picked up her first box of estrogen patches from a pharmacy, no problem at all. But she hasn’t been able to fill the prescription since.
“Well, now I can’t get it,” said Walding, 42, who lives in Fluvanna County and just got a job with a venture capital firm. “So now I’m on nothing! There are times and days that I'm freezing, and then other times that I’m sweating profusely when I sleep which obviously impacts the quality that I’m getting. I feel crummy. I’m not showing up for me, I’m not showing up for my company.”
About 1.3 million American women begin menopause each year. Estrogen patches, around since the 1920s, and used alone or in combination with other drugs, relieve menopause symptoms like night sweats, sleeplessness, joint aches, and brain fog.
But the patches have become a hot commodity after the FDA removed drug warnings last fall and said hormone replacement therapy, or HRT, offered more benefits than risks—an about-face from the early 2000s when women were warned away from it.
Prescriptions for estrogen-delivering patches more than tripled since 2018 as the number of women receiving HRT grew by 184%. That growth will probably continue. New evidence suggests women on HRT live longer, have better heart health, cognitive function, and are less likely to fracture a hip or get diabetes.
“For many years now, those of us in the field have known hormone therapy is very safe, and we preferentially use these transdermal patches because they are small, they’re easy to apply, you change them either twice a week or once a week,” said Dr. JoAnn Pinkerton, a professor of obstetrics and gynecology who directs UVA Health’s Midlife Health Center. “These patches have become a really important part of what we prescribe for acutely menopausal women.”
Dr. JoAnn Pinkerton is a professor of obstetrics and gynecology and directs UVA’s Midlife Health Center. She says the shortage—due to skyrocketing demand and manufacturing inertia—will stick around through year’s end.
“I would say to women to be patient, to not freak out if you can’t get your patch,” Pinkerton said, “and to talk to your provider about other options so we can maintain until we get back to where people can get the product that they actually want.”
Until the shortage cools, Walding’s borrowing patches from friends and considering herbal remedies.
“Women, we rally,” said Walding. “We’ve seen our grandmothers, we’ve seen our mothers … and we’re still having to claw our way out of effectively getting this fixed once and for all for our daughters. They are right behind us.”
Pinkerton says women who can’t get the patches might also consider getting a prescription hormone gel that’s applied to the skin or vaginal creams or rings. Oral estrogen, which comes with slightly more risk because it’s processed by the liver, may also be an option.