U.S. — Prescriptions for estrogen patches increased by 162% over the last two years, contributing to current shortages of three types of these patches in the U.S. The Food and Drug Administration removed a black box warning discouraging women from taking hormone replacement therapy last fall.

The American Society of Health-System Pharmacists reports an ongoing shortage of three types of estrogen patches. The FDA indicated last fall that it would collaborate with companies to remove references to risks in hormone replacement therapy medication labels. However, the FDA has not officially declared a shortage of estradiol.

Doctors prescribe estrogen to alleviate menopause symptoms, including hot flashes and brain fog. Estradiol is commonly administered through transdermal patches that gradually release the hormone onto the skin. For over two decades, the FDA had advised against treating menopause with estrogen, citing risks suggested by the 2002 Women's Health Initiative study.

Francesca Turner, a doctor, stated that she and her staff are working to address the challenges patients face in accessing the medication. "Between my nurse, patients' pharmacists and myself, we are doing this pretty much every day trying to figure out how to navigate this for our patients," Turner said. Susan Loeb-Zeitlin, director of the Women's Midlife Center at Weill Cornell Medicine, noted the difficulty in obtaining the patches. "You can get them, but it takes a lot of time and effort when we're all so busy at this time of our lives," Loeb-Zeitlin said.

The increase in demand is also attributed to patient advocacy and social media discussions. Jessica Shepherd, chief medical officer of Hers, stated that community-driven demand has contributed to the rise in prescriptions. "The demand has actually come from more of the community of women saying within their groups or communities that they are still suffering," Shepherd said. She also noted the influence of social media and celebrities in raising awareness. "This was much more brought about by social media, where people are really able to air their voice, and you see a lot of celebrities that were talking about their journey as well," Shepherd added. Hers' perimenopause and menopause program has experienced a threefold increase in interest since its introduction in October.

Prescriptions for estrogen patches rose from 594,000 in June 2024 to 1.6 million in May. Estrogen patches represent 44% of all estrogen prescriptions, and prescriptions for all types of estrogen have risen 78% over the past two years. Amneal has stated its efforts to increase production of estrogen patches to meet the heightened demand. Sandoz indicated that recent changes in prescribing behavior have created a demand that cannot currently be fully met, noting the complexity of manufacturing estradiol patches while working to increase production. The American Society of Health-System Pharmacists' shortage database relies on public reports from healthcare providers, while the FDA's shortage data originates from manufacturers.