Estrogen patch shortage prompts doctors, lawmakers to seek FDA action as women struggle to find treatment
Women across the country are reporting ongoing difficulty filling prescriptions for estrogen patches used to treat symptoms of menopause, as demand for hormone replacement therapy has surged following changes in federal labeling.
Some patients and doctors are now calling on the Food and Drug Administration to formally recognize a shortage of the medications, saying the agency's shortage database does not reflect problems they are seeing at pharmacies.
Diane Harris, a Los Angeles mother of three, said she recently struggled to refill her prescription for an estradiol patch, which she is supposed to replace twice a week.
"I was calling every pharmacy I could come up with," Harris said. "I was definitely very stressed."
Unable to find a consistent supply, Harris said she began using the patches less frequently. She eventually found a pharmacy more than 25 miles from her home that could fill her prescription.
Harris said she was even considering looking for the medication at pharmacies in Canada.
"It's a real problem that it's not available," she said. "People can't get it. The pharmacies don't have it. They don't know when it's going to come and they don't know when the shortage is going to end."
The problems come as demand for estrogen patches has increased dramatically. Demand for progesterone pills, which are often prescribed along with estrogen, has also grown, leading to an uneven supply.
The FDA removed a 26-year-old safety alert known as a "black box warning" from many hormone replacement therapy products in February. Since then, prescriptions for estrogen patches increased from about 594,000 in June 2024 to 1.6 million in May 2026, according to nationwide data from HealthVerity, a healthcare technology company.
Dr. Suzanne Hackenmiller, an obstetrician-gynecologist in Arizona, said the change made more women and doctors comfortable with hormone therapy.
"More women felt safe to use estrogen. More doctors felt safe to prescribe it," Hackenmiller said.
Hackenmiller said hormone replacement therapy can do more than alleviate menopausal symptoms. She said estrogen, when started early in perimenopause or shortly after menopause, may reduce the risk of cardiovascular disease, osteoporosis and colon cancer.
"In my mind, these are medically necessary medications that are preventing disease in women after menopause," she said.
Hackenmiller has started a petition urging the FDA to formally declare a shortage of estradiol patches. She said such a declaration could give manufacturers an incentive to increase production and potentially encourage additional companies to enter the market.
"If they would declare a shortage, then the companies that currently make the estradiol patch could ramp up production," Hackenmiller said. "Other companies could potentially start to make the patch."
A formal shortage designation could also affect what patients pay for their medication, she said.
Hackenmiller said some patients who normally receive a 90-day supply and pay one insurance copay are instead forced to obtain 30-day supplies because pharmacies cannot provide the full prescription. That can result in patients paying the same copay multiple times.
The American Society of Health-System Pharmacists, which collects reports from pharmacists, health care providers and patients, lists more than a dozen estradiol patch products on its active drug shortage list.
A group of Democratic members of the U.S. House has urged the FDA to add estradiol patches to the agency's federal drug shortage database.
In a letter to the FDA, lawmakers said the agency's reliance on historical demand data could mean the agency is not seeing the full extent of the problem as demand rises rapidly.
"The FDA relies on historic demand data to determine if drug manufacturers are keeping pace, and these data may be lagging given how quickly demand for the patches has spiked," the letter said.
CBS California Investigates reached out to the FDA for comment on this story and did not receive a response. On Thursday morning, the FDA posted an update that the agency was aware of reports that patients were experiencing difficulty accessing their medication due to increased demand.
The FDA said that although availability for certain products or brands varies by pharmacy or location, estradiol transdermal patches remain available. The agency added that it continuously monitors supply and offers assistance to manufacturers seeking to increase production.
"The FDA views increased interest in menopause treatment as an important development for women's health and is working closely with manufacturers to help ensure that the supply of estradiol patches keeps pace with demand," the agency said in its update.
The FDA recommends patients contact their healthcare providers and pharmacists to find where they can access estradiol transdermal patches or to find alternative options if their usual medication is unavailable.
Hackenmiller said the availability problems are particularly frustrating after years of debate over the safety of menopausal hormone therapy.
"We've spent 20 years dealing with misinformation around menopausal hormone therapy," she said. "We're finally able to set the record straight, prescribe these medications, have women feeling better from symptoms, and protecting against those medical conditions. And now it's like the rug is being pulled out from under them."
For Harris, the concern is what will happen when her next refill is due.
"Women's health needs attention," Harris said. "Women who are older — we tend to be a little bit invisible in our society. I think it's really important that our needs are seen, acknowledged and addressed."
