Cassie Kircher began using estrogen patches more than 10 years ago, after she had a full hysterectomy. Before that, night sweats from perimenopause had kept her awake at all hours, leaving her exhausted and anxious during the day.
Estrogen finally helped her sleep. The patches “changed my life,” she said.
When Ms. Kircher, 71, tried to fill her three-month prescription at a pharmacy in North Carolina last month, she couldn’t. “They said, ‘We don’t have any, we can’t get any, there isn’t any,’” Ms. Kircher said.
Across the country, women have reported difficulty obtaining estrogen patches, which deliver estrogen through the skin and into the bloodstream to ease hot flashes, mood swings, sleep issues and other menopausal and perimenopausal symptoms. While the causes of the supply issues aren’t entirely clear, doctors and pharmacy experts say an increase in demand is most likely a major driver. Hormone-therapy prescriptions rose 86 percent between 2021 and 2025, according to medical-record data from Epic Research.
It’s a sign of just how much attitudes about the patches, and about menopause, have changed. After a report in 2002 suggested that hormone therapy increased the risks of breast cancer and cardiovascular disease, its popularity plummeted — and stayed low even after further research debunked that concern.
But in the last few years, the conversation has started to change. More health care providers are catering to menopause treatment. Last year, the Food and Drug Administration began removing safety warning labels from the patches. And anecdotally, women seem to be talking and hearing about perimenopause and menopause more in their group chats, on social media and in popular culture.
“Menopause is now so chic that everybody’s interested,” said Dr. Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine. “People who didn’t even want to hear about estrogen-replacement therapy three years ago are now like, ‘Let’s get estrogen.’ And I just think manufacturers aren’t keeping up with the demand.”
There is currently a shortage of 10 different formulations of patches that deliver estradiol, a type of estrogen, according to the Drug Information Service, an independent group at the University of Utah that tracks access to medications. (Another patch that had recently been in shortage, made by Viatris, is now back in stock.) There do not appear to be shortages of other menopausal hormone therapies.
A spokeswoman for Sandoz, one of the manufacturers, said in a statement that supply challenges in the patch market were due to a global shortage and “unprecedented demand” for estradiol patches because of the F.D.A.’s removal of the warning. The company said it was working to increase capacity and estimated that it would release more patches late this month, according to the Drug Information Service.
Amneal Pharmaceuticals, some of whose products are also running low, said that the patches required specialized manufacturing and that there was “finite industry capacity” for producing them. The company could not estimate when it might release more patches.
A Pendulum Swing
Even with the increased demand, hormone therapy, which can include estrogen and progesterone, is nowhere near as popular as it was before the 2002 study. In 1999, an estimated 27 percent of postmenopausal women were on some type of the therapy. In the years after the study was released, the share dropped to just 5 percent.
More research clarified that the increased risk of breast cancer was small in absolute terms, was most likely tied to the type of progesterone used and could be mitigated, Dr. Minkin said. And it became clear that estrogen didn’t increase the risk of cardiovascular disease in healthier women who started the therapy in their 50s.
Still, by the end of 2023, less than 2 percent of menopausal women were using hormone therapy, according to forthcoming research by Dr. Stephanie S. Faubion, medical director of The Menopause Society.
But with the reassurance on safety, and the declining stigma around menopause, doctors said more women were now seeking the treatment.
In the past, when patients came in with menopausal symptoms, “I would have to basically stand on my head to convince them” that estrogen therapy was safe and they should take it, Dr. Minkin said.
When Ms. Kircher was prescribed estrogen in 2015, after having her uterus and ovaries removed, all she read about was the hormone’s link to breast cancer. She had no idea it could help her sleep through the night.
Today, though, women like Ms. Kircher come in armed with information about the risks and benefits and ask for estrogen, said Dr. Minkin, who prescribes it five to 10 times a day.
Monica Molenaar, a founder of Alloy Health, a menopause telehealth platform, said that when the company started operating in 2021, “nobody wanted to admit that they were in menopause or perimenopause.” With public figures like Michelle Obama, Brooke Shields and Oprah Winfrey openly talking about menopause and helping to normalize the experience, she said, more women are seeking relief from their symptoms. Ms. Molenaar said the company’s client base had doubled every year since it began.
Dr. Faubion, who directs the Mayo Clinic Center for Women’s Health, said that for some, the pendulum had swung too far, with patients clamoring for estrogen as a cure-all for any number of ailments, such as joint aches and weight gain. “Everything is getting blamed on the menopause transition now, and they think hormonal therapy is going to fix it, and it often won’t,” she said.
A Popular Option
It’s not clear why the shortage is affecting only patches, but one reason could be their popularity. Doctors and patients tend to favor the patch because it delivers estrogen to the whole body but is more affordable than gels and sprays and safer than pills. That is because it bypasses the liver and carries slightly less risk of blood clots, said Dr. Robert Kauffman, a professor of obstetrics and gynecology at Texas Tech University Health Sciences Center.
Dr. Minkin said some patients also preferred the patch because it helped maintain a more even level of estrogen by releasing it continuously, as compared with pills.
Dana Johnson, 52, started using an estrogen patch in early 2024 after trying a variety of other hormone therapies. “I wish I had been on it for longer,” she said. She had experienced intense night sweats. “There have been half a dozen times where I’ve had to change pajamas twice in a night,” she said. “That just makes for a really crappy next day.”
She was reliably filling her prescription for two patches from Costco, but two weeks ago, the pharmacy told her one was on back order. Ms. Johnson tried other pharmacies before reluctantly paying out of pocket for a three-month supply on Amazon Pharmacy.
The patches arrived last Tuesday, the night before she needed to change hers. “I am grateful for this delivery,” she said.
Nina Agrawal is a Times health reporter.
The post The Estrogen Patch Surged in Popularity. Now It’s in Shortage. appeared first on New York Times.
