Estrogen patches face shortage as more women seek hormone therapy

[0:00] More women are seeking treatment for symptoms of menopause and perimenopause, [0:04] driving a shortage of estrogen patches, one of the most commonly used forms of hormone therapy. [0:10] As Stephanie Sy reports, manufacturers are struggling to keep up with demand, [0:14] leaving many women to manage a range of difficult symptoms with little relief in sight. [0:20] Jeff, while there are multiple reasons for the shortage, rising demand is at least partly to blame. [0:25] The popularity of estrogen patches has been surging for several years. [0:30] And awareness has grown since last year, when the Food and Drug Administration lifted a 20-year-old black box warning on estrogen [0:37] that overstated the risks of hormone therapy. [0:41] We spoke to women across the country who are impacted by the shortage. [0:45] Here's some of what they told us. [0:47] Hi, my name is Nicole Stark, and I've been on a HRT patch since April of 2025. [0:53] I had originally talked with my doctor, like I said, back in April. [0:56] She thought it was a good idea for me then to try something out as a very low dose. [1:01] The very first time I put that prescription through, no issue, totally fine. [1:06] She had put me through for a three-month trial, kind of, and I checked back in with her. [1:12] It was at that second, I guess, refill, or the first refill at that point, that I kind of knew that something was going to be up. [1:20] My name is Trevia Mance, and I have only been using the patch for six months. [1:26] Because the patch is new, for me, missing was a problem. [1:30] And I actually ended up missing two doses. [1:34] My name is Michelle Pearls. [1:35] I've been on the patch for less than one year. [1:37] When I started getting these particular patches, which are twice-weekly patches, there were delays in being able to get the medication, and I was not able to get three boxes at a time, which is what we're supposed to be getting pursuant to our insurance policy through Aetna. [1:56] Sometimes I was able to get one box. [1:59] So, as of right now, I've actually been without the patch for the last month. [2:02] The night sweats have been intense. [2:04] And my irritability is definitely not in check. [2:11] I've been a far less pleasant person to be around, and I know that, but I can't stop it. [2:16] And it's really unsettling. [2:18] There was panic. [2:19] There was, you know, when they said, oh, it's on back order, and then you have to wait. [2:25] They're like, you know, oh, every day, every day. [2:28] But because I have a clotting disorder, I didn't have the option of creams or lotions because you can't gauge the dosage as well. [2:37] So I called up Wegmans. [2:38] They were wonderful. [2:39] They were very helpful. [2:40] And they said, yes, we can get you this medication. [2:43] We can get you three boxes worth tomorrow. [2:45] But then they called me back and said, by the way, your insurance is not going to cover this. [2:50] At this point, I think it's been pretty much weekly that I've checked back with my local pharmacy, and it's the same answer. [2:58] So, you know, and they just kind of throw up their hands of, we're not sure when, sorry, is their answer. [3:03] So I'm not sure what that's going to look like. [3:06] What we ended up having to do was go with a different manufacturer, which, of course, requires different, you know, going through your insurance and prior authorization. [3:14] And then I was able to get the patches through them. [3:16] I still had to pay, you know, quite a bit more than I would have through my insurance. [3:21] It's a fair amount more. [3:22] It's a fair amount more. [3:23] And right now I'm a full-time student. [3:25] I'm not working. [3:26] So it is impacting us. [3:27] But my quality of life is worth, you know, this sacrifice for me at this time. [3:33] For more on this, we turn to Dr. Lauren Stryker, a professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine. [3:42] Dr. Stryker, thanks for joining us on the NewsHour. [3:45] You heard all those women scrambling for these estrogen patches. [3:50] Give us a quick sense of how much we've seen demand surge overall for estrogen prescriptions and when the shortages became evident. [3:59] Well, first of all, I wouldn't call it a surge. [4:01] I would call it an explosion. [4:03] There has been an increase in estrogen prescriptions 86 percent in the last five years, and 50 percent of those are for patches. [4:12] So while we haven't had the shortage until recently, it's really the perfect storm of having supply chain issues and tariffs. [4:20] And then you put on top of that, so many women are suddenly getting prescriptions for patches that never had before. [4:27] We're going to get to the demand in a second, but the supply shortage has no clear end in sight. [4:31] What tips do you have for women who can't get their prescriptions filled? [4:36] Well, they have a number of different options. [4:37] First of all, sometimes it's as simple as trying a different pharmacy. [4:41] There are different distributors, and sometimes maybe CVS has something that Walgreens doesn't. [4:46] So you do have to do a little bit of looking around, a little bit of footwork. [4:49] But the other thing that women are not considering that's critically important is that the patch is not the only form of hormone therapy. [4:58] Now, we talk about transdermal hormone therapy being preferable for many women, [5:02] because the absorption through the skin means that it bypasses the liver, [5:07] and it doesn't have an increased risk of blood clots and some other cardiovascular issues. [5:12] And that's why a lot of women go the patch route. [5:14] But the patch is not the only transdermal estrogen. [5:17] We have transdermal creams and sprays and gels, and all of them are equally safe. [5:24] So that would be my number one thing, is if you can't get your patch, [5:28] that doesn't mean that you might not be able to use another transdermal option. [5:33] Not to mention that a lot of women are candidates for a pill, for an oral option. [5:39] A lot of women have been led to believe that the only option is the through-the-skin option, which has advantages. [5:45] But there are also advantages to the pill for some women, and some women are perfectly good candidates. [5:50] So just exploring those kinds of options are useful. [5:54] And then, if you are a patch person and you want to use that patch, [5:58] then you can start to do some little tips and tricks, if you will. [6:01] You can get a patch that's half the dose and use two of them. [6:05] Maybe you can get a higher-dose patch and cut that patch in half. [6:09] But you need to be aware that you cannot cut every single patch. [6:14] Dr. Stryker, you know the topic of menopause has become huge on social media, [6:19] with Hollywood actresses and influencers openly talking about their symptoms and the benefits of hormone therapy. [6:26] Are these estrogen product shortages an unintended consequence of all that? [6:30] And how much is hype versus good health advice? [6:34] Well, there's no question that everyone's talking about menopause, including influencers and celebrities. [6:40] And this is a good thing. [6:41] We want people to talk about menopause. [6:42] But along with that comes the other part, that fact that people are being talked into this idea that [6:49] every single woman needs to take hormone therapy, no matter what their symptoms are, [6:54] no matter what their goals are, no matter how old they are. [6:57] But the other thing that's happening is that we have a lot more doctors who are put in the position of needing to prescribe hormone therapy. [7:05] And on one hand, this is a good thing. [7:06] We want doctors to prescribe it to women that would benefit and that is appropriate. [7:10] But you also have doctors that, quite frankly, are not menopause experts. [7:14] So maybe they only know about the patch. [7:17] And they tell everyone, the patch is what you should use. [7:20] The patch is safest. [7:21] Bioidentical is always best. [7:23] And that's not necessarily the case. [7:26] So it's a little problematic because it's great that this has become such a topic of conversation. [7:31] But we also need to keep in mind that this is individualized therapy. [7:36] And if there was a doctor who prescribed the same blood pressure pill to every single patient that walked in the office, [7:42] you'd say, hmm, that's not a very good doctor. [7:45] Yet we have a lot of doctors that are prescribing the exact same hormone therapy to every woman who walks into their office. [7:52] And that's something that I'd like to see change. [7:54] The FDA reversed those broad warnings about hormone therapy last year. [8:00] But you've also suggested in your writing that the FDA's messaging about hormone therapy may be leading to undue demand. [8:09] Can you talk a little bit about that? [8:11] Yeah. [8:11] Some of the statements that were made by the representatives of the FDA, RFK and Dr. Mark Carey, [8:17] really have not been shown scientifically to be true. [8:21] You know, as an example, they talk about how if women use hormone therapy, that it's going to prevent dementia down the road. [8:28] The science does not back that up. [8:30] They talked about how it's going to decrease cardiovascular disease. [8:34] The science does not necessarily back that up. [8:37] Again, it's individualized. [8:39] There are certain people that are at increased risk. [8:42] People who have hot flashes, for example, who are not sleeping, [8:45] are going to benefit from getting rid of those hot flashes and sleeping more, [8:49] which in turn is going to reduce the risk of having dementia or cardiovascular disease down the road. [8:55] But we have women who are coming up to me and saying, [8:58] I'm 65 years old. [9:00] I missed the boat. [9:01] I wasn't prescribed hormone therapy. [9:02] And I feel like I'm doomed. [9:04] I'm doomed to die a premature, horrible death from dementia or cardiovascular disease. [9:08] And nothing can be further from the truth. [9:10] So we have an awful lot of women who are asking for hormone therapy [9:15] that not necessarily are going to benefit from hormone therapy. [9:19] Some really important information. [9:21] That is Dr. Lauren Stryker joining us. [9:23] Thank you. [9:24] Thank you. [9:34] Support journalism you trust. [9:36] Support PBS News. [9:39] Donate now or even better, start a monthly contribution today.