En esta noticia
Women across the United States are facing increasing difficulties obtaining estrogen-based hormone therapy as supply disruptions spread beyond the patches commonly prescribed to manage menopause symptoms. Some injectable medications and vaginal creams are also experiencing shortages, back orders or limited availability, leaving patients and healthcare providers searching for alternatives.
The situation reflects a sharp increase in demand for menopausal hormone therapy (HRT) following changes in the way federal health officials have presented the treatment’s risks and benefits. As more women seek prescriptions, manufacturers have struggled to expand production quickly enough to meet demand.
The shortage has also created a domino effect. Patients who cannot find their usual estrogen patches are turning to other formulations, including gels and creams, putting additional pressure on products that are already facing supply constraints.
Why estrogen patches are becoming harder to find
Estradiol patches deliver estrogen through the skin and are commonly prescribed to help relieve menopause symptoms such as hot flashes and night sweats. However, pharmacies have reported difficulties obtaining certain brands and strengths.
The Food and Drug Administration (FDA) said in September that it was working with all six manufacturers of FDA-approved estradiol patches to increase production. The agency has not declared an official shortage and says the patches remain available, although the American Society of Health-System Pharmacists has listed them as being in shortage since January and availability varies by pharmacy. Although the agency reported that supply had nearly doubled over the previous year, the increase had not kept pace with demand. Expanding output takes time, since the patches require specialized equipment and are low-margin generic products, manufacturers say.
One factor behind the growing interest in hormone therapy was the FDA’s decision in November 2025 to ask manufacturers to remove certain risk statements about cardiovascular disease, breast cancer and probable dementia from the boxed warning on their labels. In February 2026, the agency approved the changes for a first group of six products. The warnings were based on findings from the Women’s Health Initiative study, published in 2002.
The change contributed to renewed interest in treatments that women had previously approached with greater caution. As demand increased, manufacturers faced additional pressure to supply pharmacies and healthcare providers.
Shortages are spreading to injections and vaginal creams
The supply problems are no longer limited to patches. The American Society of Health-System Pharmacists (ASHP) listed several estradiol valerate injection products from Hikma, American Regent and Par Sterile Products as being in shortage in early September.
The organization also reported supply disruptions involving vaginal estradiol creams made by Viatris’ Mylan unit, Padagis and Teva. Some products were listed as being on back order or subject to allocation, meaning pharmacies could receive limited quantities.
CVS Health said manufacturers had struggled for several months to provide enough of certain strengths of estradiol injections. The company added that the situation had worsened in recent weeks.
The growing number of shortages may also be connected to changes in patients’ prescriptions. Kathleen Jordan, chief medical officer of telehealth provider Midi Health, described a domino effect: after persistent difficulties obtaining patches, patients and prescribers began looking for alternatives such as gels and creams, increasing demand for those products as well.
Cost Plus Drugs reports a fivefold to tenfold increase in demand
The surge is also visible at online pharmacies. Cost Plus Drugs, the digital pharmacy founded by entrepreneur Mark Cuban, said demand for products sold through its platform had increased between fivefold and tenfold for almost every product.
Cuban attributed the growth partly to the company’s low prices. He said Cost Plus Drugs was purchasing as much as possible from suppliers to maintain inventory while its partners worked to expand production capacity.
Despite the increase, the company said it had largely managed to maintain its supply of estrogen replacement products, with only intermittent interruptions.
The situation illustrates how demand is affecting different parts of the pharmaceutical market. Even when a pharmacy manages to secure inventory, it may face difficulties replenishing certain products as manufacturers work to increase output.
What manufacturers are doing to increase production
Drugmakers say they are taking steps to improve availability, although expanding production takes time.
Viatris, which manufactures estradiol patches and creams, reported a significant increase in demand and said it had been working throughout 2026 to expand supply. The company added a production shift at its St. Albans, Vermont, facility earlier in the year, bringing the plant to around-the-clock operations.
Viatris said its output was now significantly higher and that it was meeting its current supply plans for vaginal estradiol cream. It also announced investments in additional equipment, a new production line and potential partnerships with third parties to increase the long-term supply of patches.
Amneal, another manufacturer of estradiol patches, also reported a substantial increase in demand following the FDA’s warning changes. The company said it was working to boost production.
However, the supply situation may not be explained by a general shortage of raw materials. Kevin Schipper, director of product lifecycle management at pharmaceutical consulting firm ProPharma, said the pattern of disruptions did not appear to point to a broad lack of raw materials, although he did not rule out supply-chain problems.
For patients, the availability of an alternative does not necessarily mean that one product can replace another. Vaginal estrogen treatments are generally used for symptoms affecting the vaginal and urinary areas, while systemic hormone therapy is prescribed for broader menopause symptoms.