If you’re a middle-aged woman, or you know one, you’ve probably heard about the shortage of estrogen patches in the U.S.

For women seeking relief from hot flashes, mood swings and other bothersome symptoms of menopause, the patches can be highly effective, supplying estrogen as a woman’s own levels decline during menopause and perimenopause.

But a shortage of patches this year is forcing women to search multiple pharmacies for patches or consider alternate doses or treatments. Some women are venting their frustration on social media and are commiserating with others who are dealing with symptoms of menopause and perimenopause.

With no clear sign of when the shortage will end, doctors and pharmacists are urging women to plan ahead for refills and be prepared for possible challenges in filling their prescription.

To help sort through the issues surrounding the shortage, we talked with Liza Claus, who has a doctorate in pharmacy and is a clinical pharmacist at the University of Colorado Anschutz Skaggs School of Pharmacy and Pharmaceutical Sciences. Claus, who also is an associate professor at the school, focuses on teaching and research in women’s health issues. She also works closely with family medicine doctors who are fielding many calls and messages from women who can’t get their patch refills.

What are estrogen patches?

An estrogen patch is one of several types of menopause hormone therapy, also called hormone replacement therapy, to help women manage their menopause symptoms. Most of the patches that doctors prescribe for menopause contain estradiol, a form of estrogen.

The patches are popular because they deliver estrogen through the skin by way of a small- or medium-sized adhesive patch that women attach to their stomach or buttocks. The patches are easy to use, and women change them every three or four days, or every week, depending on the type of patch.

Estradiol patches are popular because they bypass the liver and therefore decrease the risk of blood clots and cardiovascular problems compared with estrogen pills.

Other forms of hormone therapy include gels, creams, vaginal rings and pills. Women who have vaginal dryness as their sole menopausal symptom typically use estradiol in a vaginal cream or tablet form.

When did the estrogen patch shortage begin?

The American Society of Health System Pharmacists reported a hormone patch shortage on Jan. 30, and the society’s experts regularly track medication shortages.

Claus said she first noticed women having problems getting their estrogen patch prescriptions filled this spring, and the shortage is ongoing.

“It’s an increasingly common problem, and it has definitely been frustrating for patients,” she said.

Claus said colleagues and friends have begun asking her about the shortage.

Leaders with the U.S. Food and Drug Administration (FDA) have not declared an official shortage. Doing so wouldn’t immediately resolve the shortage. But in an official shortage, FDA officials would likely provide guidance for pharmacists and doctors about things like substitutions for certain drugs in short supply.

On Sept. 3, FDA leaders issued an “Update on Estradiol Transdermal Patch Availability.”

“Although availability of certain products or brands may vary by pharmacy or location, estradiol transdermal patches remain available,” the update said, adding that FDA officials are expediting drug makers’ requests to increase supply.

Which estrogen patch products, brands and doses are most affected?

The shortage includes the once-weekly Climara patch and a twice-weekly Vivelle-Dot patch, and their generic forms, but not at every pharmacy, Claus said.

The shortage is complicated by the fact that not every generic product and not every dose of a particular brand of patches is in short supply at any given time. Patches go by a variety of names, depending on whether they are brand-name or generic products. Patches come in varying dosages and are formulated so women change them once a week or twice a week. Further, the stock at pharmacies can vary depending on their agreements with medication wholesalers and distributors, Claus said. So, it’s possible that one pharmacy may be out of one kind of patch while another has it.

Is the estrogen patch shortage widespread?

Yes, the shortage is happening across the country.

What is causing the estrogen patch shortage?

A supply and demand mismatch is causing the shortage of estrogen patches, Claus said.

Women have become increasingly interested in menopause hormone therapy in recent years, thanks to new research, recent drug labeling changes and broader discussions about menopause among celebrities and social media influencers.

In November 2025, FDA leaders announced that menopausal hormone therapy medications would no longer require a “black-box” warning across all hormone replacement therapy products. Instead, updated boxed warnings will be product-specific.  The black-box warning is the most serious safety alert for medications, and for more than two decades, many women were afraid to use hormone therapy because they worried that the medication would increase their risk of getting breast cancer and heart disease.

The label change helped women and prescribers revisit the data and feel more comfortable with hormone therapy, Claus said.

Patches are a popular option for women who are using hormone therapy because they are easy to use and don’t pose the risks of oral pills. However, the patches are more difficult to produce than some other medication formulations such as oral pills, which may be an additional factor in the reasons for the shortage, Claus said.

“Patients are finally on medications that are making them feel better, and now they are running into this shortage,” she said.

What’s the best way to find estrogen patches while shortages continue?

Claus recommends women do the following:

• Call your pharmacist to see if and when you’ll be able to get your patch.
• Call your provider to discuss alternatives to estrogen patches, if your patch is not available.
• Report the shortage to the FDA at [email protected] or through the FDA drug shortage reporting page.

Plan ahead if you expect a problem with your patch refill. She notes that doctor’s offices and pharmacies are fielding numerous calls and messages from women.

“Start communicating with your doctor sooner rather than later,” she said. “There are multiple effective options for managing menopausal symptoms, but the risks can differ by formulation and route, so that’s an important conversation to have with your medical provider.

“And the process of finding the right solution can take time.”

How long will the estrogen patch shortage last?

It’s not clear when the estrogen patch shortage will end, Claus said.

Drug makers are reporting backorders, shortages and delays in producing and delivering enough patches. They are providing patches to pharmacies as quickly as possible, Claus said.

You can find information about specific estrogen patch manufacturers and possible shortages on the American Society of Health System Pharmacists Shortages website.

If you’re considering moving your prescription to a different pharmacy, Claus advises calling to make sure they have your patch in stock.

How are patients affected?

Many doctors are being creative in helping women during this shortage, Claus said. That can mean finding a different pharmacy that has the appropriate patches in stock or prescribing a different type of patch. For example, a patient who was using a once-a-week patch might switch to a twice-a-week patch, based on availability. Your doctor also might recommend switching to a different patch that is in stock, as a short-term solution. Clause advises patients to contact their pharmacy to see which doses are in stock, then consult with their medical provider about any possible prescription changes.

In some cases, doctors may recommend a different type of estrogen, such as a topical spray or gel. A vaginal ring is another good alternative, she said. While most vaginal estradiol products treat localized symptoms like vaginal dryness, there is a particular type of vaginal ring (Femring) that can provide systemic estrogen therapy.

Another alternative is an oral estradiol tablet. But not all women can take the tablet form, especially those who have blood clot or cardiovascular risks, she said.

Should I try a compounding pharmacy if my pharmacy can’t fill my estrogen patch prescription?

Claus does not recommend using compounded hormone therapy if your patch is hard to obtain.

Compounded drugs are not FDA-approved, meaning they are not required to meet FDA rules for safety, effectiveness or manufacturing quality.

There are several FDA-approved alternatives, including transdermal estradiol gels and sprays, a vaginal ring and oral tablets.

What if I can’t refill my estrogen patch prescription, and I have to stop hormone therapy?

Claus said some women have been unable to refill their patch prescriptions for several days or even weeks. If they choose not to try another method, women can expect their menopause symptoms to return.

“This could be a return of hot flashes, night sweats, mood changes, difficulty sleeping or brain fog,” she said.

Women should talk with their providers about which alternatives to patches are appropriate for their situation.

Should I keep taking progesterone if I can’t get my estrogen patch?

If you have a uterus and are taking progesterone along with your estrogen, do not stop taking progesterone while you sort out challenges with estrogen patch shortages, Claus said.

Progesterone protects against endometrial cancer, so it’s important to maintain that element of your hormone therapy. Talk with your doctor about your progesterone prescription if you take a break from estrogen, she said.

I am about to start estrogen patch therapy. Should I hold off?

Women can find relief from menopause symptoms from methods other than patches until the shortage ends, Claus said. She advises women to talk with their providers.