All five manufacturers of estrogen patches are running at full capacity. None of them can keep up.
Women across the country are walking into pharmacies and being told their patches are on backorder. The shortage, reported by Reuters, could last up to three years. The Department of Health and Human Services told Healthline that every patch maker is producing at maximum output but still falling behind demand. The federal government has not declared an official national shortage.
The root cause traces to November 2025, when the FDA began removing long-standing black box warnings from certain hormone replacement therapy products. Those warnings had been attached to HRT since 2002, following the Women's Health Initiative study, which raised concerns about cardiovascular and cancer risks. After what it described as a comprehensive review, the FDA concluded the warnings overstated the risks for many women, particularly those who begin therapy close to the start of menopause.
FDA Commissioner Dr. Marty Makary framed the change as a correction. "We removed the black box warnings on hormone replacement therapy to tell women the truth about the short-term and profound long-term public health benefits of hormone replacement therapy," he said. "Demand for hormone replacement therapy has surged since our announcement."
The data backs that up. An analysis by health data company Truveta shows that patch use specifically increased by more than triple between 2018 and early 2026. Among women ages 45 to 54, prescribing rates jumped 184 percent. By February 2026, roughly 1 in 20 women in that age group had an estrogen-based HRT prescription.
Dr. G. Thomas Ruiz, an OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, California, said the shift has been dramatic in his own practice. "As soon as the FDA changed its black box warning, I got so many patients who are no longer fearful," he told Healthline. More than 1 million U.S. women begin menopause each year, according to available estimates, and the surge in prescriptions reflects years of suppressed demand now releasing all at once.
Women who cannot find patches have several effective alternatives available. Estrogen gels, sprays, and oral tablets all treat menopausal symptoms and are currently not subject to the same supply crunch. These options work through different delivery mechanisms but address the same underlying hormonal changes. Doctors are advising patients who are affected to speak with their providers about switching formulations while supplies catch up to demand.
The shortage puts an uncomfortable spotlight on how fragile the supply chain for a widely needed medication can be. With five manufacturers already maxed out and no federal emergency declaration in place, pharmacists and physicians are left navigating the gap largely on their own, directing patients to alternative brands, different dosages, or entirely different drug forms. How long that workaround lasts depends on whether manufacturers can expand capacity, and so far, no timeline for relief has been confirmed.
