Menopause clinics across the U.S. are hearing from women who are having trouble filling prescriptions for estrogen patches, a common hormone replacement therapy.
“There’s just more demand for these medications, and I think it’s exponentially risen over the last three or four years,” said Dr. Rajita Patil, director of UCLA Health’s Comprehensive Menopause Program. “I don’t think that the supply chain was ready for that.”
Hormone replacement therapy prescriptions for women 50-65 have increased 86% since 2021, according to Epic Research, which analyzes electronic health records nationwide.
Jessica Halem uses twice-weekly estradiol patches. (Courtesy Jessica Halem) (Courtesy Jessica Halem)
In November, the Food and Drug Administration removed the “black box” warning on hormone replacement therapy products. The warning had linked older versions of the drugs to increased risk of breast cancer, heart attack and stroke. Many experts have said that the warning was outdated and that the benefits of hormone therapy outweigh the risks.
“We have seen interest generally rising over the past several years, but that removal of the black box warning, I think, has had a big impact on people who had been hesitant to even talk about it or consider it,” said Dr. Nina Ali, director of the Menopause Center at Baylor College of Medicine in Houston.
“Right away, women who were hesitant were jumping in, making appointments with us,” said Patricia Handler, a nurse practitioner with the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago. “Our waitlist is well over 1,000 people to be seen.”
Jessica Halem says she regrets every day she spent in menopause not using hormone replacement therapy.
Jessica Halem. (Courtesy Jessica Halem) (Courtesy Jessica Halem)
Halem, 53, went into menopause three years ago. Symptoms like hot flashes kept her awake at night and she struggled to do certain yoga poses because she would get dizzy. But last year, her doctor prescribed estrogen patches and progesterone pills.
“I just instantly felt more like myself,” said Halem, the co-founder of a biotech startup focused on hormone therapies. “I will never go off of these drugs.”
When she went to refill her prescription, her pharmacy in Cape Cod, Massachusetts, said the patches she uses weren’t available.
“I call the pharmacy, and that’s when they start to tell me there’s a shortage of estradiol patches. ‘We don’t have any here,’” she said.
The same thing happened to Kristy Martin in Denham Springs, Louisiana.
Kristy Martin. (Courtesy Kristy Martin) (Courtesy Kristy Martin)
“I went into a panic,” Martin said. The 41-year-old started using hormone replacement therapy when she found out she was in perimenopause last year.
“My life prior to these patches was so hard to deal with day-to-day activities,” she said. “I couldn’t sleep. I was sweating constantly, the night sweats, the mood swings. It was not conducive to a great lifestyle.”
Ali, of Baylor College of Medicine, said the shortages seem to be affecting the twice-weekly estradiol patches, which happen to be the method she most often prescribes.
During perimenopause and menopause, the body produces less estrogen, leading to symptoms including hot flashes, night sweats and mood swings. Estradiol patches replenish the body’s estrogen.
According to the American College of Obstetricians and Gynecologists, estrogen hormone therapy — which includes estradiol patches — is the most effective treatment for hot flashes and night sweats. Other forms of estrogen therapy include pills, gels, injections and vaginal inserts.
CVS said in a statement that there have been supply challenges with select hormone replacement therapies over the last several weeks due to products being on backorder.
Viatris, which makes a generic twice-weekly estrogen patch, said in a statement that it was meeting its current supply plans. “We know demand for this product has increased and we are currently taking steps to optimize current capacity and further expand production long-term,” the statement said.
Sandoz, which also makes a twice-weekly patch, didn’t respond to a request for comment.
A spokesperson for the FDA said the agency is monitoring the supply of estradiol patches, but supply is still available.
Ali said women often try patches first because they are typically covered by insurance and have fewer side effects than the pills.
There is less of a risk of blood clots associated with the patches compared with pills, she said. “Because of that, they’re often preferred, and they’re certainly preferred for people who have more baseline medical risk factors,” she said.
Dr. Flavia Fairbanks Ruano, director of the female sexual health division at UHealth Jackson in Florida, said she started hearing from patients struggling to find the patches last month. When that happens, she has to switch them to different formulations.
But that’s not always a smooth process.
They can experience side effects, Patil, of UCLA, said. Some women become more symptomatic on weekly patches compared with twice-weekly, she said.
Kristy Martin got a notification from CVS that her estrogen patches were out of stock. (Courtesy Kristy Martin) (Courtesy Kristy Martin)
Even switching between different brands of the same product can be difficult: “The ingredient is still estradiol, but there’s always a different preservative or something else that’s a little different in each of those patches,” she said.
Martin, in Louisiana, was able to fill her prescription for the twice-weekly estrogen patch, but she received a notification that the patches are out of stock for her next refill.
“It just makes me very anxious, just knowing that all the symptoms that I dreaded for over a year could be back if I’m not able to get my medication,” she said.
This article was originally published on NBCNews.com
