Quick Facts

• Estrogen patch shortages hit major pharmacies including CVS and Amazon after FDA removed black box warnings in November 2025
• Global hormone replacement therapy market valued at $19 billion in 2026, expected to reach $33.7 billion by 2036
• An estimated 50 million U.S. women are in or approaching menopause, creating unprecedented demand

Widespread shortages of estrogen patches used for menopause hormone therapy are forcing women across the country into what one patient calls a “monthly mad scramble” to fill prescriptions.

The crisis began after the FDA removed black box warnings from hormone therapy products on November 10, 2025. The warnings went into full effect in February 2026.

CVS confirmed to NPR that “manufacturers have been unable to provide sufficient supply of hormone replacement therapies over the last several weeks.” Amazon Pharmacy is notifying customers it cannot fill prescriptions for popular estradiol twice-weekly patches.

Perfect Storm of Demand

The shortage stems from a dramatic shift in prescribing patterns. FDA Commissioner Marty Makary said the agency would “stop the fear machine steering women away from this life-changing, even lifesaving, treatment.”

Sandoz, a major manufacturer, reported “unprecedented demand that cannot be fully met at present” following the regulatory changes. Amneal Pharmaceuticals confirmed seeing “a significant increase in demand” after the warning removal.

The American Society of Health-System Pharmacists lists multiple estrogen products with current shortages, though manufacturers have not provided reasons for supply constraints.

Patient Impact Severe

Women are experiencing treatment disruptions that bring back menopause symptoms. One patient told NPR she went without patches for “a couple of anxious weeks in January.”

“There’s definitely some symptoms that I noticed popping back after I went off of the patch for a while, and they still haven’t completely gone away,” said another patient in perimenopause.

Doctors report women are scrambling to switch brands or dosages. Some are considering going without treatment entirely.

Medical Benefits Drive Demand

Dr. Nora Lansen of Elektra Health explained why patches are preferred: “The transdermal version of estradiol has a lower risk of blood clots. Without passing through the liver and its metabolism, this transdermal version is really a much safer option.”

Recent studies show women who start hormone therapy within 10 years of menopause onset have reduced all-cause mortality and fractures. They may also cut cardiovascular disease risk by 50%, Alzheimer’s disease by 35%, and bone fractures by 50% to 60%.

Manufacturing Constraints

The shortage reflects manufacturing capacity limits for complex transdermal systems. Industry experts say “there is finite industry capacity for producing them.”

Supply chain issues, tariff impacts on overseas manufacturers, and the sudden demand surge have created a perfect storm. The global hormone replacement therapy market is expected to grow at 5.9% annually through 2036.

Alternative transdermal estrogen forms remain available, though they often use the same drug from the same manufacturers.

Read more: Why the ‘mad scramble’ to fill hormone therapy prescriptions for menopause