Why Is It So Hard to Find an Estrogen Patch Right Now?
There are a lot of cranky perimenopausal, menopausal, and post-menopausal women in the world right now.
Why?
Because there’s a shortage of topical estrogen patches.
Finally, after a 20-year hiatus, largely due to the reinterpretation of the Women’s Health Initiative (WHI) study, women have greater access to hormones again. More recent analysis of the research has helped clarify the benefits and risks of hormone therapy, leading the FDA to remove long-standing black box warnings on menopausal hormone therapy products.
The result? Estrogen patch use has increased by 184% since 2023! Many women who were previously denied hormones now have them. Can you hear that collective sigh of relief?
Enter the present: Due to the uptick in demand, there isn’t enough supply.
Wah wah.
(Have you seen any of the hilarious social media posts on the shortage? The Holderness Family has a great one on Instagram – @theholdernessfamily.)
Every pharmacist I’ve spoken to in the past six months has mentioned “the shortage”, and the American Society of Health-System Pharmacists (ASHP), the largest professional pharmacy association in the U.S., has reported shortages of multiple estradiol patch products.
Who’s not acknowledging a nationwide shortage? The FDA.
ASHP’s data comes from pharmacists, practitioners, and patients on the ground. The FDA relies on information reported by manufacturers. The two systems don’t always paint the same picture.
(Underneath the “Your Move” section below, there is a link where you can report the shortage to the FDA.)
The Burden of the Shortage Lands On Patients
Unfortunately, much of the work of navigating this shortage has landed on patients.
Checking pharmacy stock would normally fall to your provider’s office staff, but most practices don’t have the staffing to call every local pharmacy during a shortage.
Pharmacy phone lines often route to automated systems patients can’t get past, while provider lines might get through. So those with the least time and access end up with the burden of calling, getting more frustrated with each “no”.
I spent hours one recent Saturday afternoon calling every pharmacy in my town, a neighboring town, and even a town three hours away that would be on my drive to visit my kids in Utah.
Of the 20 pharmacies I called, NONE had the twice-weekly patch in the dose I needed. So I had to switch to the weekly patch.
What to Know If You’re Calling Pharmacies
A few things to keep in mind if you’re calling pharmacies:
1. Shipments change daily.
Pharmacists have told me they don’t know what they’re getting until it arrives; so a “no” today isn’t necessarily a “no” next week, or even tomorrow.
Word on the street is that 0.0375 mg and 0.05 mg twice-weekly patches are running lowest right now, likely because they’re among the most commonly prescribed doses.
2. Ask about weekly patches.
If your twice-weekly patch isn’t available, ask your prescriber whether a weekly patch, at your twice/weekly dosage, may be an appropriate temporary alternative before considering a change in strength. For example, if your twice/week patch is .05, you will be requesting a weekly .05 patch.
Some women notice that a weekly patch feels less beneficial than the twice-weekly version. Your prescriber can help determine the appropriate equivalent formulation for you.
More on that trade-off next week.
Your Move
Don’t just ask, “Do you have the estrogen patch in X dose?”
Ask specifically for your twice/week dose. If they don’t have it, ask whether a weekly option is available and talk with your prescriber if it could work for you.
And check back. Stock shifts daily.
If you hit a wall like I did, report it. The FDA relies in part on reports of supply issues to identify and respond to drug shortages.
REPORT A DRUG SHORTAGE TO THE FDA
Or you can send an email to drugshortages@fda.hhs.gov.
Next Week
We’ll dive deeper into the weekly vs. twice-weekly trade-off, what to do once you’ve confirmed there’s nothing on the shelf, and the bridge I’ve been using with my own patients.
Warmly,
Dr. Krista
Olive Says
Don’t hate. Meditate!