Hormone therapy use is surging among women seeking relief from menopause symptoms like hot flashes and night sweats. But a shortage of estrogen patches is leaving some women scrambling to fill their prescriptions.

Among women ages 45 to 54, hormone therapy use nearly tripled between 2017 and 2026. Demand for estrogen patches soared after the FDA removed certain safety warnings from hormone therapy labels in November 2025. Manufacturers haven’t been able to keep up with demand.

The FDA is working with manufacturers to increase supplies of estrogen patches. In the meantime, Dr. Claire Bowles, an ob-gyn and medical director of Novant Health Menopause and Midlife Women’s Health who sees patients through the Novant Health Virtual Menopause Wellness program, explains what to do if your pharmacy can’t fill your prescription.

Why is there a shortage of estrogen patches?

Supply isn't matching demand. We're hearing about it every day: Patients go to their pharmacies and can't pick up their prescriptions and they are emailing us and saying, “What do I do?” It's been a big issue.

It’s very frustrating, because women are thankful to have this treatment available, and then suddenly feel like it's at their fingertips and then it’s gone.

What should I do if my usual estrogen patch isn't available?

Start with the pharmacist. Ask what estrogen patches they have in stock and send your clinician a message through MyChart to let us know what's available. If the pharmacy has a different patch that is appropriate, we can change the prescription.

The pharmacy might have a patch from a different manufacturer or one that’s changed on a different schedule. A patient who normally uses a weekly patch, for example, may find that the pharmacy has a twice-weekly option instead. We can make that change quickly through the electronic medical record.

The pharmacist cannot simply make that change without communicating with the prescriber, but patients don't necessarily have to leave the pharmacy empty-handed.

Patients can also call other pharmacies in the area to see whether their usual medication is available elsewhere. Availability can change as new shipments arrive, so checking back with the pharmacy may also help.

What if I’ve tried to switch to a different prescription but still can’t find an estrogen patch?

If a patient is on the patch, we try to keep them on the patch. But if there are no patches available, there are other delivery options like estrogen gels, sprays and oral estrogen. The right alternative depends on the individual patient.

If we're able to keep someone on a transdermal option, such as a different patch or a gel, we generally try to do that first because estrogen delivered through the skin may pose less risk of blood clots than oral estrogen.

For some patients, including younger patients without risk factors like a history of blood clots, migraines or cardiovascular disease, oral estrogen might be a good alternative.

Should I stop my hormone therapy if I can't find my patch?

No. You should never stop or change your medication without talking to your clinician. We really want to be part of that conversation.

Stopping estrogen suddenly may cause menopausal symptoms, including hot flashes, night sweats, sleep disturbances and mood changes, to return. If you have a uterus, it’s especially important to keep taking progesterone without interruption.

Patients also shouldn't assume they can modify the dose themselves. We’ve heard about some women who cut an estrogen patch in half to try to stretch their supply, but many patches are designed in a way that cutting a patch does not necessarily deliver exactly half the medication.

It’s a good idea to order your refill a few weeks before it’s due so you have time to find an alternative, if needed. You can also ask your clinician to prescribe a 90-day refill if you have been stable on your dose and your insurance allows it.

What's the most important advice for women who can't find their estrogen patch?

Don't panic, and don't give up on finding a solution. Call your pharmacy first and find out what they have in stock, then let your healthcare team know what's available.

If the pharmacy doesn't have an appropriate patch, your clinician can help explore other options such as searching for patches at other pharmacies or prescribing another transdermal formulation or an oral option if they are medically appropriate.

The supply situation is changing all the time and an estrogen patch that is out of stock today may be back in stock soon or another appropriate option may be available in the meantime.