Women in the U.S. seeking hormone replacement therapy to relieve menopause symptoms are encountering shortages of several estrogen-based treatments, extending supply problems beyond patches to include certain injectable and vaginal formulations.
The U.S. Food and Drug Administration has teamed up to work with manufacturers since September to increase the availability of estrogen patches following months of supply disruptions. However, pharmacies and organizations tracking medicine shortages have also reported difficulties obtaining other forms of estrogen.
Demand for hormone replacement therapy has climbed since the FDA removed a standard boxed warning from certain hormone treatments last year. The warning had highlighted potential risks, including breast and ovarian cancer, stroke and other major health conditions, based partly on findings from a major study published in 2002.
The growing shortages of alternative formulations may somewhat reflect patients switching away from estrogen patches that have become increasingly difficult to obtain. Kevin Schipper, who oversees product lifecycle management at pharmaceutical consulting firm ProPharma, said this shift could be placing additional pressure on supplies of other hormone therapies.
The American Society of Health-System Pharmacists reported shortages of several estradiol injection products in early September, including medicines supplied by American Regent, Par Sterile Products and Hikma.
Vaginal estradiol creams have also faced availability problems. Products manufactured by Teva, Padagis and Mylan, Viatris’ generics business, have been listed as being on backorder or subject to allocation, according to the organization’s shortage tracking information.
The FDA did not respond to a request for comment regarding the latest supply disruptions.
CVS Health said manufacturers have struggled for several months to provide adequate quantities of certain estradiol injection strengths, with the situation deteriorating further in recent weeks.
Dr Kathleen Jordan, chief medical officer at telehealth provider Midi Health, said supply chain difficulties were becoming increasingly widespread. She explained that prolonged shortages of estrogen patches have encouraged clinicians and patients to turn to alternatives such as creams and gels, creating a knock-on effect that has begun affecting the availability of those products as well.
Cost Plus Drugs, the online pharmacy established by billionaire entrepreneur Mark Cuban, said it was purchasing as much inventory as possible from suppliers to maintain product availability. Cuban said demand across almost every product sold through the platform had increased fivefold to tenfold, driven by its competitive pricing, while suppliers were working to expand manufacturing capacity.
According to Cuban, the pharmacy has largely maintained supplies of estrogen replacement treatments, experiencing only occasional disruptions.
In September, the U.S. Food and Drug Administration reported that the domestic supply of approved estradiol patches had nearly doubled compared with the previous year. However, production growth had still fallen short of meeting rising demand.
Viatris, which manufactures estradiol patches and vaginal creams, reported a substantial increase in orders and said it had spent the year working to boost output. Earlier in the year, the company added another production shift at its facility in St. Albans, Vermont, enabling continuous, around-the-clock operations and significantly increasing manufacturing volumes.
Estrogen Supply Shortage Creates New Challenges for Women
The U.S. Estrogen supply shortage is worsening as women struggle to find prescription hormone replacement treatments used to manage menopause symptoms. According to Reuters reporting published on October 28, 2026, supply problems that initially affected estrogen patches are now extending to certain injectable and vaginal estrogen products. The growing disruption is making it more difficult for some patients to obtain their usual prescriptions and maintain consistent treatment. Although the U.S. Food and Drug Administration (FDA) has been working with manufacturers to increase patch production, rising demand continues to put pressure on the supply chain.
