Heard About the Estradiol Patch Shortage? Here’s How to Avoid Running Out

If you’re a woman using menopausal hormone therapy in the US, you probably already know there’s a shortage of estradiol patches.

While there's no mention on the official FDA drug shortage website, for women who rely on estrogen patches for hormone replacement therapy to relieve hot flashes and insomnia, the struggle is real. There are delayed refills, surprise brand substitutions and calling or driving around to find a pharmacy with the patch you want.

“This is not unique to one pharmacy. It’s a supply chain issue,” says Dr. Kathleen Jordan, chief medical officer at Midi Health, the nation’s largest telehealth company treating 25,000 midlife women a week. “This has been going on for a couple years. It happens sporadically.”

The reasons for the shortage are layered, but it boils down to too much demand on the existing supply. Beginning in 2020, women’s hormonal telehealth companies started educating women about the potential health benefits of hormone therapy and making treatment more accessible. And in November 2025, when the US Food and Drug Administration recommended that the misleading black box health warning be removed from bio-identical estradiol patches, gels and topical creams, more women felt comfortable about starting hormone therapy.

Jordan notes the estradiol patch supply shrank when Bayer SA discontinued its Climara estradiol patch in late 2023. Today there are three companies producing the majority of the estradiol patches available in the US: Sandoz, Viatris (formerly Mylan) and Amneal.

The supply fluctuations may require women to become proactive and flexible. “There are so many different versions of patches. I think most people should be able to find an option,” says Jean Cunningham, PharmD, a board-certified pharmacotherapy specialist based in Ohio. She suggests calling different pharmacies in your area or asking your pharmacist to help find a location with a better supply.

If there’s nothing available locally, Cunningham said women may have to seek out an online pharmacy. Online options include GoodRx, Cost Plus Drugs and The HRT Club, where customers pay a small annual membership fee for access to discounted hormonal medications. HRT Club founder and CEO Cyrille Labourel says the company is currently filling prescriptions for 10,000 active members in the US.

“Even before this FDA change, it was quite challenging,” says Labourel, explaining that just two companies produce the majority of the estradiol patches for the US market. He predicts that supplies will remain spotty, and prices will likely rise until there’s another company supplying the US market. HRT Club has direct contracts with manufacturers and suppliers to ensure their supplies, but as more women seek menopausal care, it’s getting challenging. Labourel shared industry data showing the overall estradiol market grew 14% in 2024, with patch sales accounting for 30% of the market, a 4% increase from 2023, according to the 2024 IQVIA MIDAS® Quarterly Volume and Value Sales report.

Jordan says as more women seek care for menopausal symptoms, “we’re hoping pharma keeps up.” In the meantime, she offers three tips to help women using estradiol patches ensure that they don't run out.

Plan ahead.

Get in the habit of ordering your patch refills a couple weeks in advance of putting on your last patch. That way you have some cushion in case there's a delay.

Ask for a transfer.

If your pharmacy is out of patches and no restocks are coming soon, ask them to transfer your prescription to another pharmacy. “Pharmacies don’t always offer that. You kind of have to ask,” Jordan says.

Ask about equivalent options.

Twice weekly patches are the most common, but ask if they have once weekly patches in stock. Or, as urologist Kelly Casperson, MD suggested on Instagram, if you use a .05 mg patch, see if they have a 1.0 in stock and cut it in half.

If you’re tired of searching for patches, then consider asking your clinicians about the other options for systemic estradiol. The choices include estradiol gel and spray applied to the skin, plus a vaginal ring that delivers estradiol just as safely and effectively as a patch. And oral estradiol, which contains a much lower dose of hormones compared to birth control pills, is also an option for some women.

A new medication requires a new prescription, but at least you won’t have to go without the estradiol you need to treat your symptoms.