Experts say there is a lack of menopausal care, leading to delays in care.
Dr. Stéphanie Fabion, president of the Menopause Society, said medical schools need more training on menopause to prevent misdiagnoses and improve patient care.
Every month, Jenny Carrick calls the pharmacy, which feels like a gamble.
Will her estrogen patch be in stock?
It causes stress and makes her wonder if she should ration (no) and whether it causes as much anxiety as menopause (probably).
The shortage of estrogen patches, due to manufacturing issues and the discontinuation of some brands, has been exacerbated by an increase in estrogen prescriptions since the Food and Drug Administration removed the black box warning label last fall. This shortage leaves women exhausted and frustrated, calling pharmacies every month for the medications they need to treat menopausal symptoms.
Some women switch from generic drugs to over-the-counter brand-name drugs, which can cost up to $300 a month and are not covered by insurance. Some people are forced to use different brands of estrogen each month, leading to inconsistent care. Women are driving 45 miles to pick up coveted boxes containing tiny plastic patches that are placed near their belly buttons and replaced twice a week to alleviate symptoms ranging from frozen shoulders to vaginal dryness.
According to the Menopause Society, hormone replacement therapy (often a combination of estrogen and progestin) is the preferred treatment for menopausal symptoms. Estrogen helps protect against osteoporosis and can also help improve mood, memory, and sex drive. It is also used by transgender men and women as part of gender-affirming care.
“I know my whole family is dependent on me taking this estrogen patch,” Carrick, 55, jokingly told the pharmacist.
“If there was a Viagra shortage, we would have heard about it.”
Many women struggle with menopause and menopause symptoms for years before getting help. According to one study, one in five women wait a year before their doctor diagnoses them as menopausal. They may be prescribed antidepressants first instead of hormone replacement therapy.
“It was a long two- to three-year journey to get HRT, and now I’m finally at a dose that works for me. I struggle to get the patch every month,” says Carrick, a marketing and communications director in the Sacramento, California area. She will order her next prescription as soon as she qualifies for insurance. Her pharmacist called several places to track it down.
The pharmacy blames manufacturing problems. CVS spokeswoman Roslyn Guarino said some hormone replacement treatments have been on backorder by CVS for several weeks, and pharmacists are looking at other locations to help customers.
Sandoz, one of the leading manufacturers of estrogen patches, did not respond to messages from USA TODAY. But in January, Sand told Australia’s Department of Health, Disability and Aging that one of its popular patches, Estradot, was likely to face supply issues until December 2026.
“If there’s a Viagra shortage, you can bet we’re going to hear about it,” said Abby Schiller, a goal coach who lives in the Los Angeles area.
Track Estrogen Patch Over 7 Hours
Last month, Schiller, 53, spent seven hours calling major pharmacy chains and small family pharmacies to get her next dose.
“The fact that we carry the burden of what we have to do and this is added to that burden and we get it done month after month speaks to the resourcefulness of women,” Schiller said. “So many people are dependent on this drug. We are the decision-makers in our homes, businesses, child care, and communities. They can’t pull this crutch out from under us.”
Women who don’t have access to the patch should not have it rationed or go without it, doctors say.
Heather Hirsch, a physician and founder of concierge business The Collaborative, encourages women to try different pharmacies, not just the location. Some mail-order programs are not experiencing similar shortages.
She recommends that women call their provider and try a different form of estrogen. She also recommends using gels, rings, and sprays daily. Dr. Hirsch says that oral estrogen can still be used to treat menopausal symptoms in healthy women who are not at risk for blood clots.
“Don’t give up,” Hirsch says. “In some cases, it may be beneficial to try a different method,” she says, as some women prefer to take their estrogen daily.
Alyssa Mastromonaco, 49, said her pharmacy only gives her 30-day patches instead of 90-day patches. Each time it was a different generic brand.
“My symptoms started coming back. My gynecologist pointed out that generics can legally vary in dosage by about 20%. And looking back, one patch was minus 20% and the other was about 15% plus compared to the patch I was using before the shortage,” says Mastromonaco, co-host of the podcast “Hysteria.”
She moved to Alloy, a women’s telemedicine company specializing in menopause and menopause that sources medications from multiple companies. Currently, she gets patches in 90-day increments.
“It cost a little bit more money, but it was worth it,” she said.
Do you want to talk about menopause? We look forward to hearing from our readers.
Laura Trujillo is a national columnist focused on health and wellness. She is the author of “Stepping Back from the Ledge: A Daughter’s Search for Truth and Renewal” and can be reached at ltrujillo@usatoday.com.
