This story was originally reported by Jennifer Gerson by The 19th, and republished via Newsgroup rewiring‘s partnership with the 19th News Network.
One of the most commonly used forms of hormone therapy for menopause is currently difficult to find.
This applies to estradiol patches, such as two of the largest manufacturers report be in short supply. Estradiol is a form of estrogen and these patches are a way to deliver the hormone transdermally or through the skin. Transdermal estrogen is often prescribed by menopause care specialists because the release keeps the estrogen from being processed by the liver and thus does not increase the risk of blood clots or heart problems.
The reasons for the shortage are not entirely clear, although it is likely a combination of pre-existing supply chain issues, the impact of tariffs on foreign drug makers, and increased demand for the patches following a shift in regulations. In November, the Food and Drug Administration cancelled the 20-year-old black box warning about estrogen products used in menopausal hormone therapy, warning of serious side effects, likely making these medications feel more approachable.
Systemic estrogen – the patch-based form of hormone therapy – treats some of the best-known and most disruptive symptoms of menopause: hot flashes, night sweats, heart palpitations and mood swings.
But experts say if you can’t find the patch prescribed to you to address these symptoms, there are other options.
Dr. Lauren Streicherprofessor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and author of a forthcoming AARP book on menopause, said there is no need to panic.
“It doesn’t matter how it gets in there, it will help your hot flashes, it will help your symptoms,” Streicher said.
Patches are not the only form of transdermal estrogen available – and in fact, all transdermal estrogens use the same drug, often manufactured by the same company and then distributed to pharmaceutical companies. So some end up in transdermal patches, but there are also gels, creams and sprays that end up on your skin and have the same active substance.
Transdermal estrogen isn’t the only form of estrogen available for hormone therapy, either, Streicher explains.
Oral estrogen – taken via the pill – is also a safe form of estrogen for many people, depending on their medical history. For someone who has no history of blood clots, this may be a good option. That has also proven to be the case lower cholesterol levels And reduce lipidsboth great for heart health.
Some patients may turn to oral estrogen because the patch-free transdermal options are often not covered by insurance.
Streicher doesn’t recommend going to compounding pharmacies to bridge the gap, because it’s impossible to know the exact dosage you’ll actually receive from the products dispensed there.
As the systemic dose of estrogen leaves your body, any symptoms you experience will return – how long this lasts will vary from person to person – but Streicher assured that the consequences of stopping the patch will not be more serious than that.
“Your brain isn’t going to eat itself,” she noted.
But aside from the discomfort, there is no inherent danger associated with temporarily discontinuing hormone therapy. Likewise, there is no danger in continuing once you have access to the hormone therapy you want – and yes, your symptoms will subside once you resume your estrogen intake.
In light of the shortage, Streicher recommended that those who wish to continue hormone therapy should seek the care of a gynecologist who is well-versed in menopausal care and very familiar with the different forms of estrogen used in menopausal hormone therapy and their dosage. Seeing someone who specializes in menopausal care can help ensure you have options if you want to continue hormone therapy, even if you can’t find patches. (Can’t find a menopause specialist near you? There are also many telehealth services that focus specifically on hormone therapy and connect patients with menopause specialists who can prescribe it.)
“These are nuanced things,” Streicher said. “It takes an expert to be able to help someone with that. And most people, especially if you have someone who just prescribes patches, they’ll scratch their heads and say, ‘I don’t know how to help you.’ So keep looking. Keep looking until you find a doctor who has expertise in hormone therapy.”
Because whether it’s finding a brand name instead of a generic, another form of transdermal application, seeing if you’re a candidate for oral estrogen, or just waiting – there are options and care.
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