Updated October 21, 2026, 4:01 p.m. ET
Sen. Kirsten Gillibrand, Democrat of New York, is calling for accountability from the Food and Drug Administration as women struggle to fill prescriptions for estrogen patches for more than a year after supply problems.
Demand has increased for the popular menopause drug after the FDA removed the black box warning label on estrogen products.
Experts say demand will increase with new guidelines recently announced by the American College of Obstetricians and Gynecologists for hormone replacement therapy, which will increase the number of women eligible for treatment.
“Estradiol patches are a widely used and highly effective first-line treatment for managing menopausal symptoms, and the FDA should do everything in its power to ensure that this therapy is available to all women who need it,” Gillibrand told USA TODAY. “This is an urgent women’s health priority, and I won’t rest until we have answers. »
Gillibrand sends a letter to the FDA on October 21 demanding that the agency share its plans to make estrogen patches available, including the adoption of emergency measures. She shared an advance copy of the letter with USA TODAY.
The agency acknowledged that women are having trouble finding patches, but the FDA has not called it a shortage, which could prompt the agency to speed up reviews to allow manufacturers to use new facilities, help them resolve supply issues and, in some cases, even authorize compounding.
Health and Human Services Secretary Robert F. Kennedy Jr. met with doctors and manufacturers to increase access to estrogen patches and teach doctors about other options, such as estrogen gels and sprays, on September 15.
USA TODAY has reached out to Kennedy and the FDA for comment.
In the meantime, the FDA advises women to discuss options with their pharmacist or doctor.
“Passive oversight and generic guidance fail to adequately mitigate a nationwide manufacturing deficit,” Gillibrand wrote in the letter signed by Senators Tammy Duckworth, D-Illinois, and Adam Schiff, D-Calif.
Women say they are frustrated that they still have to struggle to access the medications they need. The American Society of Health-System Pharmacists, which represents more than 65,000 pharmacists, says nearly 20 formulations of estrogen patches are affected by the shortage, double the number from earlier this year.
Hormone replacement therapy has fallen from 27% of postmenopausal women in 1999 to 5% in 2020, according to the National Institutes of Health.
The FDA’s black box warning turned many women away from hormone replacement therapy after a 2002 study by the Women’s Health Initiative linked it to a higher risk of breast cancer, heart attack and stroke in postmenopausal women. It was later recognized that the risks mainly affected older women when hormone therapy was started.
As more doctors have become certified in menopause care over the past decade, the use of hormone replacement therapy has increased. Prescriptions for estradiol patches increased from about 594,000 in June 2024 to 1.6 million in May 2026, according to HealthVerity, a data company. Mark Cuban, owner of CostPlus Drugs, said in a recent podcast with Dr. Mary Claire Haver about menopause that patch volume has increased at least tenfold in recent years.
The shortage was getting worse even before the FDA changed its labeling, Kathleen Jordan, chief medical officer and co-founder of Midi, a female menopause telehealth provider, told USA TODAY earlier this year. “The problem is not the increase in demand for patches, the problem is with the manufacturers. The demand is only increasing as access to care improves. It could take years to resolve.”
What can women do if they can’t find the patch
Sharon Malone, an obstetrician-gynecologist and medical advisor for Alloy, says women shouldn’t skip treatment, but also not panic. “We want them to be symptom-free,” she said.
Doctors offer these suggestions for patients struggling with the current shortage:
- Try local and mail order pharmacies as stocks vary.
- Try an estrogen spray or gel, which can also be applied to the arm or thigh. Ask your doctor for a prescription. The spray or gel offers providers the ability to modify doses without changing the prescription.
- If women can take oral estrogen (some women with blood clots or other health problems cannot), it’s a good temporary solution.
- If your pharmacy cannot fill your patch, report it to the FDA at drugshortages@fda.hhs.gov.
- Haver also suggests that women alert the manufacturer of the drug they’re looking for, by sharing their ZIP code and asking for a restocking date.
Gn Health
