Menopause care gets a hot flash: How some hormone therapies are becoming harder to find as discussions grow

More women are seeking care for perimenopause and menopause symptoms as larger, more precise studies and U.S. Food and Drug Administration (FDA) recommendations surrounding Hormone Replacement Therapy, or HRT, have been updated. For over two decades, many women have been pushing through hot flashes, sleepless nights, mood changes and brain fog without much support due to a report linking HRT with higher rates of cancer—a report now outdated.

Today, the conversation around menopause and HRT care has become more open, and some patients are running into a new frustration: certain hormone therapies, especially estradiol patches, have become harder to fill. In some cases, progesterone products have also been affected.

Demand for hormone therapy has been rising as more patients and clinicians revisit menopause treatment with updated information.

In late 2025, the FDA and Health and Human Services (HHS) announced changes to labeling for many menopausal hormone therapy products, removing broad boxed-warning language that had shaped public perception for years. This shift in thought does not mean this treatment is right for everyone, but it has helped reopen a conversation many women had been told was closed.

What are the risks of using HRT?

According to the Women’s Health Initiative, or WHI, 1 out of every 8 women, or 12%, may develop breast cancer by age 80. Hormone therapy may increase this risk by 0.8%, bringing the risk from 12% to 12.8%.

“In comparison, HRT is a smaller risk than regular alcohol use or going for prolonged periods without being active,” says BCH physician, Dr. Brenda Price, a board-certified Obstetrician and Gynecologist with Boulder Women's Care.

HRT options in shortage

With more research available, more women are choosing to try hormone therapy for symptom relief, and this increased demand has resulted in shortages. However, not all hormone therapies are affected equally.

Estradiol patches have been among the most visible problem areas, with multiple brands and doses showing back orders, intermittent releases or allocation issues. Some oral progesterone products have also tightened in supply. For patients, that can mean a partial fill, a delayed refill, a switch in manufacturer, or a call from the pharmacy stating the usual prescription is temporarily unavailable.

What to do if your HRT prescription is affected

Right now, if your hormone therapy is difficult to fill, the safest next step is to contact your prescribing clinician and pharmacist before making changes on your own. Ask whether another strength, manufacturer or alternative treatment option may be available. Do not assume you have to simply wait it out without guidance.

Dr. Price notes, “We are having to switch patients' dosages to some that are not optimal, having patients wear 2 patches at a time to add up to the correct dose, or having them cut a higher dose patch down to approximate a smaller dose. We have to switch to bigger more awkward patches, switch to gel which is not always the same dose or switch to oral estrogen which has been documented to be not as safe because it increases the risks of blood clots. This is not ideal as dosing will not be as precise this way and women may have side effects or issues. There are also supply issues with oral progesterone, and this has to be used in combination with the Estrogen with women who still have a uterus.”

Good news: The conversation about HRT is still open

Menopause is a life altering event—this shortage of helpful medication can be stressful for women who have finally found relief from symptoms that affect sleep, focus, mood or daily life. It can also be confusing for patients who are just beginning care and hearing more about HRT for the first time. The good news is that a shortage does not mean a woman is out of options. One positive shift is that menopause care has become more visible, with more support communities, educational resources and discussion of both hormonal and nonhormonal treatment options.

For women, this moment can certainly be frustrating because it reveals two truths at once: menopause care is finally getting some much-needed discussion, and access to some therapies is uneven and strained. But the larger message has not changed. If symptoms are affecting your quality of life, the conversation is still worth having—and if your usual medication is delayed, your care team may be able to help you navigate the next step.