Estrogen patch prescriptions hard to fill for Charlotte-area women

CHARLOTTE, N.C. (WBTV) - Women in the Charlotte area and across the country are facing mounting obstacles filling prescriptions for estrogen patches used in hormone replacement therapy, or HRT.

Nicole Bentivegna, a certified nurse practitioner at Signature Wellness, said she is dealing with the exact same issue.

“On my drive up here, I got a text alert from my pharmacy saying your patch is on back order,” Bentivegna said.

Across the country, some women have reported calling pharmacy after pharmacy just to track down an available estrogen patch. Bentivegna said she doesn’t want her patients to carry that burden alone.

“We actually dedicated two medical assistants in the practice to start calling pharmacies in all of the Charlotte area ZIP codes that we take care of, which is a pretty large area,” Bentivegna said. She noted that local supplies are constantly fluctuating.

The supply crunch comes as demand hits record highs.

The FDA removed the safety alert known as a “black box warning” from many HRT therapies in February. Prescriptions for estrogen patches subsequently climbed from 594,000 in June 2024 to 1.6 million in May.

Dr. Claire Bowles, medical director of Novant Health’s Pelvic Health and Menopause Care, said the delays have taken a serious toll on patients.

“It’s been very frustrating for patients,” Dr. Bowles said.

Bowles explained that HRT can reduce long-term risks of cardiovascular disease and osteoporosis, and stopping the therapy without transition can trigger immediate, severe symptoms.

“Going off hormone replacement suddenly can affect your sleep. It can affect your mood. It can cause anxiety. It can cause heart palpitations,” Bowles said.

The FDA has not officially classified the patch, known as estradiol, as being in a national shortage. However, an Arizona physician recently launched a petition urging the federal agency to make an official declaration.

“When the FDA calls something a shortage, it allows compounding pharmacists to start making replacement options,” Bowles said. “And there are still replacement options out there, but without calling it a shortage, it creates difficulty for patients.”

Elected officials are also joining the effort. In August, a group of Democratic House lawmakers sent a formal letter to the FDA urging the agency to add estradiol to the federal drug shortage list.

Both Bowles and Bentivegna advise patients not to try navigating the shortage alone or stopping cold turkey.

Instead, they urge patients to consult their healthcare provider to discuss alternative formulations—such as gels, sprays, or oral options—and to consider checking pharmacies in neighboring areas outside their regular ZIP code.