Can't Find Your Estrogen Patch? You Still Have Options.
You go to pick up your estrogen patch and the pharmacist tells you it's on backorder. No restock date. Maybe try another pharmacy.
So you call three more and get the same answer.
If that has been your month, I want you to know two things. You are not stuck, and you do not have to sort this out by yourself.
One of my patients, a 49-year-old woman, had been dealing with this for a while. She could not find her patch consistently, so with each refill she got whatever brand the pharmacy happened to have. With all that switching, her symptoms started to increase. Hot flashes, poor sleep, and hip pain.
We moved her to a compounded estrogen cream that is delivered to her home. She no longer has to wonder which brand she will get, or whether she will get one at all. Over the past few months, her symptoms have been much better.
Please don't just go without
When estrogen stops suddenly, the symptoms it was controlling tend to come back. Hot flashes, night sweats, the 3 a.m. wake-ups, the brain fog. Many of you waited a long time to feel like yourself again, and a supply problem should not be the thing that takes it away.
I also don't want you stretching a patch past its wear time to make the box last. A patch worn too long delivers less estrogen, so you end up underdosed without knowing it.
If you are down to your last week or two, that is the time to reach out. Not the day you run out.
Step one: find what is on the shelf
A shortage usually hits one brand, one strength, or one manufacturer. It rarely hits everything.
Estradiol comes in several patch brands, in both twice-weekly and once-weekly versions. It also comes as a gel, a spray, a vaginal ring, and a tablet. All of these are FDA-approved products you can fill at a standard pharmacy, and many are covered by insurance.
I can call the pharmacy and see what is in stock for you, so you are not driving around town or sitting on hold. Then I work out which available product is the closest match to the dose you were already doing well on, and write the prescription for it.
Switching is not always a one-to-one swap. Your body may absorb a gel differently than a patch, and as my patient found, even bouncing between patch brands can bring symptoms back. So the goal is one product you can get reliably, and I check in after the change and adjust if your symptoms tell us to.
Step two: a compounded option made for you
Sometimes nothing at the standard pharmacy fits. The strength you need is out everywhere, or you have already tried the alternatives and they did not work for you.
This is where my pharmacy relationships help. I work closely with compounding pharmacies, which prepare the medication to order, and I can prescribe through them. For estrogen, that most often means a compounded cream or an estrogen injection, in a dose set specifically for you. Every compounded product I prescribe can be delivered to your home, so there is no pharmacy counter involved at all.
I want to be straightforward about one thing. Compounded hormones do not go through the same FDA approval process as the products at your regular pharmacy. That is why I only use compounding pharmacies I know and trust, and why I use them when there is a clear reason to. A shortage that leaves you without your medication is a clear reason.
What to do next
If you are a current patient, message the office before you run out. Tell me what you take, the dose, and how many days you have left. I will take it from there.
If you are not a patient yet and your prescriber has not been able to offer you an alternative, book a New Patient Visit ($495). We will go over what you have been taking, what has worked, and what hasn't, and you will leave with a plan you can fill. I see women at my office in Oregon City and the surrounding Portland area. I also offer televisit for women in Oregon and Washington.
A backorder is a supply problem. It does not have to become your hot flashes coming back.
Rena Mattingly, MSN, APRN, AGNP-C Health in Her Hands
**This post is for education and is not medical advice. Talk with your own provider before changing how you take any medication.
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