Elizabeth Borsting had been on hormone replacement therapy (HRT) for a year and a half when she noticed her estrogen patch was missing from her bag of Costco prescriptions.
“They told me, ‘Yeah, we’re out, there’s a shortage, but you can pick it up [40 miles away],’’’ she told The Post.
Borsting didn’t have the time to travel unexpectedly, but the clock was ticking — and she needed the patch, stat. Before HRT, she’d been battling menopausal mood swings that made her feel like a sullen teenager who was home from school, feeling sick (and pissed off) with PMS symptoms. She couldn’t deal with that again.
Borsting’s husband happened to be traveling in Utah at the time, so she sent the prescription nearly 400 miles away in the hopes that it could be filled there. It worked, but the alert of a shortage launched her own rat race to figure out where to find estrogen patches on a regular basis — and she’s not alone.
Borsting is one of many women who have faced challenges getting their hands on estrogen patches, which have been in short supply since earlier this year.
“Trying to find estrogen patches right now is like a high-stakes scavenger hunt that nobody asked to be a part of,” one woman griped on TikTok. “It’s harder to find my estrogen patches and my HRT right now than it is to find buried treasure.”
“I am driving all over God’s creation to find a CVS that is stocking the estrogen patches,” said another. “Please pray I find the estrogen patches. I don’t want to be a homicidal maniac.”
With no clear end to the shortage in sight — experts estimate it could last several more months to several more years — some women are going to surprising lengths to manage their symptoms, from rationing to trading to flying to other countries.
What is HRT — and why do women need it?
During perimenopause, hormone levels fluctuate as the ovaries gradually produce less estrogen and progesterone.
Besides irregular periods, this can cause symptoms like hot flashes, night sweats, brain fog, mood swings, vaginal dryness, weight gain, body aches, sleep issues and “perimenopause rage” — all of which can seriously impact quality of life.
HRT replaces the hormones that are in decline, which can relieve these symptoms.
But for months, millions of American women in menopause and perimenopause have been facing uncertainty over access to their prescriptions.
In November 2025, the FDA removed the black box labeling from estrogen-based HRT that had warned of increased risks of cardiovascular disease, dementia and certain cancers.
The warning was based on a study from 2002, which found that menopausal women taking estrogen had higher risks for some kinds of cancers, heart disease and stroke — but further research in the decades since has found that risk doesn’t actually apply to all women, so HRT is safer and more effective for the general public than previously thought.
With the black box removal, more women started to take these drugs. Within three months, reports surfaced that estrogen patches were short throughout the country, and perhaps the world: Stock in Canada is reportedly hit-or-miss, and Australia has faced similar access challenges.
In an effort to limit the shortage getting worse, HRT patients are now limited to buying a one-month supply of estrogen patches at a time, so each month is a crapshoot to know whether the patch is going to be available locally or not.
That’s led some women to get more creative in order to maintain their stock of meds.
“I am in [the] US and ready to fly to Tijuana. I am not kidding. Taking orders for friends and family with me”
Redditor
Oh, the places she’ll go (to get HRT)
On social media, women are spilling their workarounds to the shortage — and they’re not above taking extras from those who have them.
“Facebook saved me when someone offered their prescription-strength that didn’t work out for them for free! Three month supply,” one raved on TikTok.
Some have resorted to rationing, with one Redditor writing that she’d built a stockpile by switching her patches a bit less often.
“This way I don’t have to worry if supplies are delayed,” she said — even though other users warned of hives, rashes and other skin irritations if supplies were extended this way.
At least a few desperate women are even prepared to dip south of the border to hunt for their meds.
“I am in [the] US and ready to fly to Tijuana. I am not kidding. Taking orders for friends and family with me,” wrote one Redditor.
“I’ve decided that if my medications become completely unavailable to me and online pharmacies don’t work, I’m going to start taking annual trips to Mexico,” said another.
Many others aren’t traveling quite as far, but they’re still making much more of an effort than they typically need to.
Amy Roberts, a PR professional from Utah, has had to drive 45 minutes each way to the nearest metropolitan area, Salt Lake City, to find her medicine. It’s happened four or five times now, and each trip costs $25 in gas money without taking into account her time.
But she can’t do without it. Prior to taking HRT, she’d often jolted wide-awake in the middle of the night, soaked in sweat, and stayed up, heart-pounding, for hours. The insomnia took a toll on her day to day life.
Then there was the “total implosion of memory,” she says: Once before HRT, she showed up to a veterinary appointment but forgot to bring her dog. Another day, she earnestly debated whether ‘cat’ was spelled with a c, or a k. Her brain fog was so severe, she couldn’t remember.
Desperate for alternatives
Hormone therapy has the most evidence supporting how effective it is for treating menopause and perimenopause symptoms — but as it’s become tough for some to get their hands on it, a few are searching for other solutions.
For instance, the precarity of the HRT ecosystem has pushed Roberts and her friends toward considering injectable peptides compounded through local pharmacies.
Roberts obtains hers — NAD+, which “helps with brain fog and builds immunity” — through a nurse practitioner. She’s also keeping an eye on GHK-Cu, a copper-based peptide that “helps with your skin and hair” because perimenopause symptoms include thinning hair and dry, flaky skin.
She spends $200 per month out of pocket on a single peptide injectable, but she knows people on four to five peptides who pay $500 to $600 out-of-pocket per month.
Dr. Sindhu Koshy, a menopause-certified cardiologist at Henry Ford Health in Michigan, does not recommend peptide treatments to bolster HRT — or even to help in a pinch.
“They’re not FDA approved, and not tested,” she said. “They don’t manage the key menopausal symptoms like hot flashes, night sweats, and brain fog.”
What comes next?
Laura Bray, the founder of Angels for Change, the only patient advocacy organization in the country focused on drug shortages, said that this shortage was bound to occur because there wasn’t a hint from the FDA to drug manufacturers and pharmacists that the black box label would be removed.
“When you remove something like that, there is automatically a spike in demand,” she said. “These facilities that make [HRT] are huge assets worth a billion dollars. They don’t sit idle.”
The life cycle for ramping up production of a generic drug in the pharmaceutical world is 12–18 months, she explained, and the cheaper the medicine, the more susceptible it is to shortages.
If the first reports of estrogen patch shortages were in February, it may be another six months until every patient can find the drugs reliably. Six months may not sound like much, but patients who don’t have the time or money to jump through hoops to access estrogen patches may face health risks.
“Women have their first cardiac events in their 40s, 50s and 60s,” said Koshy. “When estrogen decreases [during perimenopause], there’s a change in vascular symptoms. Blood pressure increases… It also affects cholesterol, where your bad cholesterol goes up, and your good goes down.”
In the meantime, many doctors and pharmacists are recommending women continue their estrogen therapy in other forms, like pills, gel or mist, which can still stabilize hormones and are not in shortage.
But patch devotees insist it’s not an adequate replacement.
“My doc prescribed me the gel (applied to your upper thigh once a day). Well, IT IS NOT THE SAME!!” wailed one TikTokker, echoing many more. “I want my patch!!!!!”
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