HRT Prescriptions Surge 86% as Pharmacies Struggle to Keep Up With Demand

Hormone replacement therapy (HRT) prescriptions have skyrocketed 86% from 2021 through the end of 2025, creating widespread pharmacy shortages that are leaving women unable to access estrogen patches and other hormone treatments. The surge follows the FDA's removal of black box warning labels from most menopausal hormone therapy products, giving doctors and patients renewed confidence in a treatment that had fallen out of favor for decades.

Why Are HRT Prescriptions Suddenly Surging?

The dramatic increase in HRT demand stems from a major shift in how doctors and patients view hormone replacement therapy. For years, many physicians were hesitant to prescribe HRT due to a 2002 Women's Health Initiative study that raised concerns about cancer and cardiovascular risks. However, subsequent research has clarified those findings, showing that estrogen does not cause breast cancer and that HRT is safe when used appropriately.

"I was one of those doctors that kind of blew women off when they came in with a multitude of symptoms," explains Dr. Gunjan Raina. "I would just kind of roll my eyes and be like, oh my God, I don't know how to help her. And didn't realize all this time that it was due to her hormones, her estrogen and progesterone, testosterone dropping as you age. And now that we know better, and the FDA has lifted the black box warning, doctors are feeling more confident and comfortable, and patients are feeling more confident and comfortable to start taking hormone replacement therapy".

The FDA's decision to remove warning labels has been transformative. Women across the country are now walking into pharmacies to fill prescriptions for estrogen patches, progesterone, and other hormone treatments, only to find empty shelves. The shortage has been particularly acute for estrogen patches, which have become harder to locate at many pharmacies nationwide.

What Symptoms Is HRT Treating?

Hormone replacement therapy is primarily used to alleviate symptoms related to hormonal deficiency, especially during menopause in women. The treatment works by replacing hormones such as estrogen or progesterone—or both—that the body is no longer producing in adequate amounts. Common symptoms that HRT targets include hot flashes, night sweats, mood swings, and vaginal dryness.

Beyond menopausal symptoms, some patients experience broader hormonal imbalances. Marci Longnecker, an office coordinator at Dr. Raina's clinic, discovered through bloodwork that her progesterone, estrogen, and testosterone levels were all lower than they should be. After being prescribed an estrogen patch and finding the right dose, she experienced significant relief—until the recent shortage made refills difficult to obtain.

How to Find HRT When Your Pharmacy Is Out of Stock

• Call Multiple Pharmacies: If your preferred pharmacy doesn't have your prescription in stock, contact other pharmacies in your area to locate available inventory before your current supply runs out.
• Ask About Alternative Delivery Methods: Just because you're currently taking an estrogen patch doesn't mean you have to stay with that form. Talk to your doctor about switching to a gel, pill, or other delivery method temporarily or permanently while waiting for patches to become available again.
• Work With Your Provider on Adjustments: Your healthcare provider can help you transition between different routes of administration for a few weeks. Many patients discover they prefer the alternative form and choose to continue with it even after patches become available again.

Dr. Raina notes that the shortage has shown signs of easing in recent weeks. "The last six to eight weeks were rough, but we were able to find some pharmacies in stock," she explains. "We were able to switch some routes of administration. They're now taking the pill or the gel. And they're really, really happy".

What Does the Future Hold for the HRT Market?

The current pharmacy shortages reflect a much larger transformation in the hormone replacement therapy market. According to market research, the global HRT market is projected to expand significantly from $23.58 billion in 2025 to $38.18 billion by 2033, growing at a compound annual growth rate of 6.21%. This expansion is being driven by several key factors:

• Technological Advancements: Innovations in delivery methods and formulation technologies are making HRT more accessible and effective for patients with different preferences and needs.
• Growing Awareness and Acceptance: Increased public understanding of menopausal health and the benefits of HRT has contributed to higher adoption rates, particularly in North America where the United States and Canada lead in HRT uptake.
• Supportive Government Policies: Favorable government initiatives and reimbursement policies are removing financial barriers that previously prevented patients from accessing hormone replacement therapy.
• Rising Hormonal Disorders: An aging population and growing recognition of hormonal imbalances are expanding the patient population that could benefit from HRT treatment.

Major pharmaceutical companies including Abbott Laboratories, Hoffmann-La Roche, AbbVie, Pfizer, Eli Lilly, Novartis, and others are competing in this expanding market, developing new products and delivery systems to meet growing demand.

For women currently struggling to fill their HRT prescriptions, the good news is that the shortage appears temporary. As manufacturers ramp up production and supply chains stabilize, access should improve. In the meantime, working closely with your healthcare provider to explore alternative delivery methods can help ensure you continue receiving the hormone replacement therapy that's improving your quality of life during this important life transition.