Dr. Heidi Queen, MD | Energize Health & Hormones 

For many women working with Dr. Heidi Queen at Energize Health & Hormones, menopause hormone therapy (MHT) has been part of a thoughtful, individualized plan — not a trend, not a quick fix, and not a one-size-fits-all prescription.

So when patients hear there’s a nationwide shortage of estrogen patches, it can feel unsettling. If the patch has been your steady solution for hot flashes, sleep disruption, mood changes, or brain fog, the idea of “out of stock” is more than an inconvenience. But this moment also offers an opportunity to zoom out and ask an important question: Was the patch the only option — or just the most commonly offered one?

Why Is There a Patch Shortage?

Drug shortages aren’t unusual. At any given time, hundreds of medications across categories — from antibiotics to emergency treatments — are in short supply due to supply chain disruptions. Most pharmaceutical ingredients are sourced globally, and manufacturing depends on complex international logistics. Trade policies, transportation issues, raw material access, and even extreme weather can ripple through the system. Estrogen patches are no exception.

At the same time, demand has surged. Public conversation about menopause has expanded significantly over the past few years. Women are seeking care in higher numbers. Prescriptions for estrogen have climbed sharply since 2021, and nearly half of those prescriptions are for transdermal patches. Greater awareness is a good thing. Fewer women are being denied therapy out of outdated fear. But when demand spikes in a system that isn’t built for rapid scaling, shortages follow.

Is the Patch Always the Best Option?

Transdermal estrogen — including patches — is an excellent option for many women. It bypasses the liver, avoids certain clotting risks associated with oral estrogen, and provides steady hormone levels. For women with a history of blood clots, migraines with aura, or certain cardiovascular risks, transdermal delivery may indeed be preferred. But “preferred for some” is not the same as “best for everyone.”

There are more than ten FDA-approved transdermal estrogen products available, including gels, sprays, and systemic vaginal rings. There are also numerous oral estradiol options in varying doses. And that’s before we even discuss the range of progesterone and progestogen choices that may be paired with estrogen, depending on whether a woman has a uterus and what her risk profile looks like.

Yet many women leave appointments — or telehealth visits — with the same combination: an estrogen patch and micronized progesterone. It’s a legitimate pairing. But when it becomes automatic, something important is lost: personalization. Dr. Queen’s approach is different. In concierge primary care and integrative hormone management, the starting point is not “What’s most popular?” It’s:

• What is your medical history?
• What are your goals?
• What symptoms are we addressing?
• What risks need to be considered?
• What does your insurance actually cover?
• What fits your lifestyle?

That’s shared decision-making. And it matters.

Oral Estrogen: Outdated or Underutilized?

In recent years, some messaging around menopause has implied that oral estrogen is inherently dangerous or obsolete. That’s not accurate. For many healthy women without clotting risk factors, oral estradiol remains a safe and effective option. It may also have unique metabolic effects that are beneficial in certain scenarios. The key is screening appropriately. If a woman is a strong candidate for either oral or transdermal therapy, the choice should come down to informed preference — not dogma.

Likewise, if someone prefers not to wear a patch for decades — perhaps due to skin irritation, adhesive reactions, or simple lifestyle preferences — alternatives should be discussed without hesitation. Hormone therapy isn’t a brand. It’s a medical treatment. And medical treatments deserve nuance.

What to Do During the Shortage

If you’re currently using a patch and encountering supply issues, there are practical steps to consider — ideally in conversation with your prescribing clinician. You might try a different pharmacy. Inventory varies regionally. You could switch to another transdermal product such as a gel, spray, or systemic ring. Insurance coverage can be frustrating, but shortages create legitimate grounds for reconsideration.

For some women, oral estrogen may be a safe and temporary (or even long-term) alternative. Some patients stretch patches slightly longer than prescribed or adjust dosing strategies under supervision. In certain cases, matrix-style patches — which have estrogen distributed throughout the adhesive — can be cut to adjust dosing if needed. Reservoir-style patches cannot safely be cut, as they contain a separate estrogen chamber that can leak.

These are not DIY decisions. They’re collaborative ones. And this is exactly where having a physician who understands the full landscape of options becomes critical.

The Bigger Picture: More Access, Smarter Use

It’s worth saying clearly: increased interest in menopause care is a positive development. For decades, women who would have benefited from hormone therapy were denied it due to fear-based interpretations of early studies. Today, the pendulum has swung toward greater openness — and that’s progress.

But progress doesn’t mean indiscriminate prescribing. It doesn’t mean hormones are risk-free, and it doesn’t mean every symptom in midlife automatically requires estrogen.

The right candidate.
The right formulation.
The right dose.
The right monitoring plan.

That’s good medicine.

At Energize Health & Hormones, Dr. Queen integrates evidence-based Western medicine with a broader view of metabolic health, mental clarity, cardiovascular risk, bone protection, and long-term prevention. Hormone therapy is one tool in a larger strategy — not the strategy itself. If your patch is suddenly unavailable, it may feel like instability. But it can also be a moment to reassess:

Is this still the best option for you?
Are we optimizing dose?
Are there other delivery systems worth considering?
Are we looking at the whole picture — sleep, stress, nutrition, strength training, metabolic markers — alongside hormones?

Hormone therapy is not one-size-fits-all. And it certainly isn’t one-product-fits-all. If you’re navigating the patch shortage — or wondering whether your current regimen truly reflects your health history and goals — Dr. Heidi Queen can help you step back, review your options carefully, and build a plan that fits your physiology and your life. Because in menopause care, thoughtful personalization is more powerful than popularity.

To learn more about primary care with Dr. Queen, to explore the practice or schedule a complimentary discovery call at (415) 548-7901 or use our online appointment form. Isn’t it time you for you to experience a more connected way to care for your health?