What is HRT?

Hormone replacement therapy is widely used to help women manage symptoms of menopause. It can take many forms, from gels and sprays to patches, pills, creams and intrauterine systems.

As the NHS notes, HRT typically involves two hormones – oestrogen and progestogen – and replaces levels lost as women go through menopause. These can be given separately or in a single type of HRT. Women who have had a hysterectomy only require oestrogen-containing HRT.

According to the NHS Business Services Authority (NHSBSA), almost 2 million women in England aged 40 and above were prescribed HRT for menopause symptoms in 2025-26. Experts, however, say that access varies and shortages have been a problem.

Which items are affected by the current shortages?

According to a medicine supply notification issued by the Department of Health and Social Care this week, FemSeven Conti patches are out of stock and are expected to remain so until late November. The patches contain estradiol – a type of oestrogen– and a synthetic progestogen called levonorgestrel.

There are also shortages of various Estradot patches – a type of HRT that contains estradiol – and the situation is not expected to end until January.

This is not the first time there have been HRT shortages, and the supply issues affecting Estradot have been long-lasting. The shortages of some products began in December 2024, according to NHSBSA.

“When you have found an HRT treatment that helps you sleep, manage hot flushes and feel more like yourself, being told it is unavailable can be unsettling,” said Sobia Qasim, a pharmacist at the online pharmacy Curely.

Sehar Shahid, a member of the National Pharmacy Association’s board, also raised concerns. “We are deeply frustrated and concerned by shortages to a number of HRT products, with shortages of Estradot being the second longest running individual medicine shortage in the UK,” she said.

“Certain HRT products are specialised and cannot always be easily substituted for an alternative.”

What alternatives are there?

According to the FemSeven Conti notification, alternative patches include Evorel Conti, Estradot Conti 30/95 and Estradot Conti 40/130. These contain estradiol and a different type of synthetic progestogen called norethisterone, and are used twice rather than once a week.

Paula Briggs, a consultant in sexual and reproductive health and a former chair of the British Menopause Society, said keeping the same dose of estradiol was the important aspect. “They have different progestogens, but I do not think that that would have any adverse impact on symptom control,” she said, noting progestogens are required to protect the lining of the womb rather than manage symptoms.

Serious shortage protocols for the Estradot products also list alternatives, such as estradiol-containing patches by Estraderm MX and Evorel. “If we’re using the same dose of oestrogen delivered in a similar patch through the skin, really there is no need to worry,” said Briggs.

What should women do if they are affected by the shortages?

Shahid said people who had experienced disruption to their usual HRT regime should speak to their clinician, while Qasim cautioned against leaving a patch on for longer than prescribed, cutting patches up or borrowing HRT treatments from others.

What needs to happen next?

Briggs said shortages were likely to occur in the future “because year on year we’re seeing a more than 10% increase in use”, she said.

Shahid urged the government to take action. “The new secretary of state should convene a taskforce to fully grasp this issue, bringing together all aspects of the supply chain,” she said.