THE CURRENT PATCH ISSUE
Last updated 28/5/2023
There is currently a global supply shortage of estrogen patches used in HRT.
Here in NZ we are feeling this too – and many women have been struggling to get hold of their usual scripts, causing lots of anxiety.
WHAT CAN YOU DO?
WATCH THE VIDEO ABOVE :) AND PHONE AROUND PHARMACIES
Whilst some pharmacies have run out, others may still have stock on their shelves – so it’s worth calling around different pharmacies to ask if they have any estrogen patches - including pharmacies that are outside your area. They may be able to courier the medication out to you.
You might get given a different brand to your usual one. The main brands are:
- Climara (changed ONCE weekly, instead of twice weekly like the other patches)
All of these different brands contain body-identical estradiol.
Whilst for most women the precise brand of patch makes no difference, some women seem to get on better with certain brands. If you think your symptoms have returned or worsened after using a different brand of patch, you should see your doctor to discuss another option.
You may also get given a different dosage of patch and be advised to cut the patch into smaller pieces (eg, if your usual dose is a 25mcg patch, you might be given a 50mcg patch to cut in half, or a 100mcg patch to cut into quarters). Although it’s fiddly and annoying, this is ok to do. The drug is evenly distributed throughout the patches so it is ok to cut them to achieve a smaller dose.
If you are really struggling to obtain any patches, you may be able to switch to taking estrogen tablets temporarily. These are not suitable if you have a history of clots or are at risk of clots; or if you have certain types of migraines. Your doctor can help you figure out if estrogen tablets are an option for you.
Here in New Zealand, we can get the following estrogen tablets:
- Progynova (fully funded and contain estradiol valerate, which converts to body-identical estradiol within the body)
- Estrofem (part-funded and contains body-identical estradiol)
- Ovestin (fully funded and contains body-identical estriol, which is a weaker form of estrogen than estradiol)
- Premarin (part-funded and contains synthetic conjugated equine estrogen)
If you cannot or do not want to take estrogen tablets, there are estrogen gels available which have the same safety profile and benefits of estrogen patches.
They are not funded or licensed yet here in New Zealand but are widely used in other countries.
There are two brands of estrogen gel available
Costs will vary between different pharmacies and they can be prescribed here under section 29 – which allows an unlicensed medication to be prescribed by a registered doctor
Below is a conversion guide that will help you and your doctor determine the correct dosage of estrogen if you want to switch from patches to a gel.