Whilst some pharmacies may have no patches in stock, others may have had a delivery; 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 though.

The main brands here in NZ are:

• Estradot
• Estraderm MX
• Estradiol Mylan
• Estradiol Sandoz
• Estradiol Viatris

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 or you have felt any unpleasant effects since you switched to using a different brand of patch, you should see your doctor to discuss this.

You can cut a lower dose patch into smaller pieces to achieve your specific dose (eg, if your usual dose is a 25mcg patch, the pharmacist can give you a 50mcg patch to cut in half, or a 100mcg patch to cut into quarters).

Although it can be fiddly, this is ok to do. All of the patches used in NZ are matrix type patches, which means the drug is evenly distributed throughout the patch so it is ok to cut them to achieve a smaller dose.

It's best to store the remaining portion of the patch in a small zip-lock bag to make sure it doesn't lose its effects, before you are ready to apply it.

One study* showed that cut estradiol patches remain stable for up to 1 month if they are stored in an airtight plastic bag at room temperature.

*REF: Ankarberg-Lindgren C, et al. 2019;8(4):360

You can combine several lower dose patches at the same time to get your usual dose. So if you are usually on 100mcg, you can use x1 25mcg alongside x1 75mcg simultaneously.

However – since Pharmac only fund two patches per week of the same strength at present, then the pharmacy will likely charge you for the extra patches if you receive duplicate patches of the same strength (eg. x2 50mcg patches to make a dose of 100mcg).

If you receive two different strength patches (eg. x1 25mcg patch and x1 50mcg patch) then you should not have any extra charges

If you are really struggling to obtain any patches, you may be able to switch to taking estrogen tablets temporarily.

However, these are not suitable if you have certain medical issues, which include any of the following:

• You have a history of blood clots
• You are at high risk of having a blood clot
• You suffer from migraines with aura

You will need to see your doctor to figure out if estrogen tablets are a safe option for you and to obtain a new prescription.

Here in New Zealand, we can get the following estrogen tablets:

• Progynova (fully funded) - contains estradiol valerate, which converts to body-identical estradiol within the body
• Estrofem (part funded)- contains body-identical estradiol
• Ovestin (fully funded) - contains body-identical estriol, which is a weaker form of estrogen than estradiol
• Premarin (part funded) - contains synthetic conjugated equine estrogen

There are also combination tablets available, which contain oral estradiol combined with a synthetic progestin called norethisterone. They are all part funded

• Kliogest - contains high dose estradiol and continuous norethisterone
• Kliovance – contains low dose estradiol and continuous norethisterone
• Trisequens – contains variable dose estradiol and cyclical norethisterone

For more information about switching from patches to pills, scroll down to see a dose conversion table at the end of this page.

If you cannot or do not want to take estrogen tablets, there are estrogen gels available which have all the same safety profile and benefits of estrogen patches.

This means any woman that uses an estrogen patch could safely use a gel instead.

They are not funded yet here in New Zealand but are available on prescription for a cost at your pharmacy.

Any pharmacy can order estrogen gels from their wholesalers under Section 29.

This allows doctors to prescribe medications that have not yet been licensed with Medsafe.

There are two brands of estrogen gel available

• Sandrena (this comes in separate sachets)
• Estrogel (this comes in a pump bottle)

Both types of gel are applied ONCE DAILY, either to the arm, thigh or lower abdomen.

Exact costs will vary between different pharmacies but will be at least around $30 per month.

For more information about switching from patches to gels, scroll down to see a dose conversion table at the end of this page.

UPDATE as of May 16th 2024:

Estrogel has now received Medsafe approval. However, current stock within NZ is still Section 29 stock, so pharmacies will need to continue to order through Section 29 until that stock is depleted.

Once this happens, there will then be no Section 29 restriction on ordering Estrogel.

The makers of Sandrena have also applied for Medsafe approval and this is pending.