← Research library

HRT Shortage Tracker 2026: U.S. Estradiol and Progesterone Supply

By The HRT Index Editorial Team · Editorial research — not medically reviewed

Published: July 31, 2026 · Last verified: July 31, 2026· Dataset version: 2026-07-31

As of July 31, 2026, this HRT shortage tracker identifies three U.S. menopause-related hormone product groups on ASHP's current shortage list: estradiol transdermal systems, oral progesterone capsules, and estradiol vaginal cream. A same-day search of the FDA's national drug-shortage data found zero current entries matching those three groups. Across the three ASHP bulletins, we counted 26 affected presentation entries and 31 entries listed as available.

The ASHP and FDA results are not contradictory. FDA determines whether supply is meeting current or projected demand across the national market. ASHP lists manufacturer-confirmed disruptions that it considers national in impact and that affect pharmacy preparation or dispensing, including disruptions in which some presentations remain available.

Current U.S. HRT shortage status

Source: The HRT Index U.S. Menopause HRT Supply Monitor, snapshot HRTI-HRTS-US-2026-07-31-v1, assembled from the ASHP current shortage list, the three linked ASHP product bulletins, and the FDA Drug Shortage Database, all checked July 31, 2026.

One definition before you go further: in this tracker, “available” means listed as available by the source on its own stated source date. It does not mean a particular pharmacy has stock. Neither FDA nor ASHP reports inventory at an individual pharmacy.

One scope boundary too:ASHP also listed testosterone cypionate injection and the testosterone transdermal system as current on July 31, 2026. Those records are outside this dataset's declared estrogen-and-progestogen scope and are not added to the three-group total.

Which HRT products are in shortage right now?

As of July 31, 2026, ASHP lists three current U.S. menopause-related hormone product groups within this tracker's scope: estradiol transdermal systems, oral progesterone capsules, and estradiol vaginal cream. The same-day FDA file contained no current entries matching those three groups.

Here is the full reconciliation, with the dates and counting unit needed to quote it accurately.

Current U.S. HRT shortage snapshot

Source: The HRT Index U.S. Menopause HRT Supply Monitor, snapshot HRTI-HRTS-US-2026-07-31-v1. Counts derived under the presentation-entry rule below from ASHP's estradiol transdermal system, progesterone capsules, and estradiol vaginal cream bulletins. FDA status came from the July 31, 2026 database export.

The headline numbers

• 3 menopause-related hormone product groups currently listed by ASHP
• 0 corresponding current product groups found in the FDA export
• 26 affected presentation entries across the three ASHP bulletins
• 31 presentation entries the same bulletins list as available
• 30 to 55 days between each ASHP bulletin's source date and this tracker's verification date

Read the middle two numbers together. Every current bulletin also contains at least one presentation listed as available. That is why “all estrogen patches are gone” is not an accurate description of the source data. A shortage listing describes a disrupted supply pattern, not an empty shelf everywhere.

Other menopause-related product groups checked

The number three only means something if the search boundary is visible. We checked the following groups against ASHP's current-only list and searched the FDA export for the named hormone terms. No matching current shortage entry was found in either source on July 31, 2026.

Source: The HRT Index search of the ASHP current-only shortage list and the FDA Drug Shortage Database export retrieved July 31, 2026. “No matching current entry” is a register finding, not a guarantee of local availability.

The FDA file contained one match to the hormone terms used in our search: progesterone vaginal gel, Crinone 4%, with the status To Be Discontinued and an update date of March 27, 2026. FDA defines discontinuation and current shortage as different statuses, so we excluded it from the current-shortage total and disclose it here instead of pretending the search returned nothing at all.

What does this HRT shortage data show — and what does it not show?

This tracker shows how FDA and ASHP classify product-level supply conditions on a specific date, how old each source is, and how the normalized record changes between snapshots. It does not show local pharmacy inventory, the number of patients affected, or whether one product can replace another.

What it shows

• Which menopause-related product groups ASHP currently lists within the stated scope
• Whether the same product group appears as current in FDA's national dataset
• How many line-item presentations each ASHP bulletin lists as affected and available
• When each shortage episode was first posted and when the bulletin was last dated
• Whether a stated resupply estimate is still ahead, has been reached, or has passed
• What changed between dated HRT Index snapshots

What it does not show

• Inventory at your pharmacy. Neither national source reports stock at an individual location.
• Patient counts. Twenty-six affected presentation entries means 26 bulletin line items — not 26 patients, 26,000 patients, or any patient total.
• Interchangeability. A listed-available presentation is not automatically an appropriate substitute for an affected one.
• Whether an elapsed estimate came true. When a manufacturer's estimated release date passes without a source revision, the result is unconfirmed. We flag it instead of guessing.
• Total U.S. inventory, market share, prescriptions delayed, or the clinical severity of an interruption.

FDA says local supply problems can occur even when national supply is adequate. A national database showing no current shortage and a pharmacy saying it cannot obtain a prescription can therefore both be accurate on the same day. (FDA shortage FAQ)

How was this HRT shortage tracker produced?

We downloaded FDA's national drug-shortage data and checked ASHP's current-only list and the corresponding product bulletins inside the same July 31, 2026 snapshot window. We then applied a published menopause-HRT scope, counted line-item presentations under one rule, calculated source age, and preserved the primary sources' own dates.

The value of the “3 versus 0” finding depends on whether another person can reproduce it, so the method is visible rather than hidden behind the number.

Primary sources

• FDA Drug Shortage Database for current, resolved, and discontinuation records
• FDA drug-shortage definitions and FAQ for the national threshold, local-supply distinction, and status definitions
• ASHP current-only drug-shortage list for the set of active ASHP bulletins
• ASHP's three product bulletins for affected and available presentations, reasons, estimates, and source dates
• ASHP's FDA-versus-ASHP parameters page for the formal differences between the two systems
• Truveta Research only for separately labeled utilization context, never as shortage evidence
• NHS Business Services Authority and Department of Health and Social Care materials for the separate United Kingdom section

Manufacturer explanations are reported only where an authoritative source attributes them. A pharmacy anecdote can be evidence about that pharmacy; it is not evidence of a national shortage.

Inclusion criteria

A product group enters the U.S. tracker when all of the following are true:

1. It is a U.S. prescription estrogen or progestogen product commonly used for menopause or perimenopause.
2. It appears on ASHP's current-only shortage list, FDA's current-shortage data, or both.
3. The product and dosage form can be normalized without guessing.
4. The source was checked inside the dated snapshot window.

The underlying shortage bulletin applies to the drug product, not exclusively to menopause prescriptions. Some included drugs have other indications and patient populations.

Exclusion criteria

We exclude:

• Non-U.S. statuses from the U.S. totals
• Testosterone replacement products
• Fertility-only and contraceptive-only products
• Compounded preparations
• Non-hormonal menopause medicines
• Local pharmacy inventory reports
• Any claim that one strength, brand, route, or formulation is a patient-specific substitute for another

The United Kingdom is covered separately because its Serious Shortage Protocol system measures something different and cannot be added to U.S. counts.

FDA query and normalization method

We searched every text field in the downloaded FDA file, case-insensitively, for:

estradiol, estrogen, progesterone, medroxyprogesterone, norethindrone,
conjugated estrogens, bazedoxifene, levonorgestrel, testosterone

The only matching row in the downloaded file was progesterone vaginal gel, carrying the FDA status To Be Discontinued. It was excluded from the current-shortage count because it was not a current shortage.

Presentation-entry counting rule

An ASHP bulletin lists individual product presentations: a named manufacturer's product at a specific strength and package configuration. We count those line items.

• Affected presentation entries = line items under the bulletin's affected-products section
• Source-listed available entries = line items under the bulletin's available-products section

These are not package counts, prescription counts, patient counts, national inventory units, market share, or proof of therapeutic interchangeability. Count bulletins and you get one number. Count manufacturers and you get another. Count line-item presentations and you get the numbers used here. All can be valid; only one is this dataset's denominator.

Source-age calculation

Source age in days = tracker verification date − primary source date

We keep three timestamps separate:

• Last verified — when every source in the snapshot was checked
• Source date — the primary source's own displayed date
• Last changed — when the normalized status, count, analysis, or method materially changed

A routine source check that finds no substantive change does not earn a false new dateModified.

Resupply-estimate classification

Each product group is classified as:

Source: The HRT Index resupply-estimate classification used in snapshot HRTI-HRTS-US-2026-07-31-v1.

An estimate is not a promise. A passed estimate triggers another check; it does not resolve the shortage automatically.

Reproducibility receipt

Source:                FDA Drug Shortage Database export
Retrieved:             2026-07-31
Downloaded file size:  535,002 bytes
Rows parsed:           1,636
Maximum update date:   2026-07-31
SHA-256:               ac82aa0debc45af080a385a9ae692c1015331bb1a503e182d08a1151dd40ccc8

Status counts in the downloaded file:
  Current:             1,180
  To Be Discontinued:    432
  Resolved:               24

Snapshot ID:           HRTI-HRTS-US-2026-07-31-v1

The hash identifies the exact source file used for this snapshot. It does not prove the source file is complete or correct; it makes the extraction reproducible against the same file.

A note on ASHP's bulletin terms

ASHP states that its bulletins are copyrighted by the University of Utah Drug Information Service, that ASHP is the exclusive authorized distributor, and that applications of the bulletin information are limited to personal, non-commercial use. This page therefore does not reproduce the full bulletins, manufacturer notes, or an NDC-level mirror. It provides a limited editorial synthesis, original calculations, and direct links to the source pages.

Why does FDA show no HRT shortage when ASHP does?

FDA and ASHP use different inclusion and resolution rules. FDA asks whether national supply meets current or projected national demand. ASHP includes manufacturer-confirmed disruptions that it considers national in impact and that affect pharmacy preparation or dispensing or require alternatives, and it can keep a product listed while availability is partial or restricted.

FDA and ASHP shortage criteria compared

Source: ASHP's FDA and ASHP Shortage Parameters and the FDA drug-shortage FAQ, checked July 31, 2026.

What FDA means by current shortage

The Federal Food, Drug, and Cosmetic Act defines a shortage as a period when U.S. demand or projected demand exceeds supply. FDA evaluates that balance across the nationwide market. It also says local supply issues are often temporary distribution problems and can exist when manufacturers collectively have enough national supply.

What ASHP means by current shortage

ASHP receives voluntary reports from practitioners, patients, and others, then verifies qualifying shortages with manufacturers. Its inclusion rule reaches disruptions that affect how a pharmacy prepares or dispenses a product or require an alternative that may affect patient care. ASHP also states that it frequently lists more shortages than FDA and that products may remain listed despite partial or restricted availability.

Why this tracker keeps both answers

Because collapsing them into one yes-or-no verdict destroys the information. FDA's answer describes national market sufficiency under its threshold. ASHP's answer describes a confirmed disruption under a stricter full-availability resolution rule. This tracker shows both statuses on the same date and labels the source behind each one.

Why do published HRT shortage counts disagree?

Published estrogen-patch counts can differ without one of them being false because the source date and the counting unit move. AARP reported 10 estrogen patch products from ASHP's February 19 bulletin; this tracker counted 20 affected line-item presentations in ASHP's July 1 bulletin; FDA's current national count for the product group was zero on July 31.

Verified count comparison

Source: AARP's March 13 report, ASHP's July 1 estradiol-transdermal bulletin, and the FDA export used for snapshot HRTI-HRTS-US-2026-07-31-v1.

Two things changed.

The source changed. The February and July ASHP bulletins described different dates. A shortage count without its source date is already missing half the fact.

The denominator changed.“Products,” manufacturers, dosage strengths, product families, and manufacturer-strength-package presentation rows are not the same unit. A count of 10 and a count of 20 can both be accurate if one source date differs and the publishers counted different objects.

That is why every count on this page carries a date and a counting rule. It is also why the phrase “20 HRT products are in national shortage” would be wrong. The accurate statement is narrower: ASHP's July 1 estradiol-transdermal bulletin contained 20 affected line-item presentation entries.

Which estradiol patches are affected?

ASHP's estradiol transdermal system bulletin, revised July 1, 2026, contains 20 affected presentation entries and 26 entries listed as available. Six affected entries are once-weekly four-patch presentations; 14 are twice-weekly eight-patch presentations.

Current estradiol-patch signal

Source: The HRT Index count of ASHP's estradiol transdermal system bulletin, revised July 1, 2026.

Once-weekly versus twice-weekly entries

Source: The HRT Index schedule-level aggregation of the July 1 ASHP bulletin. Schedule classification checked against ASHP's product and package descriptions and the official DailyMed labels for Mylan once-weekly estradiol and Mylan twice-weekly estradiol.

The affected side is weighted toward twice-weekly products, but the bulletin also lists twice-weekly presentations as available. It still does not support the claim that every twice-weekly patch — or every patch at a given strength — is unavailable.

Why there is no single patch-shortage end date

The affected entries do not share one status:

• Amneal's listed Lyllana and Dotti presentations were on back order without an estimated release date.
• Noven's presentations were on intermittent back order with weekly releases.
• Zydus's presentations were on allocation to contracted customers.
• Sandoz listed two once-weekly strengths on allocation and four on back order without an estimate.
• Bayer and Mylan/Viatris had presentations listed as available; ASHP also noted short-dated Bayer Climara 0.06 mg/24 hour stock with a March 2027 expiration date.

Averaging that into “the patch shortage ends in [month]” would create a date the source does not contain.

On causes, narrowly

In the current patch bulletin, Noven attributed its shortage to increased demand. Amneal, Sandoz, and Zydus did not provide a reason in the bulletin. “Increased demand caused every affected estradiol patch shortage” is therefore broader than the source supports.

Is oral progesterone in shortage?

Yes under ASHP's criteria. Its progesterone-capsule bulletin, revised June 30, 2026, contains three affected presentation entries and three entries listed as available. FDA's same-day national export contained no matching current shortage entry.

Current oral-progesterone signal

Source: The HRT Index count of ASHP's progesterone capsules bulletin, revised June 30, 2026.

Progesterone entries by strength

Source: The HRT Index strength-level aggregation of the June 30 ASHP bulletin.

This is why “progesterone is available” and “progesterone is in shortage” can both appear in an accurate account. The status differs by manufacturer and strength. The table does not say that one strength or manufacturer is an appropriate replacement for another.

ASHP reported Amneal's affected 100 mg presentation on back order without an estimated release date. Hikma's affected 100 mg and 200 mg presentations carried an early-July estimate. By July 31, that estimate had passed, but the bulletin remained current and had not been revised after June 30. The only defensible status is estimate elapsed; outcome unconfirmed.

ASHP's records show a previous progesterone-capsule shortage episode resolved on October 1, 2025. The current episode was created May 14, 2026. Those are separate episodes with a gap between them — not one continuous shortage beginning in 2025.

Is estradiol vaginal cream in shortage?

Yes under ASHP's criteria. Its June 6, 2026 estradiol-vaginal-cream bulletin contains three affected presentation entries and two entries listed as available. FDA's same-day national export contained no matching current shortage entry.

Current estradiol-vaginal-cream signal

Source: The HRT Index count of ASHP's estradiol vaginal cream bulletin, created June 6, 2026.

ASHP listed Mylan/Viatris, Padagis, and Teva presentations as affected. It listed AbbVie's Estrace and a Prasco presentation as available, with Prasco described as available to current customers.

The source date matters here. An early-June estimate and a late-July estimate had both reached or passed by the July 31 verification date, but the bulletin still carried its June 6 date. That does not prove the estimates failed. It means the outcome was not confirmed in a newer bulletin and should not be silently converted into either “available” or “still backordered.”

A vaginal cream presentation and a systemic transdermal patch are different dosage forms. Their presence in the same HRT tracker does not make them interchangeable.

Is there an HRT shortage in the United Kingdom?

The United Kingdom has four active Serious Shortage Protocols for Estradot estradiol patches. SSP079, SSP080, and SSP081 began December 19, 2024; SSP082 began April 3, 2025. All four were amended July 10, 2026 and are scheduled to end October 2, 2026 unless changed again.

A Serious Shortage Protocol is not the same thing as an FDA or ASHP status. If the Department of Health and Social Care decides there is a serious shortage of a specific medicine, an SSP can authorize a pharmacy contractor to make the specified supply change when the pharmacist judges it appropriate and the patient agrees.

Active Estradot Serious Shortage Protocols

Source: NHS Business Services Authority active SSP register, checked July 31, 2026. The July 10 extension is also documented by Community Pharmacy England.

The four protocols did not all begin in December 2024. The 25-microgram protocol began April 3, 2025. That distinction matters in any duration calculation.

The three systems count different things: FDA classifies national U.S. market shortages; ASHP publishes product bulletins and presentation-level availability detail; the UK SSP register lists legal protocols for specified prescription items and permitted actions. Adding a UK protocol count to a U.S. presentation count would create a total with no coherent unit. This page reports them side by side and never combines them.

The United Kingdom's October 2, 2026 SSP end date is an administrative validity date, not a forecast that supply will be normal on October 3.

Is rising HRT demand causing the shortages?

HRT use has risen substantially, but the available evidence does not establish one cause for all three current U.S. product groups. Truveta found large increases in estrogen-based and progesterone-containing HRT use; ASHP's current patch bulletin attributes increased demand to Noven specifically, not to every affected manufacturer or product group.

Estrogen-based HRT utilization, 2018 to 2026

Source: Truveta Research, estrogen-based HRT analysis, published April 9, 2026. The producer labels the findings preliminary and not peer reviewed; data were accessed March 30, 2026.

The first row is an estrogen-based prescribing rate among women aged 18 and older with prescription data. The route rows are dispensing rates among the separate dispensing cohort defined by Truveta. They should not be treated as one denominator.

Progesterone-containing HRT utilization, 2018 to 2026

Truveta's separate analysis of women aged 45 and older found progesterone-containing HRT prescribing rose from 3.0 per 1,000 in January 2018 to 12.4 per 1,000 in May 2026, a producer-reported increase of 308.7%. Among women aged 45–54, the rate rose from 5.1 to 30.0 per 1,000, a reported 488.0% increase. The cohort included both micronized progesterone and synthetic progestins used in menopausal hormone therapy, so it is broader than the oral-micronized-progesterone shortage bulletin. (Truveta progesterone-containing HRT analysis)

Those are preliminary, non-peer-reviewed utilization findings from the original data producer. They are relevant demand context. They do not prove that demand caused the patch, capsule, or cream disruptions.

The FDA labeling timeline, stated accurately

FDA requested labeling changes for menopausal hormone therapies on November 10, 2025. It did not complete the first approvals that day. On February 12, 2026, FDA announced approval of revised labeling for the first six products. (FDA request; FDA approval announcement)

The regulatory changes, rising utilization, and supply disruptions occurred in the same broad period. No source used in this tracker establishes that the label changes caused the shortages.

For the product-by-product regulatory record, see the FDA HRT Label Change Tracker.

How long will the HRT shortages last?

No source provides one reliable end date for the three U.S. product groups. The current ASHP bulletins contain a mixture of allocation, intermittent releases, back orders without estimates, and estimates that had already reached or passed by July 31.

On July 31, the progesterone-capsule and vaginal-cream bulletins each contained at least one estimate that had reached or passed. The patch bulletin contained allocation, intermittent weekly releases, and back orders without a release estimate. That is enough to reject a single category-wide end date; it is not enough to predict when any individual pharmacy will receive stock.

A U.S. product group leaves the tracker's current table when the authoritative source changes the relevant status under the published rules. It does not leave because a forecast date arrived or because news coverage stopped.

Does “available” mean my pharmacy has it?

No. “Source-listed available” means the presentation appeared in the source's available-products section on that source's date. It says nothing about stock at a specific chain, wholesaler, independent pharmacy, or location.

There are several layers people collapse into the word available:

1. National market supply — what FDA evaluates
2. Manufacturer and presentation status — what ASHP bulletins summarize
3. Distributor and wholesaler allocation — what a pharmacy can order
4. Individual pharmacy inventory — what is physically available at one location
5. The exact prescription — product, strength, route, and package written for one patient

This tracker can see layers one and two. It cannot see layers three through five.

FDA explicitly says local supply issues are usually temporary and often involve distribution, and that it checks national manufacturer capacity when those reports arrive. The British Menopause Society stopped publishing regular HRT availability updates in February 2025 because manufacturer availability could differ from wholesaler availability. That decision does not prove any U.S. status; it reinforces why every status on this page is labeled with its source and date. (FDA FAQ; British Menopause Society notice)

What should someone do if an HRT prescription cannot be filled?

This tracker cannot determine which medicine, strength, route, or brand is appropriate for an individual. Someone who cannot fill a prescription should confirm the exact product and presentation with the dispensing pharmacy and discuss any change with the prescribing clinician or pharmacist rather than changing, stretching, or stopping therapy based on a national tracker.

The useful thing this page adds to that conversation is precision. “Estradiol patches are on back order” can hide a mix of affected and source-listed available manufacturers, strengths, schedules, and package sizes. The exact product matters.

This page does not turn that fact into a substitution recommendation. FDA likewise says the appropriateness of alternatives depends on the patient and directs people having trouble acquiring a drug to their healthcare provider. (FDA shortage FAQ)

What changed in the latest HRT shortage update?

The change log records substantive events: a new or resolved episode, a revised source date, a changed presentation count, a newly elapsed estimate, or a methodology correction. A no-change source check does not create a false new update date.

Snapshot change log

Source: The HRT Index change log. U.S. dates come from ASHP; UK dates come from NHSBSA; the snapshot date is The HRT Index's verification date.

Dated dataset files use versioned URLs and must not be silently overwritten. Material corrections to the article are recorded under the site's corrections policy.

Limitations: what this data cannot establish

We would rather state these plainly than make a careful reader discover them.

• The public databases are live records, not complete version histories. FDA keeps resolved shortages visible for six months and discontinuations for one year, but that is not a permanent snapshot of every prior state. ASHP provides current and resolved lists, but its public bulletins do not provide a line-by-line version history. The HRT Index snapshots are a separate editorial record, not an official archive.
• The ASHP counts carry the bulletin's source date. The tracker may be verified today while a source bulletin is 30 or 55 days old. The source-age column keeps those dates from being mistaken for the same timestamp.
• “No matching current entry” means exactly that. It does not mean plentiful, locally stocked, unaffected, or guaranteed fillable.
• Presentation counts are line items, not people. The count of 26 cannot be converted into patients, prescriptions, packages, or market share from these sources.
• Source-listed available entries can overlap a current shortage bulletin. They describe other presentations in the same product group; they do not cancel the affected entries or prove therapeutic substitutability.
• Elapsed estimates remain unconfirmed until a source changes. A date passing does not establish whether a manufacturer shipped product, whether distributors received it, or whether pharmacies can order it.
• The U.S. and UK measures are not commensurable. FDA status, ASHP presentation entries, and UK SSPs are different units and are never summed.
• The utilization studies are preliminary and not peer reviewed. They provide context from the original data producer, not shortage measurements or causal proof.
• This is editorial research, not medical review. No clinician has reviewed this page. It reports supply-source classifications and does not provide a diagnosis, treatment plan, dosage conversion, or individualized substitution advice.

Frequently asked questions about the HRT shortage tracker

How to cite this page

For APA format: The HRT Index Editorial Team. (2026, July 31). HRT shortage tracker 2026: U.S. estradiol and progesterone supply. The HRT Index. https://thehrtindex.com/research/hrt-shortage-tracker/

Data downloads

The downloads contain The HRT Index's normalized three-row dataset, method fields, source dates, and extraction receipt. They do not reproduce ASHP's full bulletin text or NDC-level feed.

• Dated CSV snapshot (July 31, 2026)
• Latest JSON snapshot

Primary sources

• FDA Drug Shortage Database
• FDA: Drug Shortages
• FDA: Frequently Asked Questions About Drug Shortages
• ASHP Current Drug Shortages
• ASHP: FDA and ASHP Shortage Parameters
• ASHP: Estradiol Transdermal System bulletin
• ASHP: Progesterone Capsules bulletin
• ASHP: Estradiol Vaginal Cream bulletin
• DailyMed: Mylan Once-Weekly Estradiol Transdermal System
• DailyMed: Mylan Twice-Weekly Estradiol Transdermal System
• NHS Business Services Authority: Serious Shortage Protocols
• Community Pharmacy England: Estradot SSP update
• British Menopause Society: HRT supply update policy
• FDA: Requested Menopausal Hormone Therapy Labeling Changes, Nov. 10, 2025
• FDA: First Six Menopausal Hormone Therapy Label Approvals, Feb. 12, 2026
• Truveta Research: Estrogen-Based HRT Use
• Truveta Research: Progesterone-Containing HRT Use

Supporting source used for the published-count comparison: AARP, March 13, 2026.

Related research and standards

• FDA HRT Label Change Tracker
• FDA-Approved HRT Reference
• The HRT Index Research & Reference Library
• Editorial standards
• Corrections policy and log