US Faces Tightening Progesterone Supply Amid Rising Menopause Treatment Demand

The U.S. is currently experiencing tighter supplies of progesterone, a key hormone used in many fertility and menopause-related treatments. Patients and pharmacists across the country have noticed intermittent shortages of oral progesterone capsules, a concerning development given its vital role in hormone replacement therapy (HRT).

This supply squeeze coincides with ongoing struggles to fill prescriptions for estrogen patches, another cornerstone treatment for menopausal symptoms. The rising demand for HRT therapies followed significant changes late last year when the U.S. Food and Drug Administration dropped a long-standing safety warning on many hormone therapies, leading doctors to prescribe them more confidently and sparking heightened interest among women experiencing menopause.

Progesterone is commonly given alongside estrogen to manage symptoms like hot flashes, mood swings, and osteoporosis, while also helping to reduce uterine cancer risk. The swollen demand has stretched available supplies, with some pharmacies unable to fulfill standard 90-day prescriptions-an unprecedented hiccup for long-time users like Robin Wilson from Iowa, who recently faced this exact issue.

Health data from Truveta indicates that prescriptions for progesterone-containing HRT in women over 45 have more than tripled since early 2021, reaching about 12 patients per 1,000 by May 2026. Moreover, prescription rates jumped over 19% following the FDA's label update, highlighting the surge in usage and pressure on the supply chain.

While estrogen patches grapple with more severe scarcity, progesterone capsules aren't far behind in facing availability challenges. The American Society of Health-System Pharmacists lists several brands-including those from Amneal Pharmaceuticals and Hikma Pharmaceuticals-as currently experiencing supply issues, though manufacturers like Amneal report expanding production to counteract demand.

Large pharmacies such as CVS acknowledge that manufacturers have struggled to keep up with the increasing demand for HRT medications over recent months. Interestingly, none of the nine companies manufacturing oral progesterone in the U.S., such as Teva, have publicly clarified the root causes behind supply hiccups. The FDA does not officially list progesterone as in shortage but confirms one manufacturer has faced delays while others continue to distribute product.

In response to supply disruptions, some healthcare providers are recommending alternatives like combination hormone patches, progestin-releasing intrauterine devices, or oral progestins to mitigate reliance on a single formulation. Meanwhile, compounding pharmacies have stepped in, preparing bespoke progesterone formulations. Yet, medical experts urge caution with compounded products, noting the risk of inconsistent dosing and potential complications due to lack of FDA oversight.

With hormone therapy demand showing no signs of slowing and supply chains adapting slowly, the situation remains dynamic. Whether manufacturers can ramp up production swiftly enough to meet this burgeoning need will be critical to watch, as delays impact patients relying on these treatments across the country.