Perimenopause
HRT prescriptions have more than doubled since 2018 — and patches are now running short
Hormone therapy is having a moment — and the numbers are striking. A new analysis of US prescribing data finds estrogen-based HRT has gone from niche to mainstream in just a few years.
Researchers at Truveta looked at electronic health records and found that estrogen-based HRT prescribing more than doubled between January 2018 and February 2026 — rising from 11.5 to 23.5 prescriptions per 1,000 women. Among women aged 45–54, the group deepest in perimenopause, roughly 1 in 20 now has an active estrogen prescription, a 184% jump.
Part of the shift is regulatory. In November 2025 the FDA removed the long-standing "black box" warning — its strongest caution — from many menopausal hormone products, after an expert panel concluded the label overstated the risks for the women who benefit most. Prescribing has climbed steeply since.
The type of HRT is changing too. Skin patches more than tripled over the period and vaginal estrogen creams rose more than fourfold, while older oral tablets fell by about 17%. That mirrors what the evidence favours: estrogen absorbed through the skin carries a lower clot risk than tablets.
The catch is supply. Demand has risen so fast that several estrogen patch products are now in shortage. If you're on a patch and struggling to fill it, don't simply stop — talk to your prescriber about an equivalent dose, a different brand or a gel, which delivers estrogen the same way through the skin.
One honest note: this analysis is preliminary and not yet peer-reviewed, and it describes prescribing trends, not whether HRT is right for any individual. Whether to start it depends on your symptoms, your timing relative to menopause and your personal risk — a conversation worth having properly, not a decision to make from a headline.
What the research says
An analysis of US electronic health records by Truveta Research found estrogen-based HRT prescribing rose from 11.5 to 23.5 per 1,000 women between January 2018 and February 2026 — a roughly 105% increase overall, and a 184% increase among women aged 45–54, of whom about 1 in 20 now hold an active prescription. Patch use more than tripled and vaginal cream use more than quadrupled, while oral HRT fell about 17%. The findings are described as preliminary and not peer-reviewed.
Truveta Research · Preliminary analysis, 2026 ↗Frequently asked questions
Why has HRT become so much more popular?
Two things converged: a wave of better public information about perimenopause, and a regulatory shift. In November 2025 the FDA removed its strongest "black box" warning from many menopausal hormone products, concluding it overstated the risk for most women. Prescribing has risen sharply since, especially skin patches and vaginal estrogen.
There's an estrogen patch shortage — what should I do?
Don't stop abruptly. Contact your prescriber or pharmacist about an equivalent-dose alternative — a different patch brand, or an estrogen gel or spray, which deliver hormone through the skin in the same way patches do. Switching form is usually straightforward when guided by your clinician.
The information on this website is educational and is not medical advice. Please consult your doctor if you have any doubts or further questions.