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Women who take hormone therapy to manage symptoms of menopause may find that their prescription isn't ready when they go to pick it up at the pharmacy. Doctors who prescribe it report shortages and delays. NPR's Allison Aubrey reports.
ALLISON AUBREY, BYLINE: If you take hormone therapy to relieve symptoms of menopause, the last thing you want to hear is that your prescription is not available. Jennifer Mondesir (ph) of Jersey City, New Jersey, who is in her late 40s and is in perimenopause, is prescribed an estrogen patch. It helps with sleep and energy levels. But about nine months ago, she started having trouble getting it.
JENNIFER MONDESIR: I went to CVS and can't tell you the amount of times I've been there and they're like, we're out of patches. Or they would be like, check back tomorrow. So it was like a monthly mad scramble.
AUBREY: Mondesir's doctor at Elektra Health told her lots of patients had shared similar stories. Dr. Nora Lansen, the chief medical officer of Elektra Health, says the use of hormone therapy has grown steadily.
NORA LANSEN: Over the past four to five years, demand has picked up as clinicians have familiarized themselves with current research and patients have become more interested.
AUBREY: It's a big change from the early 2000s when the use of hormone therapy came to a near sudden halt. Back then, the FDA placed a warning on estrogen products after the results of a large study found women taking hormone therapy had an increased risk of heart attacks, strokes and blood clots.
LANSEN: Which, of course, incited grave concern among both users and prescribers.
AUBREY: But evolving evidence of safety and a new generation of products prompted the FDA last year to drop the warning.
LANSEN: Since that's been removed and it's been considered to be a safe option for symptom management, it's become much more interesting.
AUBREY: More people heading into menopause are now asking about hormone therapy and more doctors feel comfortable prescribing it. Lansen says one significant change is how the estrogen is delivered. Instead of oral pills, many women now use estrogen patches, which delivers the hormone through the skin, which is safer because the estrogen doesn't need to make a first pass through the liver.
LANSEN: The transdermal version of estradiol has a lower risk of blood clots. And a blood clot can cause a heart attack. It can cause a stroke. So without passing through the liver in its metabolism, this transdermal version of estradiol is really a much safer option, and that's why there's been such demand.
AUBREY: There are multiple manufacturers of estrogen patches, and when NPR reached out to the pharmacy CVS, the company sent a statement explaining that manufacturers have been unable to provide sufficient supplies. The American Society of Health-System Pharmacists lists several estrogen products with current or recent shortages. The manufacturers did not provide a reason.
Jennifer Mondesir has been able to get her prescriptions without delays after switching to an online pharmacy, which she says is a big relief because before starting hormone therapy, she felt exhausted.
MONDESIR: As a personal trainer, I have to show up to my clients with energy. And I found that, you know, I would have to have, like, a second, third cup of coffee, which is not like me.
AUBREY: On menopause hormone therapy, she says she feels much better, and she hopes as supply and demand even out, the shortages and delays will cease. Allison Aubrey, NPR News.
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