Women who use two brands of hormone replacement therapy patches have been warned of supply disruptions across the UK, after the Department of Health confirmed ongoing problems with Estradot patches and a more recent shortage of FemSeven Conti.
The department told the BBC it was aware of "supply disruptions" affecting some HRT medications, and said communications had gone to healthcare professionals about the products involved. Its statement follows a Department of Health and Social Care notice on 12 October declaring FemSeven Conti out of stock until late November 2026.
The warning matters because the Estradot shortage is already nearly two years old. Serious Shortage Protocols for the patches, which allow pharmacists to supply a substitute without a new prescription, were first issued in December 2024 and have been extended at least 10 times since, most recently on 2 October to 8 January 2027.
The FemSeven Conti notice, numbered MSN/2026/048, is graded "Tier 2 – medium impact" and covers the patch combining 50 micrograms of estradiol with 7 micrograms of levonorgestrel over 24 hours. It says alternative HRT products remain available, and lists Evorel Conti, Estradot Conti 30/95 and Estradot Conti 40/130 as 24-hour patches still in supply to meet increased demand.
The four Estradot protocols cover the 25, 50, 75 and 100 microgram strengths. Under each, according to tables published by Community Pharmacy England, a prescription for Estradot can be met with Evorel or Estraderm MX patches of the same numerical strength. The Business Services Organisation in Northern Ireland lists the same protocols with the 8 January expiry date.
"Serious Shortage Protocol (SSPs) for Estradot transdermal patches are currently in place until 8 January 2027, permitting pharmacists to supply alternative products to patients without the need for a new prescription, where the patient has agreed to this," the department said.
"If patients cannot access their prescribed medication or have concerns about an alternative, they should speak to a healthcare professional for advice about their treatment options."
The statement did not give a reason for either shortage, and the department has published no date by which Estradot supply is expected to recover. The repeated extensions of the protocols are time-limited measures rather than forecasts of when stock will return.
Dr Ursula Mason, chair of the Royal College of General Practitioners Northern Ireland, told the BBC that finding a substitute "can cause real anxiety for patients".
"This can be particularly so for HRT medication when a woman has found a preparation that works well for them," she said.
"Patients can be assured that the protocol in place only allows a substitution for exactly the same active ingredient at the same dose," the department said.
Paul Irvine, a Belfast pharmacist, told the BBC he understood women "are concerned". "When they are short and they like to try alternatives, they may suffer side effects or it might just not work as well," he said.
Roisin Hillman, co-founder of Menopause Together, described by the BBC as Northern Ireland's first menopause support charity, said some women forced to switch brands had reported side effects such as itchy skin or patches falling off.
The National Pharmacy Association, which represents independent pharmacies, has described Estradot and the pancreatic enzyme drug Creon as Britain's longest-running medicine shortages on record. Creon has been covered by a protocol since May 2024.
Olivier Picard, the association's chair, said after the latest extension: "It is deeply depressing for pharmacies and patients alike that Creon and Estradot have now had their unhappy title extended as being Britain's longest running medicine shortage on record," according to Pharmacy Magazine. The association has called on the health secretary, Yvette Cooper, to set up a medicines shortage taskforce.
The FemSeven Conti return date of late November is a projection given in the DHSC notice. Earlier notices for Estradot have been superseded by successive extensions.
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