Focus: US progesterone supplies tighten as menopause treatment demand grows
Patients and clinicians across the United States are reporting intermittent shortages of oral progesterone, a hormone frequently used in fertility and menopause treatments. The supply strain follows a significant increase in demand for hormone replacement therapy (HRT) after the U.S. Food and Drug Administration (FDA) removed a long-standing safety warning from many HRT products in late 2025.
Prescriptions for progesterone-containing HRT among women aged 45 and older have more than tripled since January 2021, reaching approximately 12 women per 1,000 by May 2026, according to data from the health analytics firm Truveta.
Why Progesterone Supplies Are Strained
The current supply tightness is largely attributed to a surge in HRT utilization. According to Truveta, prescribing rates have risen more than 19% since the FDA label change. Dr. Kathleen Jordan, chief medical officer of the telehealth provider Midi Health, noted that while estrogen patches face the most significant challenges, progesterone supplies are also becoming stretched.
The American Society of Health-System Pharmacists (ASHP) has added specific oral progesterone capsule products from Amneal Pharmaceuticals and Hikma Pharmaceuticals to its shortage database. Amneal Pharmaceuticals stated it is increasing manufacturing capacity at its New York facility to address the heightened demand. Meanwhile, the U.S. Department of Health and Human Services reported that while one manufacturer is experiencing delays, other companies continue to have product available.
The compounding of hormones offers a potential workaround for patients, but it carries distinct clinical risks. Because compounded products lack the standardized regulatory oversight of FDA-approved medications, they may pose safety concerns regarding precise dosing, which could necessitate additional medical interventions like ultrasounds or biopsies.
What May Happen Next
As the market adjusts, clinicians may continue to rely on alternative formulations to manage patient needs. Because women who have undergone a hysterectomy do not require progesterone, and because options like progestin-releasing IUDs or combination patches exist, the impact of the current shortage may remain milder than the disruptions seen with estrogen patches. Michael Ganio, senior director of pharmacy practice and quality at ASHP, noted that without clear information from manufacturers, it remains difficult to determine whether the disruptions stem from manufacturing delays or simply an increase in demand that current market supply cannot meet.
Frequently Asked Questions
Is there an official national shortage of progesterone?
No. The FDA does not currently list progesterone as being in shortage, though the ASHP database includes specific products from certain manufacturers.
Why are some patients turning to compounding pharmacies?
Some providers are utilizing compounding pharmacies to prepare personalized doses of hormones when commercial supplies are unavailable or when specific doses are not otherwise on the market.
What are the risks of using compounded progesterone?
Dr. Gillian Goddard of the NYU Grossman School of Medicine cautions that compounded products are not subject to the same regulatory processes as FDA-approved drugs, which may lead to inconsistencies in the amount of hormone provided and potential health complications.
How have you or your healthcare provider managed changes in medication availability during this period of high demand?