Women Need Treatment for Hot Flashes. Why Is This So Hard?

Dr. Goddard is an endocrinologist.

My first inkling that people couldn’t get their hormone medication was a phone call from a patient in December. She’d been my patient since 2022, when chemotherapy for colon cancer had damaged her ovaries and put her into menopause, triggering hot flashes and night sweats that wrecked her sleep. Her doctors at the time had dismissed her concerns and told her she didn’t need hormone therapy.

This happens all too often. Women are told that menopause is “natural” and are expected to just deal with it. Together, my patient and I decided hormone therapy could help her. For the past three years, it had.

But now her estrogen patches were back-ordered and she was worried about getting them before she was set to travel for the holidays. The United States is experiencing an estrogen patch shortage that involves several manufacturers and is expected to continue through the end of the year.

This shortage is the direct effect of more demand. Estrogen patch prescriptions increased 72 percent between 2021 and the fall of 2025, according to medical record data from Epic Research. They picked up further after the Food and Drug Administration in November removed a black-box warning that had linked hormone therapy to cancer and heart disease.

The growing interest in menopause treatment and the spotlight it puts on women’s health is a huge step forward. For decades, many women didn’t get medication that could have significantly improved their lives, because doctors and patients thought treatment was too risky, and symptoms weren’t taken seriously. Now, with more women, including celebrities, sharing their experiences with menopause, and the re-evaluation of scientific evidence around the risks and benefits of treatment, more doctors and patients are embracing hormone therapy.As welcome as the recent attention to women’s health is and as much as I still worry about unmet need, I’m seeing signs that the pendulum might be swinging too far from “estrogen for no one” to “estrogen for all.” Menopause influencers are promoting high doses of estrogen for overall health or to achieve hormonal balance. Telehealth sites include estrogen under their “longevity” plans. One of my patients half-jokingly said to me, “All the cool girls are doing it.”

Women deserve high-quality care. The best evidence supports taking hormone therapy in menopause because it’s the most effective treatment for hot flashes and night sweats, bar none. There’s no good evidence that hormones will help you live longer or keep you from getting dementia.

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