Pharmacies run out of hormonal treatment for menopausal women and trans people

Barcelona“We have run out of the estradiol we need so much to function daily and nothing is being done,” lamented Pino Bethencourt recently on LinkedIn. This coach explained, with fear and also rage, some of the effects she could suffer if she did not obtain the hormonal treatment she had been prescribed to treat the numerous and debilitating symptoms she was suffering linked to menopause.

“If I don’t receive my dose, I will enter into total exhaustion [...], my metabolism will go completely out of balance [...], I will have hot flashes and I will wake up soaked in sweat at night. That is if I sleep, because insomnia is another typical symptom of menopause. And the dreaded mood swings, depression, and mental illnesses.”

Far from being exceptional, her case puts a face to a problem that has been affecting thousands of menopausal and trans women in Catalonia and Spain for months: the shortage in pharmacies of transdermal estradiol treatments.

Since the end of 2025, finding Lenzetto, one of the most used spray preparations, has been an odyssey to which Evopad patches and other estradiol treatments not financed by the healthcare system, such as Bijuva, Oestraclin, or Estraderm, have now been added. The situation, for many women, is desperate.

“First it was Lenzetto,” explains Elisa Llurba, director of the Gynecology and Obstetrics Service at the Hospital de Sant Pau. "Women were telling us that they had to go to several pharmacies to look for it, even outside their municipality. Now we see the same problem with the patches, especially Evopad, and also with progesterone,” she warns.

“We pharmacists are going crazy looking for alternatives, because women arrive at the pharmacies very anxious because they do not want to discontinue a treatment that is working well for them,” points out Mercè Barau, pharmacy office representative of the College of Pharmacists of Barcelona.

On March 16, the Spanish Agency for Medicines and Health Products (AEMPS) officially declared the shortage of Lenzetto, financed by the Spanish healthcare system and indicated for menopausal and trans women. Pharmacy networks that monitor the stocks of thousands of establishments were already pointing it out as one of those with the most shortage notifications, and Barcelona was one of the provinces most affected in the country.

The reasons for the shortage are diverse. To begin with, according to Gedeon Richter, the company that manufactures it, demand has increased exponentially in a short time and manufacturing forecasts have fallen short. For years, hormone therapy was associated with endometrial and breast cancer and its prescription was reduced, but subsequent scientific evidence has demonstrated its safety and benefits for cardiovascular and bone health, as well as signs of protection against dementia. That is why now, points out Llurba, it is prescribed much more than a few years ago. Although there is no registry that allows knowing how many women are following hormone therapy, a recent study pointed to 9.2%. And to this is added the prescription of this drug to trans women, and non-binary and intersex people.

Another of the reasons for the Lenzetto shortage could have to do with the prices at which it was sold in the State. The Spanish pharmaceutical market is strictly regulated, with prices fixed by the government, and it established a lower selling price than in the rest of Europe, which could have meant that the pharmaceutical company, faced with production problems, prioritized distributing it to countries with higher profit margins. Although to alleviate this situation, in April the ministry of health agreed to raise the selling price to guarantee its supply, for the moment this has not made the product reappear in pharmacies. Gedeon Richter has announced in a statement that it expects to recover stock levels to normal by the end of the year.

The lack of Lenzetto has caused the rest of the transdermal therapeutic options financed by the Spanish health service to run out, as stated in a release by the Spanish Association for the Study of Menopause (AEMM), which affirms that they are working to recover therapeutic options as soon as possible.

Beyond menopause

Although there is no official figure for women in menopause, at the beginning of 2026 there were approximately 1.22 million women between 45 and 64 years old in Catalonia, according to Idescat data. Not everyone needs hormone therapy: only those for whom the transition causes symptoms that deteriorate their quality of life, such as sweating, vaginal dryness, and insomnia. Hormone therapy also has benefits, especially for bone and cardiovascular health. Stopping treatment abruptly does not generally cause an acute medical situation or withdrawal syndrome, but the symptoms for which the patient was being treated may reappear immediately.

Hormonal treatments can be administered orally or transdermally, in the form of patches, gels, or sprays. The latter route is prioritized because it avoids the passage of the medication through the liver and reduces the risk of thrombosis.

At the Trànsit Unit of the Catalan Health Institute in Barcelona, Anna Payaró, a midwife and coordinator of this service, explains that they attend to about 1,000 new people each year, many of whom take hormonal preparations as part of their transition process.

"It is not that these people are left without medication, because there are other alternatives, such as the oral preparation. The problem is that they are left without the transdermal route, which for certain people is the safest, and switching to the oral route can involve risks that were precisely what they wanted to avoid," points out Payaró.

Other available alternatives do not have the same funding conditions and this means that the problem ceases to be just pharmacological. "A woman with economic means can buy a non-funded alternative, while for another the cost can be a barrier," suggests Llurba, for whom "we should not reach a situation in which access to appropriate treatment during menopause depends on the economic capacity of each woman," she considers.

While the shortage lasts, one of the options is magistral formulation, suggests Barau: going to the pharmacy to have an alternative prepared. If the Catalan Health Service and the AEMPS allow it, it could be funded, points out this pharmacist. "The problem is not with the raw material," explains Barau. "There is no lack of estradiol".