Can't find CombiPatch? Here are real alternatives your doctor may prescribe, including Climara Pro, Activella, Prempro, and Bijuva for HRT.
You rely on CombiPatch to manage your menopause symptoms, but your pharmacy keeps telling you it's out of stock. You're not alone — CombiPatch has been difficult to find for many patients due to ongoing supply issues with transdermal hormone patches.
If you can't get your hands on CombiPatch despite your best efforts, the good news is that several alternative medications can provide similar relief. This guide will walk you through what CombiPatch does, how it works, and the real alternatives your doctor might consider switching you to.
CombiPatch is a transdermal patch that delivers two hormones directly through your skin:
CombiPatch is FDA-approved for treating moderate to severe vasomotor symptoms (hot flashes and night sweats) of menopause and for preventing postmenopausal osteoporosis — both in women who still have their uterus. The combination of estrogen and progestin is specifically designed for women with an intact uterus because taking estrogen without a progestin increases the risk of endometrial cancer.
You apply one patch to your lower abdomen twice a week, and it delivers a steady dose of hormones around the clock. Many women prefer patches over pills because the transdermal route bypasses the liver and may carry a lower risk of blood clots compared to oral estrogen.
During menopause, your ovaries produce significantly less estrogen. This drop in estrogen is what causes hot flashes, night sweats, sleep disturbances, mood changes, and vaginal dryness. CombiPatch replaces the estrogen your body is no longer making in sufficient amounts.
The Estradiol in CombiPatch passes through the skin into your bloodstream, where it acts on estrogen receptors throughout your body to reduce vasomotor symptoms and help maintain bone density. The Norethindrone Acetate works alongside the estrogen to keep the uterine lining thin and healthy, preventing the endometrial buildup that unopposed estrogen can trigger.
Because the hormones are absorbed through the skin, they enter the bloodstream directly without passing through the digestive system first. This is called transdermal delivery, and it's one of the key features that makes patch-based HRT different from pills.
If CombiPatch isn't available, here are four alternatives that your doctor might recommend. Each one has its own benefits and trade-offs, so the right choice depends on your medical history, preferences, and what's available in your area.
What it is: Climara Pro is another combination estrogen/progestin transdermal patch. Instead of Norethindrone Acetate, it uses Levonorgestrel as the progestin component.
How you take it: Apply one patch to your lower abdomen once a week — meaning fewer patch changes than CombiPatch's twice-weekly schedule.
Who it's for: Women with an intact uterus who need combination HRT for vasomotor symptoms or osteoporosis prevention. The once-weekly application is convenient for women who prefer fewer patch changes.
Things to know: Climara Pro contains a different progestin than CombiPatch, so side effects may differ slightly. Some women find Levonorgestrel causes more or less breakthrough bleeding than Norethindrone Acetate. Like CombiPatch, Climara Pro may also experience supply challenges since it's a transdermal patch product.
What it is: Activella contains the exact same active ingredients as CombiPatch — Estradiol and Norethindrone Acetate — but in an oral tablet form.
How you take it: One tablet by mouth once daily.
Who it's for: Women who are comfortable with a pill instead of a patch and who want the same hormone combination. Because it's an oral medication, it's generally easier to manufacture and may be more consistently available than patches.
Things to know: Oral estrogen passes through the liver (called "first-pass metabolism"), which can increase certain clotting factors. Some studies suggest oral HRT may carry a slightly higher risk of blood clots compared to transdermal HRT. Discuss this with your doctor, especially if you have risk factors for blood clots. Activella is available in generic form.
What it is: Prempro is one of the oldest and most well-studied combination HRT products. It contains conjugated estrogens (derived from natural sources) and Medroxyprogesterone Acetate (a synthetic progestin).
How you take it: One tablet by mouth once daily.
Who it's for: Women with an intact uterus who need combination HRT. Prempro has been used for decades and has extensive clinical data behind it, including the large Women's Health Initiative study.
Things to know: The hormones in Prempro are different from those in CombiPatch. Conjugated estrogens are not identical to Estradiol, and Medroxyprogesterone is not the same as Norethindrone. Side effects and how you feel on Prempro may differ from CombiPatch. It's available as a generic, and its oral form means supply is generally more stable than patches.
What it is: Bijuva is a newer combination HRT product that pairs Estradiol with Progesterone (bio-identical, meaning it's the same molecular structure as the progesterone your body naturally produces).
How you take it: One capsule by mouth once daily at bedtime (the progesterone can cause drowsiness, so bedtime dosing is recommended).
Who it's for: Women who prefer a bio-identical hormone option. Some patients and providers favor bio-identical progesterone over synthetic progestins like Norethindrone Acetate.
Things to know: Bijuva is a brand-name product and may be more expensive than generic options. It uses a different progestational agent (Progesterone vs. Norethindrone Acetate), so the side effect profile may differ. It's an oral medication, so the same first-pass liver considerations apply as with Activella and Prempro.
If you're considering an alternative to CombiPatch, here are some helpful things to discuss with your doctor:
Not being able to fill your CombiPatch prescription is stressful, but it doesn't mean you have to go without hormone therapy. Climara Pro, Activella, Prempro, and Bijuva are all legitimate alternatives that can help manage your menopause symptoms while CombiPatch supply remains limited.
Work closely with your doctor to find the best fit for your needs, and use Medfinder to check availability before transferring your prescription. For more on the current supply situation, read our CombiPatch shortage update for 2026.
You focus on staying healthy. We'll handle the rest.
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