The Estradiol/Norethindrone Shortage: Where Things Stand in 2026

If you rely on Estradiol/Norethindrone to manage your menopause symptoms, you've probably noticed that finding it at the pharmacy has gotten harder. Supply issues that began in 2024 have continued into 2026, affecting women across the country who depend on this medication for relief from hot flashes, night sweats, and vaginal dryness.

Here's what you need to know about the current shortage, why it's happening, and how you can still get your medication.

Is Estradiol/Norethindrone Still in Shortage?

As of early 2026, Estradiol/Norethindrone availability remains inconsistent. Here's the breakdown by formulation:

• CombiPatch (transdermal patch): This formulation has been on the ASHP (American Society of Health-System Pharmacists) drug shortage list. Supply has been particularly limited, and some patients have gone weeks without being able to fill their prescriptions.
• Generic oral tablets (Activella equivalents): Generic tablets from manufacturers like Amneal and Teva are generally more available than the patch, but many pharmacies still report intermittent stock-outs, especially for the 0.5 mg/0.1 mg strength.
• Brand-name Activella: Brand availability varies by region and pharmacy. It tends to be more expensive and less commonly stocked than generic versions.

Why Is Estradiol/Norethindrone Hard to Find?

The shortage is driven by several overlapping factors:

Increased Demand for HRT

Updated FDA guidance and growing awareness about the benefits of hormone replacement therapy have led to a significant increase in prescriptions. More women are starting HRT, and the manufacturing base hasn't kept up.

Limited Manufacturers

Only a small number of companies produce Estradiol/Norethindrone products, especially the transdermal patch. When even one manufacturer experiences a production delay, the entire supply can be disrupted.

Raw Material Constraints

Active pharmaceutical ingredients for hormone products are sourced from a limited number of global suppliers. Any disruption in this supply chain can create shortages downstream.

For a more detailed explanation, read: Why is Estradiol/Norethindrone so hard to find?

How Much Does Estradiol/Norethindrone Cost in 2026?

Cost depends on whether you're paying with insurance or out of pocket:

• Generic oral tablets with insurance: Typically $10 to $45 per month copay
• Generic oral tablets without insurance: $50 to $100+ per month at retail cash price
• With a discount card (GoodRx, SingleCare): As low as $15 to $50 per month
• Brand-name Activella: $150 to $200+ per month without insurance
• CombiPatch: $150 to $250+ per month without insurance

For detailed savings strategies, check out: How to save money on Estradiol/Norethindrone.

Are There Any New Options?

While no new Estradiol/Norethindrone products have launched in 2026, patients have more alternative options than ever:

• Bijuva — estradiol plus bioidentical progesterone capsules
• Climara Pro — estradiol/levonorgestrel weekly patch
• Prempro — conjugated estrogens plus medroxyprogesterone, available generically

Your doctor can help determine whether one of these alternatives is right for you. Learn more: Alternatives to Estradiol/Norethindrone.

Compounding pharmacies are also an option for patients who can't find any manufactured products. A compounding pharmacy can prepare a custom estradiol/progestin combination with a prescription from your doctor.

How to Find Estradiol/Norethindrone in Stock

Here's how to maximize your chances of finding it:

1. Use Medfinder: Medfinder.com shows real-time pharmacy availability in your area. Search by medication and ZIP code to see who has it.
2. Try independent pharmacies: They often have more sourcing flexibility than large chains.
3. Ask about different strengths or formulations: If the 0.5 mg/0.1 mg tablet is unavailable, the 1 mg/0.5 mg may be in stock.
4. Consider mail-order pharmacies: They may have access to larger inventory pools.
5. Don't wait until you're out: Try to refill your prescription 7 to 10 days early so you have time to search if your pharmacy is out of stock.

For a detailed walkthrough, see: How to find Estradiol/Norethindrone in stock near you.

Final Thoughts

The Estradiol/Norethindrone shortage in 2026 is real, but it's manageable with the right approach. Stay proactive by refilling early, using real-time tools like Medfinder, and keeping an open conversation with your healthcare provider about alternatives if needed.

You deserve reliable access to the medication that keeps your menopause symptoms under control. Don't give up — there are more options and resources available than ever before.