Menopause patients left without treatment: what is happening in Spain?

Spain’s menopause treatment shortage puts patients under pressure

Usagevpn.com – Women in Spain who rely on hormone therapy for menopausal symptoms have faced months of uncertainty as key estradiol medicines became difficult to find in pharmacies. A shortage initially centred on Lenzetto, a transdermal estradiol spray, has spread pressure across other treatments, leaving many patients searching from one pharmacy to another for prescriptions that had previously been readily available.

The disruption has affected a large number of people and exposed how quickly shortages of one widely used medicine can strain an entire treatment market. When supplies of Lenzetto fell, demand shifted towards patches, gels and other estradiol products. Those alternatives were not prepared for the sudden increase.

Spain’s medicines agency, Aemps, has registered supply difficulties involving products including Evopad, Estradot and Bijuva. While officials expect conditions to begin improving in November, uncertainty remains over when availability will become consistently reliable for patients across the country.

Hopes for improvement, but supply concerns remain

Javier Padilla, Spain’s Secretary of State for Health, has indicated that the situation could begin easing from the following month. Yet Aemps has urged caution, noting that forecasts provided by Lenzetto manufacturer Gedeon Richter have not always proved dependable.

“Have not always been accurate”.

Gedeon Richter expects Lenzetto to return to Spanish pharmacies during the second half of November. However, the company has also said that global supply limitations may prevent it from fully satisfying demand through 2027. It anticipates a gradual improvement in its ability to meet demand from the latter half of that year.

For patients, the distinction matters. A medicine appearing again on pharmacy shelves does not necessarily mean that supplies will be sufficient everywhere or that treatment interruptions will immediately end. People using hormone therapy may still need advice from their prescribing clinician or pharmacist if their usual product cannot be obtained.

A European problem, not only a Spanish one

The shortage is part of a wider imbalance between demand and manufacturing capacity in several European countries. Padilla has linked the problem to a sharp increase in use that manufacturers have struggled to accommodate. Aemps has similarly described it as an international supply issue affecting European Union countries to differing degrees.

The European Medicines Agency has been informed of the difficulties surrounding Lenzetto and is considering whether coordinated action at EU level could reduce the impact. The issue is expected to be discussed by the European group that deals with medicine supply problems.

The agency is also aware of more recent disruptions involving other estradiol-based treatments in the EU. Those cases have not been classified as critical at European level and are being handled by national authorities.

Estradiol treatments are commonly associated with relief from menopause-related symptoms, but their importance extends beyond menopause care. Estradiol can also be prescribed in osteoporosis prevention and as part of gender-affirming hormone treatment for trans women. That broader clinical use increases the consequences when supplies become constrained.

How the Lenzetto shortage developed

Warning signs emerged early in the year. In February, Aemps began receiving messages from users who were unable to locate Lenzetto and contacted Gedeon Richter. At first, the company maintained that it was meeting normal demand.

The explanation changed shortly afterwards. The manufacturer said it was confronting a rise in demand that it could not quickly absorb, alongside problems involving the device used to administer the spray. Several weeks later, it said its inventory had been exhausted and that the disruption would affect all of its markets during 2026.

Aemps has also said that the company did not fulfil its requirement to provide advance notification of incidents that could interrupt continuous access to the medicine. Early warning is especially important for medicines used over extended periods, because it gives health authorities and clinicians more time to identify suitable alternatives and explain options to patients.

Demand rose sharply over recent years

Lenzetto use in Spain had grown rapidly well before the current shortage. Distributed units increased from roughly 13,000 in 2018 to about 123,000 in 2024. That scale of growth made the product increasingly important within the available range of hormone therapies.

Gedeon Richter has said that demand exceeded its manufacturing capability and that availability of the applicator could not match the pace of expansion. The company has stressed that the shortage does not arise from a quality or safety concern involving the medicine itself.

Its response includes using existing production capacity as fully as possible, pursuing additional manufacturing routes and suppliers, and setting up a new plant and production line. These steps may strengthen supply over time, but establishing and expanding pharmaceutical production cannot necessarily deliver an immediate solution for people currently unable to obtain treatment.

Why price changes did not solve the shortage

Spanish authorities have attempted several measures to increase availability. One option was to raise the regulated price in hopes of drawing additional supply into the Spanish market. The change did not resolve the situation.

Padilla has emphasised that the issue is not simply one of pricing. If manufacturers lack enough production capacity, a higher regulated price alone cannot create medicines or delivery devices that are not yet available. The experience illustrates the limits of market-based responses when a supply chain cannot keep up with rapidly growing demand.

For now, the expected return of Lenzetto in the second half of November offers a possible first step towards relief. But the continuing constraints projected into 2027 mean that Spain’s menopause patients, clinicians, pharmacists and health authorities may still face a prolonged period of adjustment before supplies are fully stable.