Hundreds of thousands of women in Spain have faced months of difficulties obtaining hormone treatments for menopause symptoms, as a shortage of Lenzetto has triggered wider supply problems affecting other hormone replacement therapies.
The shortage of the transdermal estradiol spray has increased demand for alternative products, including patches and gels, leading to supply issues with medicines such as Evopad, Estradot and Bijuva.
Spain expects supplies to improve in November
Spain’s Secretary of State for Health, Javier Padilla, said the situation should begin to ease in November.
Lenzetto manufacturer Gedeon Richter told Euronews that the medicine is expected to return to Spanish pharmacies during the second half of November. However, the company warned that it may not be able to fully meet demand throughout 2027 because of global supply constraints.
Spain’s Medicines and Medical Devices Agency (Aemps) has expressed caution over the timetable, saying forecasts provided by the manufacturer have not always been accurate.
Shortage affects other European countries
The problem extends beyond Spain, with increased demand outpacing production capacity in several European countries.
The European Medicines Agency (EMA) said it had been informed about the Lenzetto supply problems and was considering possible coordinated measures at EU level.
The EMA is also aware of recent shortages involving other estradiol-based medicines, although these have not been classified as critical at European level and are being managed by national authorities.
Estradiol treatments are mainly used to relieve menopause symptoms, but they are also prescribed for other purposes, including osteoporosis prevention and gender-affirming hormone treatment for trans women.
How the Lenzetto shortage triggered wider problems
Aemps began receiving reports of difficulties finding Lenzetto in February and contacted Gedeon Richter.
The company initially said it was meeting demand, but later reported a sharp increase in demand that it could not immediately satisfy, as well as problems with the device used to administer the medicine.
Gedeon Richter subsequently announced that it had run out of stock and that the shortage was affecting its markets throughout 2026.
Aemps also said the company had failed to provide advance notification of supply disruptions as required.
Demand for Lenzetto has increased sharply in Spain. Distributed units rose from around 13,000 in 2018 to approximately 123,000 in 2024.
Gedeon Richter said demand had exceeded manufacturing capacity and that the availability of the applicator had also failed to keep pace. The company stressed that the shortage was not linked to quality or safety problems.
Government measures have yet to resolve shortage
Spain’s Health Ministry increased the regulated price of the medicine in an attempt to encourage greater supply, but the measure did not resolve the shortage.
The ministry also contacted manufacturers of alternative treatments that are not covered by Spain’s National Health System and explored the possibility of funding them.
According to Padilla, those efforts have also faced production constraints, with manufacturers saying they lacked the capacity to increase supply even if their medicines received public funding.
Patients demand action
Patients have also begun organising in response to the shortages.
More than 25,000 people backed a petition within three weeks calling on the Spanish government to take urgent action. The petition calls for measures to prevent future shortages and ensure patients have access to alternatives when medicines become unavailable.
It also highlights the financial burden on patients, as some alternative treatments are not covered by the public health system and must be paid for privately.
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