Top 10 Questions: Shortage of Injectable Estrogen

By Deborah Dunn MBA, PAC
Trans Care Coordinator
Chase Brexton Health Care

A recent nationwide shortage of injectable estrogen is affecting many transgender and transfeminine individuals, and has created many questions. Here's what you need to know:

1. Is it true the Chase Brexton pharmacy is out of the hormone shots I take?

YES: There is a nationwide shortage of generic and brand name injectable estrogen. The companies that make the medication are having trouble with production, and makers of the drugs have reported manufacturing delays in getting the medications to the market.

2. Is this a problem that is going to last?

YES: It is supposed to last until October of 2016, but this is an estimated date. The medication could be unavailable for several months.

3. Is there a substitute for my medication?

YES: There are other alternatives for taking estrogen, in pill and patch form, that are safe and effective for gender transition. Your providers at Chase Brexton will work with you to find the best treatment plan individualized for you.

4. Will the patches and pills work the same as my shots?

FOR MANY PEOPLE, YES: The patches and pills are designed to deliver the same dose of medication to your body, and are excellent alternatives to the shot for many people. Though so far no scientific studies have shown the shot to be stronger or better, some of our patients do report that patches and pills have been less effective for them. Your provider so they can help you fine tune your best regimen.

5. Will I have to pay more for patches or pills?

IN MOST CASES, NO: If you don’t have insurance, the Chase Brexton pharmacy will do its best to get you a medicine that will be as low cost as possible. If you have insurance, the pharmacy will find something that is covered by your insurance.

6. Should I order injectable estrogen from Canada/Germany/Lexington Market until you can get my shot in stock again?

NO: It is not safe to take hormones ordered on the internet or bought on the street. Many times, there is little-to-zero active estrogen in these preparations. Many of the ingredients used in these drugs are from unknown sources and have not been tested. They may cause problems with kidneys, liver, and other organs. They also may not be effective.

7. My friend has a little leftover medicine from her last dose, can I take that?

NO: It is not safe to take estrogen/HRT prescribed to your friends. Your provider is prescribing your dosage, based on your lab results as well as your personal emotional and physical results, to meet your specific transition goals.

8. I know someone who gives shots to girls at parties/private homes. Is that a good option for me?

NO: It is not safe to get estrogen injections from pump houses, or untrained medical people who work out of their homes. Many times the same vial, needle, and syringes are used on multiple trans women which can spread HIV, hepatitis, and other serious diseases. In many cases, these injections are cut the solution with plain water or chemicals that can seriously damage your body.

9. Can you put me on something else until you get the shots again?

YES: Chase Brexton has providers that are able to help you to switch to a regimen that will effectively continue your transition. Please call 410-837-2050 for an appointment.

10. Is there anything I can do about the shortage?

YES: This crisis has prompted many health care colleagues and your providers at Chase Brexton to issue a call to action urging the manufacturers of these vital therapies to restock the supply of injectable estrogen immediately. Join fellow health care providers and patients in telling Par Sterile and Perrigo Pharmaceuticals to take all necessary steps to make injectable estrogen available immediately.

Write letters to:

Par Pharmaceutical at
Endo International PLC
One Ram Ridge Rd
Chestnut Ridge, NY 10977

Chief Executive Officer
Perrigo, Inc.
515 Eastern
Allegan, MI 49010

For some patients, a change in hormone therapy can be very distressing. If you are feeling anxious, discouraged, very sad, or hopeless, PLEASE reach out. If you are having thoughts of harming yourself, please call 911 or go to the nearest emergency room.

If you are looking for ongoing support with a therapist supportive of transgender individuals, we can be of service.