Menopause hormone therapy prescribing quadruples: 5 notes

Progesterone-containing hormone replacement therapy prescribing more than quadrupled among women age 45 and older between 2018 and 2026, according to new research published June 17 from Truveta.

The rise comes after the FDA moved to remove boxed warnings from several hormone therapy products and amid shortages affecting multiple progesterone formulations. In November 2025, the agency said existing warnings were based on outdated research and began working with manufacturers to revise product labels. Meanwhile, the American Society of Health-System Pharmacists lists oral capsules, injection in oil and vaginal inserts on its active drug shortage database. 

Here are five things to know:

1. Researchers identified 598,797 women age 45 and older with evidence of a progesterone-based HRT prescription between 2018 and 2026.
2. Prescribing rates increased from three prescriptions per 1,000 women in January 2018 to 12.4 per 1,000 women in May 2026, a 308.7% increase.
3. Women ages 45 to 54 saw the largest increase, with prescribing rates rising from 5.1 prescriptions per 1,000 women in 2018 to 30 per 1,000 women in May 2026, a 488% increase. By May 2026, 3% of women in that age group with prescription data had evidence of a progesterone-containing HRT prescription.
4. Prescribing rates among women ages 55 to 64 increased from 4.7 to 18.7 prescriptions per 1,000 women between 2018 and 2026. Rates also increased among women ages 65 to 74 and women age 75 and older.
5. Truveta said prescribing accelerated in 2024 and continued rising through 2026. Rates increased 19.3% between November 2025 and May 2026.

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