What is Lenzetto and why is its shortage causing so much concern among trans people?
Lenzetto is a medication based on estradiol, a sex hormone, administered via a skin spray. It is primarily used to treat menopausal symptoms , but it is also part of the hormone therapy for many transgender women. For them, a stable supply is essential to maintaining their gender-affirming treatment.
The shortage of Lenzetto in Spanish pharmacies has persisted since the end of 2025, and the Spanish Agency for Medicines and Health Products (AEMPS) has officially listed the drug as having supply problems since March. The manufacturer, Gedeon Richter, initially attributed the situation to an exceptional increase in demand and production capacity limitations. More recently, they have also cited problems related to the administration device.
For many trans women, the lack of Lenzetto doesn't simply mean waiting for the medication to become available again. It means having to find alternatives and, in many cases, obtaining a new prescription. Waiting lists for endocrinology appointments can make these changes even more difficult. Furthermore, the different estradiol formulations are not automatically interchangeable, and any changes must be prescribed and supervised by healthcare professionals.
Domino effect
The situation has led to a Domino effectPart of the demand has shifted towards estradiol gels and patches, which have also begun to experience supply problems. The Spanish Agency for Medicines and Health Products (AEMPS) has reported difficulties with products such as... Estradot 75, Evopad 25 and Bijuva. Some trans womenFurthermore, they experience problems with these alternatives, ranging from skin irritations to differences in absorption or perceived effects.
The crisis also has an economic dimension. Some alternatives can be more expensive, forcing patients to visit numerous pharmacies or even travel to other cities to find their treatment. In Spain , the number of Lenzetto units distributed increased from approximately 13.000 in 2018 to 123.000 in 2024, in a context of rising demand.
Shortage
Fina Campàs, president of Acció Trans, insists that the shortage not end up affecting the treatments of trans women. “ The different presentations of estradiol are not simply interchangeable, and any change must be properly prescribed,” she points out. Campàs also warns that the lack of supply “cannot force changes or interruptions in treatments .” The trans activist is calling on the Catalan Health Department and the Spanish Agency for Medicines and Health Products (AEMPS) to take measures that guarantee “ the continuity of treatments, with a stable supply and safe and accessible alternatives. Guaranteeing this continuity is guaranteeing the recognized right to health of trans women .”
While the Ministry of Health anticipates that the supply of Lenzetto will begin to recover by the end of November, complete normalization could take until 2027. In Catalonia, the Department of Health is preparing an alternative: if the shortage persists, pharmacies will be able to prepare compounded estradiol formulas from the available raw materials, a method that will allow for individualized treatments while the supply lack continues.
