Pfizer Halts Premarin Vaginal Cream Supply in India, Limiting Menopause Treatment Options
Bengaluru: U.S. drugmaker Pfizer has temporarily discontinued Premarin vaginal cream in India, shrinking estrogen therapy options for millions of women experiencing menopause-related symptoms in the country.
The decision was driven by "certain supply challenges," said Trupti Wagh, Pfizer's senior director of media relations for APAC, on Thursday. She added that the company is exploring options to resume supply as soon as possible.
Pfizer has not previously disclosed the discontinuation.
The treatment contains a mixture of estrogen hormones and is prescribed to treat vaginal dryness, painful intercourse and other symptoms of menopause caused by declining estrogen levels. The cream, which is sold across the globe including in the U.S., Canada and Singapore, has become an important treatment option in India.
Data from Pune-headquartered research firm Pharmarack showed more than 620,000 units of the cream were sold in the 12 months ended June 2026, representing over half of all units sold in the category.
Premarin vaginal cream generated sales of about 266 million rupees ($2.76 million) in that period, accounting for about 37% of India's conjugated estrogen market by value. Sales have more than quadrupled from about 62 million rupees in 2022.
The suspension could leave patients with limited alternatives in India, where treatment options for genitourinary syndrome of menopause (GSM) are already scarce.
"Globally, we have a huge range of products available for women with GSM ... creams, ovules, vaginal rings. In India, we have essentially only Premarin and Evalon, an estriol-based vaginal cream marketed by Torrent Pharmaceuticals," said Dr Sukhpreet Patel, a gynecologist and founder of MenopauseWize, a menopause education and advocacy platform.
Patel said she began hearing complaints from patients late last year that they were unable to obtain Premarin, and initially assumed the problem was linked to broader global shortages of hormone therapies.
Reuters has previously reported shortages of estrogen patches and progesterone capsules in the U.S. as demand for menopause treatment surges.
Premarin cream is currently listed as "out of stock" on several popular online pharmacies in India, including MedPlus Mart, Reliance Industries' Netmeds, Truemeds and Tata 1MG.
India accounted for about 2.8% of the global estrogen replacement therapy market in 2025, according to market research firm Grand View Research.
The market generated an estimated $334.5 million in revenue that year and is projected to grow to $604.6 million by 2033, reflecting increasing awareness and treatment of menopause-related symptoms in the country.
Patel said more women had been contacting her seeking alternatives, adding that local estrogen therapies are particularly important for patients who do not require or wish to use systemic hormone replacement therapy.
According to estimates cited by the Indian Menopause Society, India is expected to have about 400 million women aged 45 and older by 2026. Despite the large patient population, awareness and treatment rates remain low.
