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.
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