In early 2026, reports emerged in Russia of disruptions in access to at least two important hormone medicines: injectable testosterone and fludrocortisone. According to published reports, testosterone ester mixtures have been virtually absent from pharmacies since December 2025, and the shortage is continuing at least until May 2026. In March, there were also reports of disruptions in the supply of fludrocortisone, which is used in intersex variations involving adrenal function and disappeared from major pharmacy chains.

For people with intersex variations, this is a matter of continuity of care and medical necessity. People with variations in gonadal development and variations in sex hormone synthesis may need testosterone to induce puberty and to support bone and muscle health, energy levels, and overall well-being. People with congenital adrenal hyperplasia, especially the salt-wasting form, need fludrocortisone. This medicine helps maintain salt and fluid balance, sodium levels, and blood pressure.

Disruptions in access to it create a direct risk to health. When such medicines disappear from pharmacies, this leads to deteriorating health, additional expenses, and an urgent search for alternatives that do not suit everyone. In addition, switching treatment is not always simple or safe. When there is no predictable and continuous access to hormone therapy, the entire burden is shifted onto patients themselves. People are forced to search for medicines across different pharmacies, make emergency changes to their treatment regimen, or go without the treatment they need altogether.

Access to essential hormone medicines must be treated as part of the right to health. Disruptions affecting these medicines are especially dangerous for people whose condition requires continuous treatment and does not allow interruptions. ARSI calls for transparent monitoring of stocks and supplies, timely distribution of medicines across regions, access to acceptable and affordable alternatives, and protection against forcing patients onto different treatment regimens. People with intersex variations should not be made to pay with their health for failures in the supply system.

“Russia Is Experiencing a Shortage of the Vital Drug Testosterone”, MK, 29 January 2026.
“A Shortage of Testosterone Medicines for the Treatment of Sex Hormone Deficiency Has Emerged in Russia”, Pharmvestnik, 6 February 2026.
“Logistics Breakdown”, Kommersant, 17 March 2026.