Estradiol Cypionate
Long-acting estradiol injection for menopause and perimenopause symptoms and for gender-affirming hormone therapy, given every one to two weeks. Prescribed and dosed by a licensed physician.
Injection
from $139/mo
Dissolved under the tongue · Once a day
BioidenticalMenopauseOrally dissolving
BIEST 50:50 ODT
Orally dissolving tablet combining estriol and estradiol (50:50) for moderate to significant menopausal symptoms. One tablet daily under the tongue.
- Bioidentical 50:50 blend
- Dissolves under the tongue
- Adjustable dosing without injection
- Monthly$99/mo
- Every 3 months$237 billed up front$79/mo
- Every 6 monthsBest value$414 billed up front$69/mo
- Free, discreet shipping
- Licensed U.S. pharmacy
- Board-certified physicians
Disclaimer: Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.
- How
- Dissolved under the tongue
- How often
- Once a day
- Each shipment
- 30 tablets
- Strengths
- 6 options · 0.05–1 mg
What is BIEST 50:50 ODT?
(orally dissolving tablet, 50:50 blend)
BIEST 50:50 ODT delivers an equal mix of estriol and estradiol as a tablet that dissolves under your tongue. Convenient, no pills to swallow, and easy to adjust if your physician changes your dose.
What's in it
- BIEST (50:50)Estrogen: eases menopause symptoms
50:50
balanced bioidentical estriol and estradiol
One tablet daily under the tongue, usually in the morning. Your physician sets the dose based on symptom response.
Is it right for you?
Who it's for
Women who want the 50:50 blend in a tablet that dissolves under the tongue.
What sets it apart
Six strengths, the widest range of the dissolving tablets.
Worth knowing before you start
Let it dissolve fully. Swallowed, it behaves like an oral pill and passes through the liver.
Results you can feel
Fewer hot flashes
the most dramatic change from estrogen therapy
Better sleep and mood
as night sweats settle and hormones stabilize
Bone protection
estrogen slows bone loss at menopause
Steadier energy
many patients report clearer, more stable daily rhythms
How BIEST therapy works
Day 1
A US-licensed physician reviews your menopausal symptoms, history, and risk factors to set your dose.
1Weeks 1-2
Hot flashes and night sweats usually ease within the first two to four weeks.
2Month 1-2
Sleep and mood stabilize as hormone levels rise. Your physician checks in and adjusts dose if needed.
3Month 3
Check-in. Your physician reviews symptom relief, any side effects, and confirms your dose going forward.
4Beyond
BIEST therapy is reviewed yearly: dose, benefits, risks, and whether to continue.
5
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
How you use it
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
- How
- Dissolved under the tongue
- Dose
- one tablet (0.05 mg)
- How often
- Once a day
- Each shipment
- 30 tablets
- Pharmacy label
- Place one tablet (0.05 mg) under the tongue once daily for 30 days. Do not chew or swallow it whole.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
Strengths the pharmacy carries
- 0.4 mg
- 1 mg
- 0.2 mg
- 0.1 mg
- 0.5 mg
- 0.05 mg
The science of bioidentical estrogen
Sublingual delivery provides fast mucosal absorption and avoids first-pass liver metabolism. A 50:50 blend balances gentleness with efficacy.
Oral estrogen therapy increases gallbladder and clot risk more than transdermal. Your physician assesses your risk factors before prescribing and monitors you at every visit.
Learn moreImportant safety information and common side effects
BIEST is a prescription hormone combination with real benefits and real risks. Common effects include breast tenderness, bloating, nausea, headache, spotting, and injection-site reactions. Estrogen therapy increases risk of blood clots, stroke, gallbladder disease, and, with a uterus, requires progesterone to prevent endometrial cancer. Not prescribed with breast cancer, blood clots, unexplained vaginal bleeding, liver disease, or pregnancy. Smoking raises clot risk. Seek care for chest pain, shortness of breath, leg swelling, severe headache, or vision changes. Tell your physician about every medication.
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
How it works
1.Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
2.Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
3.Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
BIEST 50:50 ODT educational content reviewed by our physician
Scott Nass, MDDoctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Frequently asked questions
How do I take BIEST (50:50) ODT?
Dissolved under the tongue, once a day. The starting prescription is one tablet (0.05 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does BIEST (50:50) ODT come in?
The pharmacy carries 6: 0.05 mg, 0.1 mg, 0.2 mg, 0.4 mg, 0.5 mg, 1 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
How do I use BIEST ODT?
Place one tablet under your tongue in the morning and allow it to dissolve. Do not chew or swallow whole. Most tablets dissolve in 1-2 minutes. Take daily for best results.
Is BIEST really bioidentical?
Yes. Estriol and estradiol are both bioidentical, meaning their chemical structure matches what your body made. BIEST is a compounded formula mixing these two in a specific ratio.
Do I need progesterone with BIEST?
If you have a uterus, yes. Estrogen thickens the uterine lining, and progesterone protects it. After hysterectomy, estrogen alone is safe.
Is BIEST better than estradiol alone?
Not necessarily. Both work. BIEST appeals to patients seeking a lower dose, a gentler profile, or a compounded approach.
What if I smoke?
Smoking significantly raises your clot and stroke risk on estrogen. Your physician may recommend transdermal (topical) over oral forms, or may suggest stopping smoking first.
Hormones, balanced.
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The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Individual results vary.
Sources
- 1
The 2022 hormone therapy position statement of The North American Menopause Society.
Menopause, 2022 - 2
Estrogen and progestogen use in postmenopausal women: 2015 perspective.
Lancet, 2015
BIEST 50:50 ODTfrom $69/mo