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
Taken by mouth · Once a day
BioidenticalMenopauseOral
BIEST Capsules
Oral capsules of bioidentical estriol and estradiol (20:80 or 50:50 blends) for hot flashes, night sweats and other menopause symptoms. One capsule daily.
- Bioidentical estriol and estradiol blend
- Simple once-daily capsule
- Blend and dose set by your physician
- Monthly$109/mo
- Every 3 months$267 billed up front$89/mo
- Every 6 monthsBest value$474 billed up front$79/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
- Taken by mouth
- How often
- Once a day
- Each shipment
- 30 capsules
- Strengths
- 3 options · 1–2 mg
What are BIEST capsules?
(bi-EST, bi-estrogen)
BIEST combines estriol, a gentle estrogen, with estradiol, the main estrogen your ovaries made before menopause. In a capsule it is swallowed once a day, like a standard estrogen pill.
What's in it
- BIEST (50:50)Estrogen: eases menopause symptoms
2 blends
20:80 (more estriol) or 50:50, chosen by your physician
Oral estrogen passes through the liver first, which raises clot and gallbladder risk more than skin creams; your physician weighs this before choosing.
Is it right for you?
Who it's for
Women who prefer to swallow a capsule once a day.
What sets it apart
Oral estrogen passes through the liver first, which raises clotting factors more than creams do.
Worth knowing before you start
If you have migraines with aura, smoke or have had a clot, ask about the cream instead.
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
- Taken by mouth
- Dose
- 1 capsule (1 mg)
- How often
- Once a day
- Each shipment
- 30 capsules
- Pharmacy label
- Take 1 capsule (1 mg) by mouth once daily for 30 days.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
Strengths the pharmacy carries
- 1 mg
- 1.5 mg
- 2 mg
The science of bioidentical estrogen
Estrogen therapy is the most effective treatment for hot flashes and night sweats, and it also protects bone. BIEST is a compounded bioidentical blend used when a physician judges it fits better than an approved product.
If you have a uterus, estrogen must be paired with progesterone to protect its lining. Your physician also reviews your clot, stroke and breast cancer risk before starting.
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 capsules 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 Capsules?
Taken by mouth, once a day. The starting prescription is 1 capsule (1 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does BIEST Capsules come in?
The pharmacy carries 3: 1 mg, 1.5 mg, 2 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 capsules at the starting strength, shipped to your door from a licensed US pharmacy.
Capsule, cream or tablet under the tongue?
Capsules are the simplest; creams avoid the first pass through the liver and carry less clot risk; under-the-tongue tablets act quickly. Your physician recommends the best fit for your health history.
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 Capsulesfrom $79/mo