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
BioidenticalCombinationMenopause
BIEST + Progesterone Capsules
Single capsule combining BIEST (50:50 estriol and estradiol) plus micronized progesterone for uterine protection. One daily. Simplified regimen.
- BIEST + progesterone in one capsule
- Progesterone protects the uterine lining
- Simplified once-daily dosing
- 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
- Taken by mouth
- How often
- Once a day
- Each shipment
- 30 capsules
- Strengths
- 8 options · 1.25–5 mg BIEST / 100 mg progesterone
What is BIEST + progesterone?
(bioidentical estrogen and micronized progesterone)
This capsule delivers BIEST (50:50 estriol and estradiol) plus micronized progesterone, the natural form of progesterone your body made before menopause. If you have a uterus, progesterone is mandatory with any estrogen to protect the uterine lining from overgrowth. This combination simplifies your regimen to one capsule daily.
What's in it
- BIEST (20:80)Estrogen: eases menopause symptoms
- ProgesteroneProtects the uterus; helps sleep
Combined
BIEST 50:50 plus micronized progesterone for complete hormone protection
Take one capsule daily, usually in the evening. Your physician adjusts the hormone levels based on your symptoms and labs.
Is it right for you?
Who it's for
Women with a uterus who want estrogen and progesterone in one capsule.
What sets it apart
One capsule covers both hormones, so the progesterone that protects the uterus is never forgotten.
Worth knowing before you start
Take it at bedtime: the progesterone makes most women drowsy.
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 (1.25 mg BIEST / 200 mg progesterone)
- How often
- Once a day
- When
- At bedtime
- Each shipment
- 30 capsules
- Pharmacy label
- Take 1 capsule (1.25 mg BIEST / 200 mg progesterone) by mouth once daily at bedtime for 30 days.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
Strengths the pharmacy carries
- 1.5 mg / 100 mg
- 5 mg / 150 mg
- 5 mg / 100 mg
- 1.25 mg / 200 mg
- 1.25 mg / 150 mg
- 2.5 mg / 275 mg
- 2.5 mg / 200 mg
- 1.25 mg / 100 mg
The science of bioidentical estrogen
Micronized progesterone has better absorption than older synthetic progestins. The WHI and KEEPS trials used micronized forms and showed reduced endometrial and breast cancer risk when combined with estrogen.
Progesterone may cause drowsiness, so taking it in the evening helps. Some patients experience mood changes or water retention. Your physician monitors these effects 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 + progesterone combination 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 / Progesterone Capsules?
Taken by mouth, once a day, at bedtime. The starting prescription is 1 capsule (1.25 mg BIEST / 200 mg progesterone) each time. Your physician sets your own dose and it is printed on your label.
What strengths does BIEST / Progesterone Capsules come in?
The pharmacy carries 8: 1.25 mg / 200 mg, 1.25 mg / 150 mg, 1.25 mg / 100 mg, 1.5 mg / 100 mg, 2.5 mg / 275 mg, 2.5 mg / 200 mg, 5 mg / 150 mg, 5 mg / 100 mg. Your physician chooses which one you get.
What exactly is in it?
BIEST (20:80), Progesterone.
How much arrives in each shipment?
30 capsules at the starting strength, shipped to your door from a licensed US pharmacy.
Why is progesterone included?
Estrogen thickens the uterine lining (endometrium). Unopposed estrogen increases endometrial cancer risk significantly. Progesterone prevents this overgrowth. If you have had a hysterectomy, progesterone is not needed.
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.
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 + Progesterone Capsulesfrom $69/mo