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
Applied to the skin · Once a day
BioidenticalCombinationTopical
BIEST + Progesterone Cream
Topical cream combining BIEST (50:50) and micronized progesterone for complete hormone therapy. Apply daily to skin. Gentle absorption, uterine protection.
- BIEST + progesterone in one cream
- Topical, flexible dosing
- Progesterone protects the uterine lining
- Monthly$109/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
- Applied to the skin
- How often
- Once a day
- Each shipment
- 1 tube
- Strength
- 1.25 mg / 100 mg/mL
What is BIEST + progesterone cream?
(bioidentical hormone combination, topical)
This cream blends BIEST (50:50 estriol and estradiol) with micronized progesterone, applied directly to skin for gradual, gentle absorption. If you have a uterus, progesterone is essential to prevent endometrial overgrowth from unopposed estrogen.
What's in it
- BIEST (20:80)Estrogen: eases menopause symptoms
- ProgesteroneProtects the uterus; helps sleep
Combined
BIEST 50:50 and micronized progesterone topically absorbed
Apply 0.5-1.5 grams daily to clean skin. Your physician adjusts based on symptom response and blood work.
Is it right for you?
Who it's for
Women with a uterus who want both hormones through the skin.
What sets it apart
Both hormones in one cream. Progesterone through the skin may not protect the uterus as reliably as by mouth.
Worth knowing before you start
Any bleeding after menopause needs to be reported, whatever the form you use.
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
- Applied to the skin
- Where
- inner forearm or inner thigh
- Dose
- 1 mL (4 clicks, 1.25 mg BIEST / 100 mg progesterone)
- How often
- Once a day
- Each shipment
- 1 tube
- Pharmacy label
- Apply 1 mL (4 clicks, 1.25 mg BIEST / 100 mg progesterone) to the inner forearm or inner thigh once daily for 30 days. Rotate sites and wash hands after use.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
The science of bioidentical estrogen
Transdermal delivery of both hormones reduces first-pass liver metabolism and may lower gallbladder risk slightly compared to oral forms. Micronized progesterone provides effective endometrial protection.
Progesterone may cause mild somnolence, mood changes, or water retention. Apply the cream in the evening when possible. Your physician monitors tolerability 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 plan
- 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 cream 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 use BIEST / Progesterone Cream?
Applied to the skin, once a day. The starting prescription is 1 mL (4 clicks, 1.25 mg BIEST / 100 mg progesterone) each time. Your physician sets your own dose and it is printed on your label.
Where do I apply it?
Inner forearm or inner thigh.
What exactly is in it?
BIEST (20:80), Progesterone.
How much arrives in each shipment?
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
Can I use this if I had a hysterectomy?
No. If your uterus was surgically removed, you do not need progesterone, estrogen alone is safe and sufficient. Ask your physician for a BIEST-only cream formulation.
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 Creamfrom $109/mo