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
BioidenticalMenopauseTopical
Estradiol Cream
Bioidentical estradiol cream for moderate to severe hot flashes and night sweats. Apply daily to skin. Steady absorption, flexible dosing.
- Pure bioidentical estradiol
- Topical, adjustable dosing
- Avoids first-pass liver metabolism
- 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
- Strengths
- 8 options · 1–4 clicks, 1.5 mg
What is estradiol cream?
(bioidentical estradiol, topical)
Estradiol cream delivers bioidentical estradiol, the same form your ovaries produced, directly through the skin. Transdermal delivery avoids first-pass liver metabolism, potentially lowering gallbladder and clot risk compared to oral forms. Apply daily for steady symptom relief.
What's in it
- EstradiolEstrogen: eases menopause symptoms
Bioidentical
pure estradiol, 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 who want estradiol alone through the skin.
What sets it apart
Pure estradiol, the strongest natural estrogen, with no estriol. Eight strengths.
Worth knowing before you start
The numbers on the applicator matter: count clicks, do not guess.
Results you can feel
Hot flash relief
the most dramatic change from estrogen therapy
Better sleep and mood
as symptoms settle and hormone levels stabilize
Bone protection
estrogen slows bone loss at menopause
Steadier energy
many patients report clearer, more stable daily rhythms
How estradiol therapy works
Day 1
A US-licensed physician reviews your menopausal symptoms, history, and risk factors to determine the best form and dose for you.
1Weeks 1-2
Hot flashes and night sweats usually begin to ease within 1-4 weeks, depending on the form and dose.
2Month 1-2
Sleep quality improves, mood stabilizes. Your physician checks in and may adjust your dose or form based on symptom control.
3Month 3
Check-in. Your physician reviews your progress, any side effects, and confirms your ongoing plan.
4Beyond
Estradiol therapy is reassessed at least yearly. Your physician discusses continuing, adjusting, or stopping based on benefits and risks.
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
- 0.25 mL (1 click, 2.5 mg)
- How often
- Once a day
- Each shipment
- 1 tube
- Pharmacy label
- Apply 0.25 mL (1 click, 2.5 mg) to the inner forearm or inner thigh once daily for 90 days. Rotate sites and wash hands after use.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
Strengths the pharmacy carries
- 1.5 mg/mL
- 3 mg/mL
- 2 mg/mL
- 10 mg/mL
- 2.5 mg/mL
- 1 mg/mL
- 4 mg/mL
- 0.2 mg/mL
The science of bioidentical estradiol
The WHI trial found that transdermal estrogen carries lower clot risk than oral estrogen, likely because it bypasses first-pass liver metabolism and avoids increases in clotting factors.
Transdermal estradiol still carries risks of stroke, gallbladder disease, and, with a uterus, requires progesterone for endometrial protection. Your physician monitors your blood pressure and reviews risk factors at every visit.
Learn moreImportant safety information and common side effects
Estradiol is a prescription hormone with real benefits and real risks. Common effects include breast tenderness, nausea, headache, bloating, and spotting. Estrogen therapy increases risk of blood clots, stroke, gallbladder disease, and, with a uterus, requires progesterone for endometrial protection. Not prescribed with breast cancer history, blood clots, unexplained vaginal bleeding, liver disease, or pregnancy. Smoking significantly raises clot and stroke risk. Seek immediate 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.
Estradiol 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 Estradiol Cream?
Applied to the skin, once a day. The starting prescription is 0.25 mL (1 click, 2.5 mg) 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 strengths does Estradiol Cream come in?
The pharmacy carries 8: 10 mg/mL, 1.5 mg/mL, 3 mg/mL, 2 mg/mL, 2.5 mg/mL, 1 mg/mL, 4 mg/mL, 0.2 mg/mL. Your physician chooses which one you get.
How much arrives in each shipment?
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
How much cream should I apply?
Your physician sets the starting dose, usually 0.5-1 gram daily. Use a metered applicator. Apply to clean, dry skin on the inner arm, abdomen, or thigh. Adjust only under your physician's guidance based on symptom control.
Is estradiol really bioidentical?
Yes. Bioidentical means its chemical structure matches what your body made. FDA-approved estradiol (brand names like Estrace) and compounded estradiol are both bioidentical. The difference is regulatory oversight.
Should I take topical or oral estradiol?
Your physician helps you choose based on your symptoms, tolerance, and risk factors. Topical forms bypass first-pass liver metabolism and may carry lower clot risk. Oral forms are convenient but increase gallbladder and clot risk slightly more.
Do I need progesterone with estradiol?
If you have a uterus, yes. Estrogen thickens the uterine lining, and unopposed estrogen increases endometrial cancer risk significantly. Progesterone prevents this. After hysterectomy, estrogen alone is safe.
Estradiol, your way.
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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
Kronos Early Estrogen Prevention Study (KEEPS): cardiovascular and metabolic effects.
Menopause, 2016 - 2
The 2022 hormone therapy position statement of The North American Menopause Society.
Menopause, 2022
Estradiol Creamfrom $109/mo