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
Topical cream combining bioidentical estradiol and micronized progesterone for complete hormone therapy. Apply daily to skin. Uterine protection included.
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.
(bioidentical hormones, combination cream)
This cream blends bioidentical estradiol with micronized progesterone, providing complete hormone therapy in one application. If you have a uterus, progesterone is essential to prevent endometrial overgrowth from unopposed estrogen. Transdermal delivery is gentle and allows dose adjustment.
Combined
bioidentical estradiol and micronized progesterone
Apply 0.5-1.5 grams daily to clean skin. Your physician adjusts based on symptom response and blood work.
Women with a uterus who want estradiol and progesterone in one cream.
Estradiol alone, no estriol, combined with progesterone.
Apply at night. Report any bleeding.
the most dramatic change from estrogen therapy
as symptoms settle and hormone levels stabilize
estrogen slows bone loss at menopause
many patients report clearer, more stable daily rhythms
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.
5Individual 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.
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
A sample week
Once a day
Transdermal delivery of both hormones avoids first-pass liver metabolism and may lower gallbladder risk. Micronized progesterone provides effective endometrial protection.
Progesterone may cause drowsiness, mood changes, or water retention. Apply in the evening when possible. Your physician monitors tolerability at every visit.
Learn moreEstradiol 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.

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 + 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.
Applied to the skin, once a day. The starting prescription is 1 mL (4 clicks, 1 mg estradiol / 100 mg progesterone) each time. Your physician sets your own dose and it is printed on your label.
Inner forearm or inner thigh.
The pharmacy carries 2: 1 mg / 100 mg/mL, 2 mg / 200 mg/mL. Your physician chooses which one you get.
Estradiol, Progesterone.
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
No. After hysterectomy (surgical removal of the uterus), you do not need progesterone. Ask your physician for an estradiol-only cream formulation.
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.
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.
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
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Injection
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7-Keto DHEA, a metabolite of DHEA that does not convert to testosterone or estrogen. Supports energy and metabolism without hormonal side effects.
Capsule
from $79/mo
A low-dose aromatase inhibitor for men on testosterone therapy whose blood work shows high estradiol, easing breast tenderness and water retention. Slow-release capsule, prescribed and dosed by a licensed physician.
Capsule
from $54/mo
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.
Kronos Early Estrogen Prevention Study (KEEPS): cardiovascular and metabolic effects.
Menopause, 2016The 2022 hormone therapy position statement of The North American Menopause Society.
Menopause, 2022Estradiol + Progesterone Creamfrom $109/mo