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
FDA-approvedOralClinical trial evidence
FDA-approved bioidentical estradiol tablets for menopausal symptoms. Take once or twice daily. Strong clinical evidence from the KEEPS trial.
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 estradiol, FDA-approved oral form)
These are FDA-approved bioidentical estradiol tablets, marketed as Estrace and other brands. Unlike compounded estradiol, these products have undergone FDA review for safety, purity, and potency. The KEEPS trial (Kronos Early Estrogen Prevention Study) provided strong evidence of benefit and safety when started near menopause, especially for bone health and heart risk in younger postmenopausal women.
FDA-approved
bioidentical estradiol with clinical trial backing
Take 0.5-2 mg daily (usually in two doses), as prescribed. Effects on hot flashes appear within 2-4 weeks.
Women who want the standard, FDA-approved estradiol tablet.
The commercial generic, with decades of use.
Start low. The lowest dose that controls your symptoms is the right dose.
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
The KEEPS trial (published 2016) followed 727 healthy postmenopausal women and found that oral estradiol started within 6-8 years of menopause reduced hot flashes by >70% and slowed bone loss without increasing breast cancer risk over 5 years.
Long-term risk (beyond 5-7 years) of estrogen therapy is less clear. Your physician discusses when to reassess your therapy at each visit, balancing ongoing symptom relief against long-term risks.
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 tablets (FDA-approved) 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.
Taken by mouth, once a day. The starting prescription is 1 tablet (0.5 mg) each time. Your physician sets your own dose and it is printed on your label.
The pharmacy carries 3: 0.5 mg, 1 mg, 2 mg. Your physician chooses which one you get.
30 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
FDA-approved products undergo rigorous review for purity, potency, and manufacturing standards. Compounded products are not FDA-regulated. If you prefer maximum regulatory oversight and clinical trial evidence, FDA-approved forms offer this assurance. Your physician helps you choose.
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.
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.
That is a decision you and your physician make at every visit. Some women use it for a few years; others longer. Your physician discusses the ongoing balance of benefits and risks with you regularly.
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
A copy of the brain's own GnRH signal that keeps the testes producing testosterone and sperm, used alongside testosterone therapy and in fertility care. Prescribed and dosed by a licensed physician.
Injection
from $159/mo
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 Tablets (FDA-Approved)from $69/mo