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
Used vaginally · Once a day
BioidenticalVaginal atrophyLocalized
Estradiol Vaginal Cream
Bioidentical estradiol cream for vaginal atrophy and dryness. Applied directly into the vagina. Local relief without systemic absorption.
- Bioidentical estradiol
- Applied directly to affected tissue
- Minimal systemic absorption, local effect
- 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
- Used vaginally
- How often
- Once a day
- Each shipment
- 1 tube
- Strengths
- 7 options · 0.015–0.5 mg
What is estradiol vaginal cream?
(bioidentical estradiol, vaginal)
Estradiol vaginal cream delivers bioidentical estradiol directly to the vaginal tissue to restore moisture, elasticity, and comfort. At standard doses, minimal estradiol enters the bloodstream, making this option suitable even for patients avoiding systemic hormone therapy. Apply with the supplied applicator.
What's in it
- EstradiolEstrogen: eases menopause symptoms
Localized
bioidentical estradiol, vaginal application with minimal systemic absorption
Apply 0.5-1 gram daily for 2 weeks, then 2-3 times weekly for maintenance. Your physician adjusts based on symptom relief.
Is it right for you?
Who it's for
Women with vaginal dryness, pain with sex or repeated urinary infections after menopause.
What sets it apart
It acts where it is applied. Very little reaches the blood.
Worth knowing before you start
It usually starts nightly for two weeks and then drops to twice a week.
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
- Used vaginally
- Dose
- 1 mL (0.015 mg)
- How often
- Once a day
- When
- At bedtime
- Each shipment
- 1 tube
- Pharmacy label
- Apply 1 mL (0.015 mg) vaginally at bedtime once daily for 30 days.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
Strengths the pharmacy carries
- 0.5 mg/mL
- 0.1 mg/mL
- 0.2 mg/mL
- 0.015 mg/mL
- 1 mg/mL
- 2 mg/mL
- 0.15 mg/mL
The science of bioidentical estradiol
Vaginal atrophy from low estrogen causes thinning, dryness, burning, and pain with sex. Topical vaginal estradiol restores tissue health and lubrication effectively.
At therapeutic vaginal doses, systemic estradiol levels remain low. However, higher doses can produce measurable blood levels. Your physician may check estradiol levels if you use high doses or have hormone-sensitive conditions.
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 vaginal 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 Vaginal Cream?
Used vaginally, once a day, at bedtime. The starting prescription is 1 mL (0.015 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Estradiol Vaginal Cream come in?
The pharmacy carries 7: 0.015 mg/mL, 0.1 mg/mL, 0.15 mg/mL, 0.2 mg/mL, 0.5 mg/mL, 1 mg/mL, 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.
Will this affect my systemic hormone levels?
Vaginal estradiol at standard therapeutic doses produces minimal systemic absorption. However, your physician may check blood levels if you use high doses or have a history of hormone-sensitive cancer. Always inform your physician of this therapy.
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.
How long do I take estradiol?
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.
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 Vaginal Creamfrom $109/mo