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
BioidenticalGentleMenopausal
Estriol Cream
Bioidentical estriol, the weakest estrogen, as a topical cream for mild to moderate symptoms. Apply daily to skin. Gentlest estrogen option.
- Bioidentical estriol
- Topical, gentle absorption
- Weaker action, fewer systemic effects
- 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
- 5 options · 4 clicks, 2 mg
What is estriol cream?
(bioidentical estriol, topical)
Estriol is the weakest of the three main estrogens and the dominant form during pregnancy. Estriol cream delivers this gentle hormone topically for patients seeking the mildest estrogen option. Estriol is less likely to stimulate breast tissue and carries a theoretically gentler risk profile, though all estrogens carry the same core safety concerns. Use as monotherapy for mild symptoms or as part of a combination like BIEST.
What's in it
- EstriolEstrogen: eases menopause symptoms
Weakest
the gentlest of the three natural estrogens
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 the mildest estrogen, often for skin or vaginal symptoms.
What sets it apart
Estriol alone. It is the weakest of the three estrogens and is not in any FDA-approved product.
Worth knowing before you start
Mild does not mean risk-free: with a uterus, ask about progesterone.
Gentle symptom relief
Gradual hot flash relief
slower than higher-strength estrogens
Mood and sleep support
gentler effects as estriol slowly works
Tissue-gentle approach
weaker estrogen, theoretically gentler on breast tissue
Lower systemic load
gentler overall hormone exposure
How estriol therapy works
Day 1
A US-licensed physician reviews your symptoms, history, and why you prefer a gentler estrogen.
1Weeks 1-2
Some symptoms may ease slowly. Estriol's weaker action means gentler relief but may take longer.
2Month 1-2
Your physician checks your progress and may increase dose or recommend adding estradiol if symptom control is inadequate.
3Month 3
Review your symptom improvement and any side effects. Adjust plan as needed.
4Beyond
Estriol therapy is reviewed regularly. Your physician helps you decide if adding stronger estrogens would help.
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, 2 mg)
- How often
- Once a day
- Each shipment
- 1 tube
- Pharmacy label
- Apply 1 mL (4 clicks, 2 mg) 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
Strengths the pharmacy carries
- 2 mg/mL
- 4 mg/mL
- 3 mg/mL
- 1 mg/mL
- 0.5 mg/mL
The science of estriol
Estriol has lower receptor affinity and receptor recycling compared to estradiol, making it theoretically gentler. It is used widely in Europe and Asia but less common in the US.
Estriol still carries estrogen's core risks: clots, stroke, gallbladder disease, and breast tissue stimulation. Your physician assesses your risk factors before prescribing. As with all estrogen therapy, if you have a uterus, progesterone is essential.
Learn moreImportant safety information and common side effects
Estriol is bioidentical but still carries estrogen's core safety risks. Common effects include breast tenderness, nausea, headache, and bloating. Estriol increases risk of blood clots, stroke, gallbladder disease, and, with a uterus, requires progesterone for endometrial protection. Not prescribed with breast cancer, blood clots, unexplained vaginal bleeding, liver disease, or pregnancy. 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.
Estriol 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 Estriol Cream?
Applied to the skin, once a day. The starting prescription is 1 mL (4 clicks, 2 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 Estriol Cream come in?
The pharmacy carries 5: 2 mg/mL, 4 mg/mL, 3 mg/mL, 1 mg/mL, 0.5 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.
Is estriol really safer than estradiol?
Estriol is weaker and has lower receptor affinity, so some patients and clinicians prefer it for a gentler approach. However, the core safety risks (clots, stroke, gallbladder disease) are not eliminated. Your physician helps you weigh the gentleness against the need for symptom control.
Is estriol less effective than estradiol?
Estriol is weaker, so symptom relief may be slower or less dramatic. For mild symptoms, estriol alone may work well. For moderate to severe symptoms, your physician may recommend combining estriol with estradiol (like BIEST) for better control.
When would I choose estriol alone?
If your symptoms are mild and you prioritize a gentler hormone exposure, estriol offers that option. Some patients also choose it for personal or cultural reasons favoring weaker hormones.
Do I need progesterone with estriol?
Yes, if you have a uterus. Estriol is estrogen and thickens the endometrium. Progesterone is essential to prevent endometrial cancer, just as with any estrogen.
Estriol, the gentlest option.
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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
Estriol: review of safety and efficacy in menopausal hormone therapy.
Maturitas, 2009 - 2
The 2022 hormone therapy position statement of The North American Menopause Society.
Menopause, 2022
Estriol Creamfrom $109/mo