Daily topical cream
Biest
A compounded cream combining estriol and estradiol, most often in an 80/20 ratio. Prescribed for hot flushes, night sweats, and vaginal dryness. Applying it through the skin avoids the first pass through the liver that oral estrogen involves.
From $92/mo
Includes clinician visits, lab panel, medication, and unlimited messaging.
See if I qualifyNo charge until a clinician approves your plan.
Transdermal estrogen carries a lower clot risk than oral estrogen in observational data.
What is in it
Estriol and estradiol in a transdermal base, compounded to your prescribed ratio and strength.
How to take it
- Apply the measured dose to inner forearm or thigh once daily.
- Rotate application sites.
- Let it absorb fully and wash your hands afterward.
- Avoid skin contact with others until absorbed.
Why clinicians prescribe it
Dosed to you
Compounding allows a ratio and strength matched to your symptoms and hormone panel.
Skips the liver first pass
Transdermal delivery avoids the metabolic route that raises clot risk with oral estrogen.
Adjustable
Your clinician can move the dose in small increments as symptoms settle.
Common questions
No. Compounded preparations are made by licensed pharmacies and are not FDA-approved finished products, so they have not been through the same review. We think you should know that plainly. FDA-approved estradiol patches and gels are an alternative your clinician can prescribe instead.
Important safety information
Not for use with a history of breast or endometrial cancer, blood clots, stroke, or unexplained vaginal bleeding. Requires progesterone if you have a uterus. Report new breast lumps, chest pain, or leg swelling immediately. Compounded hormones are not FDA-approved.
This page is not medical advice. Only a licensed clinician who has reviewed your history can decide whether this treatment is appropriate for you. Tell your clinician about every medication and supplement you take.
