Bi-est Cream

Bi-est cream contains two bioidentical estrogens — estradiol (E2) and estriol (E3) — in a topical cream. These hormones are chemically identical to those naturally produced by the body.

The two estrogens serve different roles. Estradiol is the more potent form, responsible for the primary hormonal effects. Estriol is considered the mildest of the three estrogens and helps moderate the overall effect of the formulation.

Bi-est cream is compounded in several estriol-to-estradiol ratios. The ratio determines the relative proportion of each estrogen:

• 80:20 — 80% estriol, 20% estradiol (the most commonly prescribed ratio)
• 70:30 — 70% estriol, 30% estradiol
• 60:40 — 60% estriol, 40% estradiol
• 50:50 — equal parts estriol and estradiol

Within each ratio, the total dose varies. Common total strengths per gram of cream include:

• 0.625 mg/g
• 1 mg/g
• 1.25 mg/g
• 1.5 mg/g
• 2 mg/g
• 5 mg/g

For example, a prescription for "Bi-est 80:20, 1.25 mg/g" contains 1 mg estriol and 0.25 mg estradiol per gram of cream.

Your prescriber selects the ratio and total strength based on your hormone levels, symptoms, and treatment goals. The cream is compounded in VersaBase — a pharmaceutical-grade, paraben-free base designed for transdermal absorption.

As women approach menopause, estrogen production declines, leading to symptoms that can significantly affect quality of life:

• Hot flashes and night sweats
• Vaginal dryness
• Sleep disturbances
• Irregular periods
• Mood changes and irritability
• Hair thinning
• Changes in skin quality

Bi-est cream helps restore estrogen levels to alleviate these symptoms. It is often prescribed as part of a comprehensive bioidentical hormone replacement therapy (BHRT) program, alongside progesterone.

1. Apply to clean, dry skin — inner arm, inner thigh, or behind the knees
2. Rotate application sites daily to avoid irritation
3. If using a Topi-Click applicator, turn the base to dispense the prescribed number of clicks
4. Rub in gently for 1–2 minutes until the cream is fully absorbed
5. Wash hands with soap and water after application
6. Avoid skin-to-skin contact with others at the application site — estrogens can transfer through skin contact
7. Allow the area to dry before dressing

Apply at the same time each day for consistent hormone levels. Follow the dosage instructions on your prescription label.

Side effects may include:

• Vaginal bleeding
• Bloating or nausea
• Breast tenderness
• Changes in appetite
• Fluid retention or weight gain
• Irritability (usually temporary)

Most side effects are temporary and may appear when first starting the medication. They often resolve as your body adjusts. Dose adjustment may be necessary — communicate with your prescriber about any symptoms you experience.

• Store at room temperature
• Avoid extreme heat and direct sunlight
• Keep away from moisture
• Check the beyond-use date on the label