What is Bi-Est?
"Bi-Est" is short for bi-estrogen. It pairs estriol (E3), a milder estrogen, with estradiol (E2), the main estrogen produced before menopause. Providers who prescribe it typically write the ratio (for example 80:20 E3:E2) and the total strength in milligrams per gram or per milliliter.
Bi-Est is usually applied to the skin once or twice daily, often to the inner arm, inner thigh or behind the knee, rotating sites. Follow the directions on your prescription label.
Why is it compounded?
There is no commercially manufactured estriol product in the United States, and no manufactured product that combines estriol and estradiol. A compounding pharmacy prepares Bi-Est to the ratio and strength your provider orders.
How to use your dispenser
Your cream comes in a metered-dose dispenser. It measures each dose for you. How to use your dispenser
Safety information
Compounded hormones are prepared for an individual patient from a prescription and are not FDA approved. FDA-approved bioidentical estradiol and progesterone products also exist; your provider decides which option fits your care.
Estrogen therapy carries risks that your provider will review with you. Women with a uterus are generally prescribed progesterone alongside estrogen. Keep treated skin covered and avoid skin contact with children and pets until the cream has dried.
This list isn't all-inclusive. Your provider can prescribe other strengths, combinations or dosage forms. Call us at 626.631.6150 and we'll work with you and your provider to find an option that fits.
Common questions
Where should I apply Bi-Est cream?
Apply exactly as your prescription label directs. Many providers suggest thin-skinned areas such as the inner arms, inner thighs or behind the knees, rotating sites each day.
Can Bi-Est be combined with progesterone?
Yes. When prescribed, we can prepare estrogen and progesterone in one cream so you have a single application.