What is biest cream and what can it do to help improve menopausal symptoms? The majority of transdermal hormone creams that are available commercially have only one type of estrogen. This type is called estradiol or E2, and many name-brand hormone products contain a synthetic version of it. But there are actually three types of estrogen hormones in a woman’s body, in addition to hormones like progesterone and testosterone.

The Different Types of Estrogen

Estradiol, estriol, and estrone are the three types of estrogen circulating in a woman’s body. The balance of these hormones and others start to become off-balance as a woman enters menopause. The only type of estrogen that is found in commercially available hormone products in the United States is estradiol. This estrogen may be found in either biodientical or synthetic forms. The conjugated equine estrogen found in Premarin is made from mare’s urine. This product used to be one of the most popular estrogen products for menopausal symptoms however it has since become less popular than bioidentical hormone replacement.

Estriol (E3) is often considered a weaker estrogen than estradiol, but has shown promise as a treatment for alleviating menopausal symptoms. It has been shown to be especially effective at treating the vaginal symptoms of menopause. Estriol is available commercially throughout Europe, Australia, New Zealand, Asia, Latin America, and other parts of the world.

In general estrone (E1) is avoided as part of treatment, since it has been shown to have a less useful pharmacological profile and is not as effective as other estrogens. Estrone is a prodrug of estradiol, which is ultimately the effective hormone that helps reduce menopausal symptoms. Supplementation with estrone has not been shown to have a significant benefit compared to the other types of estrogen.

Bioidentical Hormones

In an article in BMC Women’s Health it states, “Unlike manufactured Conventional Hormone Therapy (CHT), such as conjugated estrogens (CE) and medroxyprogesterone acetate (MPA), BHRT hormones do not contain extra structural moieties which may alter hormone receptor binding and function in the human body.” The bioidentical hormones used by a compounding pharmacy behave identically to those produced naturally in a woman’s body. There are no “extra” hormones like there are when the product is derived from an animal. All bioidentical hormones are plant-derived.

There are commercially available hormone products that contain plant-derived 17β-estradiol or micronized progesterone, which are considered bioidentical hormones. However they are available in limited combinations and dosages. There are no commercially available preparations that contain estriol, for example. A compounding pharmacy can provide a combination of estradiol, estriol, progesterone, and testosterone in one cream. This type of product that contains a full-spectrum of essential hormones can only be created with compounding.

Biest Cream Dosage

Biest cream is most often dosed in an 80/20 ratio of E3/E2, however a 50/50 ratio is also common. If you are already taking a commercially available hormone product, it is possible to convert your dosage into the equivalent dose of biest cream. A standard biest cream dose is a cream with 0.5mg estradiol and 2mg estriol. Since a 20/80 cream always contains the same percentage of ingredients, this is usually shortened and called a 2.5mg biest cream. A 5mg biest cream would contain 1mg estradiol and 4mg estriol.

Biest Cream Side Effects

Most women who use biest cream do not experience side effects that are worse than menopausal symptoms. There are some women who will experience one or more of these side effects who may benefit from a change in dose before discontinuing treatment. These are some biest cream side effects that a woman may experience:

• Gaining weight
• Fatigue
• Skin changes like acne
• Changes in facial hair
• Bloating, cramping, spotting
• Mood swings, irritability
• Headaches
• Breast tenderness

Biest Progesterone Cream

Whenever estrogen is prescribed for hormone replacement therapy, progesterone is usually prescribed along with it if the woman has an intact uterus. This is because unopposed estrogen therapy increases the risk of developing endometrial cancer. Combining progesterone with estrogen helps significantly reduce this risk. A compounding pharmacy can add progesterone to any biest cream. Progesterone in the form of oral capsules is also available to be taken while using a transdermal estrogen cream.

Biest Progesterone Testosterone Cream

A decline in testosterone production comes with age in both women and men. This change is not necessarily a part of menopause but instead a part of aging. However the symptoms of declining testosterone production often occur simultaneously with menopause. In particular, testosterone decline is implicated in decreased libido for both women and men. A cream can be made by a compounding pharmacy that contains estradiol, estriol, progesterone, and testosterone in one formulation. A separate testosterone-only transdermal cream may also be made in doses that are customized for women.

Research

Effectiveness of Compounded Bioidentical Hormone Replacement Therapy: An Observational Cohort Study – BMC Women’s Health

Estriol: emerging clinical benefits. – Menopause