Cream
1 mg/gm | 2 mg/gm | 2.5 mg/gm
Product Overview
Estriol 1-4
Micronized estriol is a bioidentical form of estriol (E3), one of the three naturally occurring estrogens in women, along with estradiol and estrone. Estriol is considered the weakest estrogen, exhibiting significantly lower receptor binding affinity and a shorter duration of action compared to estradiol (E2). Despite its lower potency, estriol has demonstrated potential skin-related effects, including support for dermal thickness and elasticity. Estriol is most commonly used in combination with estradiol in postmenopausal women experiencing estrogen deficiency.
Estradiol 1,5-11
Micronized estradiol is a bioidentical form of 17β-estradiol, the primary estrogen produced by the ovaries in premenopausal women. It is utilized in various hormone therapy (HT) regimens and is often considered a preferred estrogen option for menopausal women due to its bioidentical composition and favorable risk profile when appropriately prescribed. When administered topically and absorbed transdermally or via subcutaneous implantation, micronized estradiol bypasses first-pass hepatic metabolism. This route of administration contributes to its favorable risk profile, as first-pass metabolism of estradiol is associated with greater increases in thromboembolic factors.
BIEST is most commonly compounded as a transdermal cream to allow for more precise and incremental dose adjustments. Any BIEST formulation must specify an estriol-to-estradiol ratio, with the most commonly used ratios being 80/20 (80% estriol and 20% estradiol) and 50/50 (50% estriol and 50% estradiol). In addition to the ratio, the concentration is typically defined in milligrams per gram (mg/g). For example, BIEST 80/20 10 mg/g provides 8 mg of transdermal estriol and 2 mg of transdermal estradiol per gram of cream, within acceptable pharmacy compounding variance not to exceed ±10%.
Note: Transdermal refers to application to the skin, as opposed to intravaginal administration.
Estriol 1-4
Acts by binding to estrogen receptors alpha (ERα) and beta (ERβ) in estrogen-responsive tissues, particularly the vaginal epithelium, bladder, urethra, and pelvic floor musculature.
Mechanisms and Effects:
Estradiol 1,5-11
Binds estrogen receptors, which are widely distributed in reproductive tissues, the brain, bone, liver, and vasculature. Upon receptor binding, estradiol influences gene transcription, leading to a broad range of systemic and local effects:
Common1-11
Local side effects:
Contraindications 1-11
Precautions 1-11
Use caution in women with:
*Use with Progesterone:
For women with an intact uterus, progesterone in some form should be included with systemic estradiol therapy to prevent endometrial hyperplasia or carcinoma
Store in a cool, dry place, away from direct light and heat; Room temperature (20°C–25°C / 68°F–77°F) is ideal. Keep out of reach of children and pets.
WPPL operates as a 503A compounding pharmacy and prepares individualized prescription medications pursuant to provider direction. Compounded preparations are not reviewed, tested, or approved by the FDA.
This listing also includes commercially manufactured products for convenience; these items are not compounded by our pharmacy and are sold as provided by their manufacturers. Actual products in stock at time of dispensing may vary due to supply chain variability. Any statements regarding non-compounded products are manufacturer-supplied, have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease. WPPL does not verify or endorse any therapeutic claims made by manufacturers. Please refer to original labeling for complete product information.
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Providers: Let’s Partner for Better Patient Care
If you are a physician, clinic, or practice seeking a dependable Compounding Pharmacy partner, WP Pharma Labs is here to help. With dedicated account setup, streamlined ordering and responsive service, we support your therapeutic goals with specialized compounds designed for your patients.
To check product availability, check on the status of an existing order, request refills:
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