BIEST Cream

Product Overview

BIEST Cream is a compounded topical hormone preparation containing a combination of two estrogens:

• Estradiol (E2) – the most potent and biologically active form of estrogen
• Estriol (E3) – a milder form of estrogen

BIEST is commonly formulated in specific ratios (such as 80:20 or 50:50 estriol to estradiol), depending on your doctor’s prescription and individual hormonal needs.

This cream is often prescribed as part of bioidentical hormone therapy (BHRT) for women experiencing hormonal changes associated with:

• Perimenopause
• Menopause
• Surgical menopause
• Hormonal imbalance
• Vaginal dryness
• Hot flushes and night sweats
• Mood fluctuations
• Low energy
• Sleep disturbance

At Angel Pharmacy, BIEST Cream (30g tube) is compounded or dispensed strictly according to your doctor’s prescription and tailored treatment plan.

How BIEST Cream Works

BIEST combines estradiol and estriol to provide estrogen support in a balanced way.

When applied to the skin, the cream:

• Delivers estrogen through transdermal absorption
• Helps stabilise fluctuating hormone levels
• Reduces hot flushes and night sweats
• Improves vaginal tissue health
• Supports skin elasticity
• May assist with mood and cognitive stability
• Helps maintain bone density

Because it is applied topically, BIEST bypasses first-pass liver metabolism, which may reduce certain systemic side effects compared to oral estrogen.

Directions for Use

Use BIEST Cream exactly as prescribed by your healthcare provider.

Typical instructions may include:

• Apply once or twice daily
• Use a measured amount as directed
• Apply to clean, dry skin
• Rotate application sites (inner arms, thighs, wrists, or lower abdomen)
• Avoid broken or irritated skin

Wash hands after application unless hands are the treatment site.

Do not adjust your dose without medical advice.

Important Safety Information

Before using BIEST Cream, inform your doctor if you have:

• A history of breast cancer
• Uterine or ovarian cancer
• Blood clots (DVT or pulmonary embolism)
• Stroke or heart disease
• Liver disease
• Unexplained vaginal bleeding
• High blood pressure
• High cholesterol
• Migraine with aura
• Diabetes

Estrogen therapy may increase the risk of:

• Blood clots
• Stroke
• Certain hormone-sensitive cancers

If you have an intact uterus, your doctor may prescribe progesterone alongside BIEST to reduce the risk of endometrial hyperplasia.

Hormone therapy should be reviewed regularly.

Possible Side Effects

Some individuals may experience:

• Breast tenderness
• Mild nausea
• Headache
• Fluid retention
• Mood changes
• Breakthrough bleeding
• Skin irritation at application site

Seek urgent medical attention if you experience:

• Chest pain
• Shortness of breath
• Severe headache
• Vision changes
• Signs of a blood clot

Drug Interactions

BIEST may interact with:

• Anti-seizure medications
• Rifampin
• Certain antifungals
• Some antivirals
• Herbal supplements such as St. John’s Wort

Always inform your pharmacist and doctor of all medications and supplements you are taking.

Pregnancy & Breastfeeding

BIEST Cream is not intended for use during pregnancy.

If you become pregnant while using this medication, contact your healthcare provider immediately.

Use during breastfeeding should only occur under medical supervision.

Storage Instructions

• Store below 25°C
• Protect from heat and direct light
• Do not freeze
• Keep out of reach of children
• Do not use after expiry date

Frequently Asked Questions

What does BIEST mean?

BIEST refers to a combination of two estrogens: estradiol (E2) and estriol (E3).

Is BIEST bioidentical?

Yes. The hormones used in BIEST are chemically identical to those produced naturally in the body.

Do I need progesterone with BIEST?

If you still have your uterus, progesterone is usually prescribed alongside estrogen therapy to protect the uterine lining.

How long before I notice improvements?

Some women notice symptom relief within a few weeks. Full effects may take several months.

Can BIEST cause weight gain?

Hormone therapy does not directly cause significant weight gain, though mild fluid retention may occur.

Disclaimer

This information is provided for educational purposes only and does not replace professional medical advice. BIEST Cream should only be used under the supervision of a qualified healthcare provider.

For personalised advice, speak with our pharmacists at Angel Pharmacy.