BIEST, a bi-estrogen blend prepared to your ratio.
BIEST is a compounded blend of two bioidentical estrogens, estriol and estradiol, prepared to the ratio your clinician prescribes. A US-licensed clinician reviews your symptoms and, where indicated, your labs, then prescribes only when it fits your history. Compounded in the USA by licensed 503A pharmacies. No hidden overseas supply chain.
- Clinician-led, US-licensed
- Bioidentical estriol and estradiol
- Labs reviewed where indicated
- Compounded in the USA by licensed 503A pharmacies
Compounded drug products are not approved or evaluated for safety, effectiveness, or quality by the FDA. Rx required.
What it is
Two bioidentical estrogens, blended to a prescribed ratio
BIEST is a compounded formulation that combines two bioidentical estrogens: estriol, a gentler estrogen, and estradiol, the primary one. It is typically prepared as a topical and blended to a ratio your clinician selects, which is the point of compounding it rather than using a single fixed product. Both hormones are structurally identical to the estrogens your body makes.
This is a clinical process. A US-licensed clinician reviews your history and, where indicated, your labs, and writes a prescription only when the medical picture supports it. If you have a uterus, BIEST is prescribed alongside progesterone to protect the uterine lining. Every dose is compounded in the USA by a licensed 503A pharmacy. Compounded BIEST is not an FDA-approved drug.
How it fits your plan
A custom ratio, paired correctly, reviewed over time
A ratio set for you
BIEST blends estriol and estradiol to a ratio your clinician chooses from your symptoms and history. Compounding is what makes that customization possible rather than a one-size product.
Paired with progesterone when needed
For women with a uterus, BIEST is prescribed together with progesterone to protect the uterine lining. Your clinician manages the pairing so your plan is complete.
Reviewed and adjusted
Where it informs the decision, your clinician reviews your estrogen and related labs and adjusts the ratio or dose over time as your symptoms evolve.
Sourcing and safety
Bioidentical, US-compounded, and prescribed by a clinician of record.
From who writes the prescription to where your BIEST is compounded, the chain behind your medication is transparent by design.
A clinician of record
A US-licensed clinician reviews your intake, discusses the trade-offs, and is your prescriber of record. Your BIEST is never sold off a shelf.
Compounded in the USA
Your BIEST blend is compounded in the USA by a licensed 503A pharmacy under your prescription, to your prescribed ratio. No hidden overseas supply chain.
Labs where indicated
Where it informs the decision, your clinician reviews estrogen and related hormone panels so your plan reflects what your body is missing.
Who it's for
For women who want a customized estrogen blend, prescribed and monitored.
BIEST is considered for women with symptoms of the menopausal transition who want a compounded blend tailored to their picture. Eligibility is a clinical decision made by your prescriber.
- Hot flashes, night sweats, or other recognized menopausal symptoms you want evaluated
- You and your clinician want an estrogen formulation blended to a specific ratio
- You prefer a topical form as part of your routine
- You want a bioidentical blend prescribed and monitored, not sourced off a shelf
Your clinician reviews your history for contraindications including a personal history of hormone-sensitive cancers, blood clots, or cardiovascular disease, and prescribes only when the evidence supports it. Not everyone qualifies, and if BIEST is not appropriate you are never charged for a medication you were not prescribed.
What you receive
One plan. Everything included.
A flat monthly price covers your compounded medication, the clinical care, and shipping. Your clinician sets the exact ratio and dose during your review and adjusts it over time.
- A bioidentical BIEST blend prescribed for you, US-licensed
- Compounded in the USA by a licensed 503A pharmacy to your prescribed ratio
- Progesterone pairing where clinically indicated
- Lab review where indicated, including hormone panels
- Async messaging with your care team and dose adjustments over time
- Cancel or pause anytime
Starting from
Free online visit. You only pay when prescribed.
- Cancel anytime
- No insurance needed
- Discreet shipping
- HSA/FSA eligible
Compounded BIEST is not an FDA-approved drug. Bioidentical hormone therapy is not appropriate for everyone. Ratio, dose, and any companion hormones are determined by a licensed clinician based on your history and, where indicated, your labs.
Compounded drug products are not approved or evaluated for safety, effectiveness, or quality by the FDA. Rx required.
BIEST questions
Things people ask before they sign up.
If something is not here, reach out, we'd rather answer it plainly than have you guess.
What is BIEST?
BIEST is a compounded blend of two bioidentical estrogens, estriol and estradiol, prepared to a ratio your clinician prescribes. Both are structurally identical to the estrogens your body makes. It is prescribed by a US-licensed clinician and is not an FDA-approved drug.
Why blend two estrogens instead of using one?
Compounding BIEST lets your clinician set a specific ratio of estriol to estradiol for your picture, rather than relying on a single fixed product. Your clinician chooses the blend based on your symptoms and history.
Do I need progesterone too?
If you have a uterus, estrogen, including BIEST, is prescribed alongside progesterone to protect the uterine lining. Your clinician manages this pairing as part of a complete plan.
Will my labs be reviewed first?
Where it informs the decision, yes. Your clinician may review estrogen and related hormone panels so your plan reflects what your body needs.
How much does it cost?
The online visit is free. If a clinician prescribes, the program is $139/month on the 3-month plan ($417 billed every 3 months), covering the medication, clinician care, and shipping. Plans are HSA and FSA eligible.
An estrogen blend made for you.
Take the free assessment. A US-licensed clinician reviews your symptoms and, where indicated, your labs, then prescribes a bioidentical BIEST blend only when it fits. The online visit is free, and you only pay if you're prescribed.