Product image is for illustrative purposes only. Actual medication, packaging, and labeling may vary depending on the dispensing pharmacy.
BIEST/
This capsule combines BIEST estrogen with progesterone, which is typically included to protect the uterine lining when estrogen is used. It is a compounded hormone-therapy option prescribed after a careful provider review, with the quantity set by your prescription.
- Several delivery forms
- Thyroid support where indicated
- Ongoing monitoring
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BIEST/Progesterone Capsule
How BIEST/Progesterone supports hormone balance
BIEST (20:80) / Progesterone IR is a combination capsule containing BIEST (estriol and estradiol, 20:80) together with immediate-release progesterone. The listed presentation ranges from 1/100 mg to 2.5/200 mg. Hormonal changes affect every woman differently. Your provider reviews your symptoms, history, and goals before recommending whether hormone therapy fits and in what form.
Several delivery forms
Creams, capsules, patches, and a vaginal insert are available through our pharmacy network. Not every option is right for every patient.
Thyroid support where indicated
T3 and T3/T4 capsules are available when your provider determines they are appropriate for you.
Ongoing monitoring
Your provider follows up to check how you are responding and adjusts your plan as needed over time.
Provider-guided from start to finish
A licensed provider reviews your health history, checks for contraindications, sets an appropriate starting plan, and monitors your progress over time.
How to use it
Clear instructions for your prescribed formulation arrive with your first order.
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Quality and ingredient standards
Made in the U.S.A.
Some treatments are compounded by licensed U.S. pharmacies in facilities registered with the FDA. Registration does not mean a compounded medication is an FDA-approved finished medication.
USP <797>
Sterile compounding standards.
Documented handling.
Every batch released to spec.
ISO Class 7
Cleanroom-grade air.
Filtered environments.
Tighter contamination control.
Clean ingredients, careful delivery
- No heavy metals
- No added dyes
- Licensed U.S. pharmacies
- Provider-prescribed
- Cold-chain protection
- Plain, unbranded packaging
- Serves all 50 states
- HSA and FSA eligible
Medication guide
What to know about BIEST/Progesterone Capsule
General education to help you prepare for a conversation with a licensed provider. It is not a prescription or personal medical advice.
- Generic name
- Estriol/estradiol (20:80) with progesterone
- Drug class
- Estrogens (compounded bioidentical combination)
- Form
- Combination capsule taken by mouth
- Regulatory status
- Compounded, not FDA-approved
This is a compounded capsule combining estriol, estradiol and progesterone. It is not FDA-approved. The National Academies found insufficient evidence that compounded bioidentical hormones are safer or more effective than FDA-approved hormone therapy.
Compounded medications are not FDA-approved. FDA does not review them for safety, effectiveness or quality before they are dispensed. A compounded preparation can differ from approved products in strength, ingredients, dosage form and how it is absorbed, so it should not be assumed to work the same way as an approved medication. Compounding is meant for patients whose needs cannot be met by an FDA-approved drug.
Overview
A single compounded capsule combining estrogen and progesterone, used by some providers for menopause symptoms in women with a uterus.
Who may be evaluated for it
- Women with bothersome menopause symptoms such as hot flashes, night sweats, sleep disruption or vaginal dryness.
- Generally best studied in women under 60 or within 10 years of their last period, per The Menopause Society’s 2022 position statement.
Who may not be a good fit
- Anyone with unexplained vaginal bleeding.
- Women with a current or past breast cancer or other estrogen-sensitive cancer.
- Women with a past blood clot, stroke or heart attack, or a known clotting disorder.
- Women with active liver disease.
- Women who are or may be pregnant.
How it works
Estradiol and estriol both act on estrogen receptors. Estriol is a weaker estrogen. Applied to skin, they are absorbed into the bloodstream, but the amount absorbed from a compounded cream varies between people and batches.
The term "bioidentical" means the hormones have the same chemical structure as those the body makes; FDA-approved estradiol products are also bioidentical.
Potential benefits and realistic timelines
What the evidence supports
- Estradiol, its main component, is effective for hot flashes in FDA-approved forms.
Not established
- That BIEST is safer than FDA-approved estrogen.
- Consistent dosing and absorption of compounded creams.
- That estriol protects the breast or uterus.
- 2 to 4 weeksHot flashes often begin to ease.
- About 3 monthsFull effect is usually seen; providers commonly reassess dose and side effects.
- OngoingNeed and dose are reviewed at least yearly. Symptoms may return after stopping.
Results vary from person to person. Your provider decides whether and how long to continue.
How it’s used
- Take by mouth as directed, usually at bedtime because progesterone can cause drowsiness.
- Do not take extra progesterone or estrogen products unless directed.
If you miss a dose
Take it when you remember the same evening; otherwise skip. Do not double up.
Storage and handling
Room temperature, away from moisture.
Your prescription label and provider instructions always take priority over this general information. Do not change your dose or stop without talking to your provider.
Side effects and safety
More common, usually manageable
- Drowsiness
- Breast tenderness
- Bloating
- Spotting
- Headache
Less common but serious
- Blood clots in the legs or lungs, and stroke (higher with oral estrogen than with skin patches).
- Endometrial (uterine lining) cancer if estrogen is taken without a progestogen by a woman who has a uterus.
- A small increase in breast cancer risk with long-term estrogen plus progestin.
- Gallbladder disease.
Get medical help right away
- Sudden chest pain, shortness of breath or coughing up blood.
- Pain, swelling or warmth in one leg.
- Sudden severe headache, vision loss, weakness or trouble speaking.
- Unexpected vaginal bleeding after menopause.
- A new breast lump.
Call 911 or go to the nearest emergency room for chest pain, trouble breathing, swelling of the face or throat, fainting, or signs of a stroke (sudden weakness, numbness, trouble speaking or seeing).
Pregnancy, breastfeeding and fertility
Not for use during pregnancy or breastfeeding. Estradiol is not a contraceptive.
Interactions and combinations
Known interactions
- Seizure medicines (carbamazepine, phenytoin), rifampin and St. John’s wort can lower estrogen levels.
- Some antifungals (ketoconazole), clarithromycin and grapefruit juice can raise estrogen levels.
- Thyroid medication: oral estrogen can increase the levothyroxine dose needed.
- Smoking increases the risk of clots and stroke.
- Sedatives and alcohol can add to drowsiness from progesterone.
Related treatments and options
Listed for education, not as a recommendation to combine. Any combination needs your provider’s approval.
- Progesterone IRAvoid
Already included; do not double up.
Already includes estrogen.
Monitoring and follow-up
- A review of your symptoms, personal and family history of breast cancer, clots, heart disease and stroke, and your blood pressure.
- Up-to-date mammogram and cervical screening as recommended for your age.
- A follow-up visit within about 3 months of starting, then at least yearly to reassess dose and whether to continue.
- Any unexpected vaginal bleeding is evaluated promptly.
- Routine hormone blood levels are generally not recommended to guide menopause therapy, per The Menopause Society.
Lab tests and follow-up visits are not included in the medication price unless your plan says so. Your provider will tell you what is needed.
Alternatives to discuss
- Estradiol Patch with Progesterone IR
FDA-approved estradiol plus progesterone, with separately adjustable doses.
- Progesterone IR
Progesterone on its own.
- BIEST (20:80) Cream
Topical estrogen without progesterone.
Lab tested medications for quality and potency.
Every medication ships from a licensed U.S. pharmacy in our network, delivered straight to your door.
Third party quality control testing
Compounded in U.S. pharmacies
Dosage, Schedule & Supply
- Dosage
- BIEST (20:80) / progesterone IR, 1/100 to 2.5/200 mg, titrated per prescription.
- Schedule
- Determined by your prescribing provider.
- Supply
- Quantity set by your prescription.
- Estimated Supply Duration
- Varies based on the quantity and schedule on your prescription.
Supply duration is an estimate based on the prescribed treatment plan. Actual duration may vary depending on dosage, frequency of use, and medication expiration.
Treatment information is for educational purposes. Your licensed healthcare provider will determine the appropriate dosage and schedule. Always follow your prescription instructions.
Frequently Asked Questions
Why a combination capsule?
It combines estrogen and the progesterone needed to protect the uterus in one pill. The trade-off is that the two doses cannot be adjusted separately without a new prescription.
Is it FDA-approved?
No. It is compounded. Approved alternatives include estradiol plus Prometrium, or approved combination products.
Is "bioidentical" safer?
Not proven. FDA-approved estradiol is also bioidentical. The National Academies found no good evidence that compounded bioidentical hormones are safer or more effective.
Do I need a prescription?
Yes. After your free consultation, a licensed provider reviews your intake, symptoms, and health history to decide what’s appropriate for you.
Is every formulation appropriate for me?
No. Your provider selects a formulation based on your individual symptoms, history, and goals, not every option listed is appropriate for every patient.
Is this available in my state?
Availability varies by formulation and state. Your provider will confirm what can be prescribed and shipped to you during your consultation.
Can I use my HSA or FSA?
Yes. Medura accepts HSA and FSA cards at checkout, and we can provide documentation for reimbursement if you need it.
What happens after I request treatment through Medura?
You complete an online assessment about your health history, current medications and goals. A licensed provider reviews it and decides whether a prescription is appropriate. Completing the assessment does not guarantee a prescription. If one is written, a licensed pharmacy prepares and ships it, and your provider can adjust or stop treatment as needed. If lab work is needed, your provider will tell you; it may be ordered and billed separately.
What to expect and possible side effects
- 1
Start with a consultation
A licensed provider reviews your intake, symptoms, and health history to determine whether hormone therapy is appropriate and which formulation may fit.
- 2
A plan matched to you
If approved, your provider selects a formulation, strength, and schedule, and explains how to use it.
- 3
Ongoing monitoring
Your provider follows up to check how you are responding and adjusts your plan as needed over time.
Questions to ask your provider
- 1.Am I a good candidate based on my age, time since menopause and health history?
- 2.Do I need a progestogen because I have a uterus?
- 3.Which form (pill, patch, cream, vaginal) has the lowest risk for me?
- 4.How will we decide my dose and when to reassess?
- 5.What screenings do I need while on hormone therapy?
References
- The Clinical Utility of Compounded Bioidentical Hormone Therapy (National Academies, 2020)(opens in a new tab)
- The 2022 Hormone Therapy Position Statement of The North American Menopause Society(opens in a new tab)
- FDA-approved labeling updates for menopausal hormone therapy boxed warnings (FDA, Feb 12, 2026)
- Menopause (MedlinePlus)(opens in a new tab)
- Compounding and the FDA: Questions and Answers (FDA)(opens in a new tab)
Sources last checked October 17, 2026. This page is for general education and does not replace advice from a licensed provider. Treatment requires a clinical evaluation, and a prescription is written only if a provider decides it is appropriate. Individual results vary.
Related Products & Treatments
Explore other options that may support your goals.
BIEST CreamBIEST alone, as a 2.5 mg/mL topical cream. Helps relieve menopause symptoms such as hot flashes and night sweats.View details for BIEST Cream
Progesterone CapsuleProgesterone alone, in immediate-release capsules. Helps support sleep and hormone balance, and protects the uterine lining for those taking estrogen.View details for Progesterone Capsule
Estradiol CapsuleEstradiol as a single-ingredient capsule. Helps relieve menopause symptoms such as hot flashes and night sweats.View details for Estradiol Capsule
DHEA CreamA compounded DHEA cream at 50–100 mg/mL in a 30 g presentation. Helps support low DHEA levels, and may ease vaginal dryness and low libido.View details for DHEA Cream
Estradiol PatchA transdermal estradiol patch at 0.025–0.1 mg/day, 8-pack. Helps relieve menopause symptoms such as hot flashes and night sweats.View details for Estradiol Patch
Estradiol Vaginal InsertA 10 mcg estradiol vaginal insert. Helps relieve vaginal dryness and discomfort during menopause.View details for Estradiol Vaginal Insert
Liothyronine T3 SR CapsuleA dye-free, sustained-release liothyronine (T3) capsule at 5–26 mcg. Helps with symptoms of low thyroid function such as fatigue, feeling cold and weight gain.View details for Liothyronine T3 SR Capsule
T3/T4 CapsuleA combination thyroid capsule containing T3 and T4. Helps with symptoms of low thyroid function such as fatigue, feeling cold and weight gain.View details for T3/T4 Capsule
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