Estradiol + Progesterone
Bioidentical hormone replacement that addresses sleep, hot flashes, mood, and bone density — dosed off your labs, not a checklist.
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Prescriptions require an online visit reviewed by a U.S.-licensed provider. Compounded medications are prepared by licensed U.S. pharmacies and are not FDA-approved. Individual results vary.
Who it’s for
- Perimenopause or menopause symptoms (sleep, hot flashes, mood)
- PCOS, irregular cycles, or hormonal acne
- Want care from clinicians who order labs before prescribing
Most people are told it's stress long before anyone thinks to check.
how it works
The primary estrogen produced by the ovaries — bioidentical estradiol replacement addresses perimenopausal and menopausal symptoms including hot flashes, sleep disruption, mood, and bone density loss.
What we can and can't tell you
The WHI window matters: benefit-risk is most favorable when started within 10 years of menopause onset. These are population findings, not personal guarantees — your regimen, route, and whether you need progesterone depend on your labs and history.
- Who makes it A LegitScript-verified 503A compounding pharmacy, from your prescription — never a gray-market or overseas supplier
- To what standard USP <797> sterile compounding and USP <800> hazardous-drug handling, where applicable
Compounded medications are not FDA-approved, are not reviewed by the FDA for safety or effectiveness, and are not generic equivalents of any brand-name drug.
what the first months look like
Estradiol starts; early spotting and breast tenderness are common as tissue re-adjusts to estrogen signaling. Not a warning sign on its own.
Vasomotor symptoms — hot flashes, night sweats, sleep disruption — are usually the first to ease. Progesterone at bedtime leans on its sedative metabolites for sleep.
Mood and urogenital comfort continue settling. Dose is titrated off symptoms and labs, not a fixed schedule.
Bone-density protection is a sustained benefit of continued therapy. Reviewed at each check-in against your risk profile.
Dosing, step by step
| Transdermal estradiol | 0.025–0.1 mg/day patch — avoids first-pass hepatic metabolism; preferred for clotting safety |
|---|---|
| Oral estradiol | 0.5–2 mg/day — alternative route where appropriate |
| Progesterone (continuous) | 100 mg/day at bedtime — taken at night to leverage the sedative effect |
| Progesterone (cyclic) | 200 mg/day, days 1–14 of each calendar month — cyclic or continuous both acceptable by preference |
Estradiol is always paired with progesterone (oral micronized) in patients with an intact uterus, for endometrial protection. Route and regimen are a clinician decision made off your labs — the ranges here are the profile's, not a target.
And when it gets rough
- Breast tenderness or bloating Common early and usually settles as your dose stabilizes; flag it at your check-in if it persists so the dose can be reviewed.
- Spotting (early) Expected in the first weeks as tissue adjusts. New or persistent bleeding later on is a same-week clinician call, not something to wait out.
- Drowsiness or dizziness on standing (progesterone) Take progesterone at bedtime so the sedation works for you; rise slowly. Tell your clinician if it carries into the day.
- Leg swelling, chest symptoms, or signs of a clot Venous thromboembolism is a rare risk, higher with oral — the reason we favor the patch. Do not manage this yourself; seek urgent care and contact your clinician immediately.
We start most people on estradiol paired with progesterone because the two belong together — if you still have your uterus, the progesterone isn't optional, it's protective. We dose off your labs and how you actually feel week to week, not a calendar, and we lean toward the patch when clotting risk is something we want to keep quiet. Early on we're watching for spotting and breast tenderness — usually the signal that we're still finding your level, and something we adjust rather than wait out. Most of the women we see spent years being handed a shrug; the point here is to take the symptoms seriously and actually treat them.
Three steps, no insurance hoops
Take the quiz
Two minutes. Tell us your symptoms, history, and goals.
Clinician reviews
A U.S.-licensed clinician reviews and writes your plan within 24 hours.
Care ships free
Your medication arrives in days. Refills auto. Check-ins included.
see it in real life
What members say
4.5Absolutely love Zappy Health. Very professional, customer service is amazing. Fast shipping and everything is certified. Zappy Health has transformed my life. I am in the best shape with my health! Thank you Zappy Health for helping me achieve my goals on a wellness journey.
Zappy Health is extremely easy to enroll in. They were helpful every step of the way & I knew within the hour of submitting my application that I was a candidate. As soon as I made my decision to start my journey the communication from them has been impressive.
The initial process of ordering the medication was extremely easy. The app is very helpful and I cannot wait to receive my medication and start my journey. Thank you so much!!
Verified Trustpilot reviews, published as written. Individual results vary and are not typical.
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