Injection
Estradiol Cypionate
Long-acting estradiol injection for menopause and perimenopause symptoms and for gender-affirming hormone therapy, given every one to two weeks. Prescribed and dosed by a licensed physician.
Starting at $139/mo
BioidenticalTopicalUterine protection
Progesterone Cream
RxPrescription onlyApplied to the skin · Once a day · 4 clicks, 50 mg · Bioidentical · Topical · Uterine protection
Starting at $79/mo
Bioidentical micronized progesterone as a topical cream for uterine protection. Apply daily to skin. Flexible dosing, gentle absorption.
Choose your plan
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Bioidentical micronized progesterone
- Topical application
- Adjustable dosing
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is progesterone cream?
(bioidentical progesterone, topical)
Progesterone cream delivers micronized progesterone through the skin for systemic absorption. Topical application avoids first-pass liver metabolism and allows flexible dosing. If you have a uterus and use estrogen, progesterone cream provides uterine protection. Apply daily to clean, dry skin.
- How it is taken
- Applied to the skin
- How often
- Once a day
- Dose range
- 4 clicks, 50 mg
- Form
- Bioidentical · Topical · Uterine protection
Topical
bioidentical micronized progesterone, applied to skin
Apply 20-40 mg daily (0.25-0.5 mL), usually in the evening. Your physician adjusts based on symptom control and blood work.
How it works,
week by week.
Day 1
A US-licensed physician explains why progesterone is mandatory if you have a uterus and use estrogen.
Week 1
Start your progesterone dose at the prescribed strength. Evening dosing helps you sleep through any drowsiness.
Weeks 2-4
You may notice mild drowsiness or mood changes. Most effects settle within 2-4 weeks. Your physician monitors these effects.
Month 3
Check-in. Your physician confirms that progesterone is working as expected and reviews any side effects.
Beyond
Continue progesterone as long as you use estrogen and have a uterus. Your physician reassesses yearly.
What you may notice,
and when.
Endometrial protection
progesterone prevents cancer from unopposed estrogen
Hormone balance
progesterone completes the estrogen-progesterone partnership
Sleep support
many patients report improved sleep with evening progesterone
Continued estrogen benefit
estrogen-progesterone together is safe with a uterus
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Progesterone is essential for uterine protection when using estrogen therapy. Common effects include drowsiness (especially if taken in the evening), mood changes, bloating, and breast tenderness. Progesterone does not increase blood clot or stroke risk significantly (unlike estrogen). Rare effects include dizziness or headache. Tell your physician if you experience severe mood changes, severe bloating, or persistent headache. Progesterone is not prescribed during pregnancy (it is already high). Stop and seek care for severe allergic symptoms.
The research behind
progesterone.
Micronized progesterone is the form studied in most menopause trials. Creams, troches and dissolving tablets have much less study, and their blood levels are low and variable.
- Heart risk markersHDL up, LDL down
The PEPI trial randomized 875 healthy postmenopausal women aged 45 to 64 to placebo, estrogen alone, or estrogen with a progestin, for 3 years. Active arms lowered LDL by about 14 to 18 mg/dL against placebo; estrogen with cyclic progesterone raised HDL less than estrogen alone. These are blood markers, not heart events.
The Writing Group for the PEPI Trial, JAMA 1995 - Breast cancerLess signal than synthetic progestins
In the French E3N cohort of 54,548 women, micronized progesterone had a relative risk of 0.9 against 1.4 for synthetic progestins (P<0.001) in observational data. A 2008 follow-up of 80,377 women found no significant association for estrogen combined with progesterone.
Fournier et al., Int J Cancer 2005; Breast Cancer Res Treat 2008 (E3N) - Cream absorptionLow blood levels
In a small 2000 study of six premenopausal and six postmenopausal women, one 64 mg topical application of micronized progesterone cream did not raise serum progesterone during the first 3 hours, though saliva levels rose. Serum levels did not reach those after oral or vaginal progesterone.
Clin Endocrinol (Oxf) 2000;53:615-620
What the studies found
- Protects the uterine lining when paired with estrogen: unopposed estrogen caused endometrial hyperplasia in 34% of women, against 1% on the other active arms (PEPI, JAMA 1995)
- Combined with estrogen, a smaller HDL rise than estrogen alone, and an LDL fall versus placebo (PEPI, JAMA 1995)
- Less breast cancer signal than synthetic progestins in observational data (E3N, Int J Cancer 2005)
The trials used oral micronized progesterone or synthetic progestins, not compounded creams, troches or dissolving tablets. The forms here are compounded and have not been tested against the trial outcomes.
What this does not say
- PEPI measured lipids and blood pressure, not heart attacks or strokes.
- Observational breast cancer data show association, not proof of safety.
- No trial shows that progesterone cream protects the uterine lining.
The research
behind it.
Transdermal progesterone delivery has variable absorption and blood levels. Your physician may check progesterone levels to confirm you are achieving therapeutic exposure.
Progesterone may cause drowsiness, mild mood changes, or breast tenderness. Evening application helps manage drowsiness. Your physician monitors these effects.
Hormone therapy beyond hot flashes:
what the research showsBones, the heart, vaginal health and sexual desire: the trials, with their numbers and their limits.Read the researchHormone therapy and breast cancer risk:
what the trials foundEstrogen alone and with progestin, why the two differ, and how physicians weigh it.Read the research
what the research showsBones, the heart, vaginal health and sexual desire: the trials, with their numbers and their limits.Read the researchHormone therapy and breast cancer risk:
what the trials foundEstrogen alone and with progestin, why the two differ, and how physicians weigh it.Read the research
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I use Progesterone Cream?
Applied to the skin, once a day. The starting prescription is 1 mL (4 clicks, 50 mg) each time. Your physician sets your own dose and it is printed on your label.
Where do I apply it?
Inner forearm or inner thigh.
What strengths does Progesterone Cream come in?
The pharmacy carries 3: 50 mg/mL, 100 mg/mL, 200 mg/mL. Your physician chooses which one you get.
How much arrives in each shipment?
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
How much progesterone cream should I apply?
Your physician sets your dose, usually 20-40 mg daily (0.25-0.5 mL), applied to clean, dry skin. Use a metered applicator. Apply to areas like your forearm, chest, or inner thigh, where skin is thin and absorption is good. Rotate application sites to avoid skin irritation.
Can I skip progesterone if my symptoms improve on estrogen alone?
No. Progesterone is mandatory with estrogen if you have a uterus. The protection is about cancer prevention, not symptom relief. Stopping progesterone while using estrogen significantly raises endometrial cancer risk. Your physician does not recommend this.
Does progesterone cause weight gain?
Some patients report mild bloating or water retention, but true weight gain is uncommon. If you notice significant weight gain, tell your physician. You may adjust dose, timing, or form.
Why do I take progesterone in the evening?
Progesterone causes drowsiness in many patients. Evening dosing helps you sleep and avoids daytime sedation. However, if you experience drowsiness, tell your physician, they may adjust timing or dose.
Progesterone cream educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
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Dissolving tablet
BIEST (20:80) 0.05 mg ODT
A low-dose bioidentical estrogen (20% estriol, 80% estradiol) in a tablet that dissolves in the mouth, for hot flashes, night sweats and other menopause symptoms. Prescribed and dosed by a licensed physician.
30 tablets per month
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Dissolving tablet
BIEST (20:80) 0.1 mg ODT
A stronger dose of bioidentical estrogen (20% estriol, 80% estradiol) in a dissolving tablet, for menopause symptoms not controlled by the lower dose. Prescribed and dosed by a licensed physician.
30 tablets per month
Starting at $99/mo
References
- 1.WHI Steering Committee: Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA, 2002
- 2.KEEPS Investigators: The Kronos Early Estrogen Prevention Study (KEEPS). Menopause, 2016
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.