From the Research
For post-menopausal women starting compounded estrogen and progesterone cream, a typical initial dose is 2.0-3.0 mg estradiol with 100 mg progesterone applied once daily to the skin, as this range was studied in a randomized clinical trial 1. The cream is usually applied to areas with thin skin such as the inner wrists, inner arms, or inner thighs, rotating application sites to prevent skin irritation.
- Start with the lower dose and adjust based on symptom relief and side effects.
- The cream should be applied at the same time each day, preferably in the evening, to maintain consistent hormone levels.
- Progesterone is included to protect the uterine lining from estrogen-stimulated overgrowth in women who have not had a hysterectomy. This combination helps manage menopausal symptoms like hot flashes, vaginal dryness, and sleep disturbances by replacing declining hormone levels. Regular follow-up with a healthcare provider every 3-6 months is recommended to monitor effectiveness and adjust dosing as needed, considering the latest guidelines on hormone therapy in menopause 2. Although other studies suggest different dosing regimens, such as 0.5-1 mg estradiol with 20-40 mg progesterone 3, 4, 5, the most relevant study for determining the initial dose of compounded estrogen and progesterone cream is the one that directly compared the pharmacokinetics of compounded preparations with conventional hormonal preparations 1.