From the Research
For post-menopausal women, a typical starting dose for compounded estrogen and progesterone cream is 2.0-3.0 mg estradiol and 100 mg progesterone, as this range was studied in a randomized clinical trial 1. The cream should be applied once daily to thin-skinned areas such as the inner wrist, inner arm, or inner thigh. Key considerations for treatment include:
- Starting at the lower dose range and titrating based on symptom relief and tolerability
- Using the cream cyclically (25 days on, 5 days off) or continuously depending on the patient's needs and provider preference
- Including progesterone to protect the endometrium from unopposed estrogen effects in women with an intact uterus
- Monitoring hormone levels after 2-3 months of therapy to ensure appropriate absorption, and reassessing symptoms regularly
- Being aware of potential side effects such as breast tenderness, bloating, or spotting, particularly during initial treatment
- Aiming to use the lowest effective dose for the shortest duration necessary to manage menopausal symptoms, as supported by recent reviews of hormone therapy in menopause 2. It's also important to note that while there is limited published information on the use of compounded bioidentical hormones, studies suggest they can be effective in relieving menopausal symptoms and are generally well-tolerated 3, 4. However, the most recent and highest quality study on this topic is from 2013, which provides the most reliable guidance on dosing 1.