From the Guidelines
Bi-Est (Bi-estrogen) Hormone Replacement Therapy
Bi-Est hormone replacement therapy typically involves a combination of estradiol and estriol, which are forms of estrogen 1.
Forms and Administration
The therapy can be administered through various routes, including oral and transdermal formulations. The transdermal administration of 17β-estradiol is often preferred due to its ability to mimic physiological serum estradiol concentrations, providing a better safety profile compared to oral formulations 1.
Dosage
The dosage of Bi-Est hormone replacement therapy can vary, but common dosages include 1–2 mg of oral 17β-estradiol daily or 50–100 micrograms of transdermal 17β-estradiol daily 1.
Benefits and Considerations
Transdermal 17β-estradiol has been shown to have a more beneficial profile on circulating lipids, markers of inflammation, and blood pressure compared to oral formulations 1. Additionally, it is more effective in achieving a bone mineral density peak and reducing bone resorption markers 1. However, the safety and effectiveness of bioidentical hormone replacement therapy, including Bi-Est, have not been extensively evaluated through the FDA's drug approval process 1.
Clinical Use
In clinical practice, Bi-Est hormone replacement therapy may be considered for individualized treatment plans, taking into account the patient's health priorities and risk factors 1. However, it is essential to weigh the potential benefits and harms of hormone therapy and consider recommendations from reputable organizations, such as the American Heart Association and the American Congress of Obstetricians and Gynecologists 1.
From the FDA Drug Label
Estradiol tablets are a medicine that contains estrogen hormones. The FDA drug label does not answer the question.
From the Research
Definition of Bi-Est
Bi-Est, also known as Bi-estrogen, is a type of hormone replacement therapy that includes a combination of estriol and estradiol 2. This therapy is often used to alleviate menopausal symptoms in perimenopausal and postmenopausal women.
Components of Bi-Est
The Bi-Est regimen typically consists of 80% estriol and 20% estradiol, which are administered transdermally 2. This combination of estrogens is designed to mimic the natural hormonal balance found in premenopausal women.
Effects of Bi-Est on Menopausal Symptoms
Studies have shown that Bi-Est can effectively reduce menopausal symptoms such as hot flashes, night sweats, irritability, anxiety, and emotional lability 3, 2, 4. Additionally, Bi-Est has been found to improve mood symptoms and quality of life in postmenopausal women 3, 2.
Administration Routes
Bi-Est can be administered through various routes, including topical and sublingual preparations 4. The effectiveness of these different routes has been studied, with sublingual therapy appearing to be more effective in reducing symptoms than topical therapy 4.
Key Findings
- Bi-Est is a type of hormone replacement therapy that combines estriol and estradiol to alleviate menopausal symptoms 2.
- Bi-Est has been shown to reduce menopausal symptoms such as hot flashes, night sweats, and emotional lability 3, 2, 4.
- Sublingual Bi-Est therapy may be more effective than topical therapy in reducing symptoms 4.
- Bi-Est has been found to improve mood symptoms and quality of life in postmenopausal women 3, 2.
Studies on Bi-Est
Some studies have investigated the effects of Bi-Est on menopausal symptoms, including:
- A study published in 2011 found that compounded Bi-Est improved mood symptoms in postmenopausal women 3.
- A study published in 2013 found that Bi-Est reduced menopausal symptoms and improved quality of life in perimenopausal and postmenopausal women 2.
- A study published in 2014 found that sublingual Bi-Est was effective in reducing vasomotor, mood, and quality-of-life symptoms in postmenopausal women 4.