Bi-est and progesterone cream

ZoieDecember 16, 2001

Taking Bi-est (1.25) twice a day for 2 months now. I have been taking 1 am and 1 pm. Also using progesterone cream pm. Feeling great. Hot flashes and vaginal dryness all gone. Also no bleeding. No period for exactly one year. My question is this, my dr. suggests taking the Bi-est this way, but the compounding pharmacy said that taking it all together once a day would give me the same effect and would be cheaper to make. Blue Cross will not cover the cost unless progesterone is added to it. Anyone taking this, take this once a day instead of twice? Anyone using Bi-est with progesterone in it rather than using the cream? Dr. say cream works better, but pharmacy says not so. It would be nice to know for sure and have my insurance cover it. I pay enough for the coverage. I am experimenting by taking both tonight instead of any this morning, but would love feedback on other's opinions. Thanks.

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Is the progesterone cream you are using prescription or otc? If it is otc you should know that you are running a grave risk of endometrial cancer in using estrogen without a proper progestin to protect your uterus.

    Bookmark   December 17, 2001 at 9:21AM
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I bought it from my doctor. Not prescription. Says like having it added to my bi-est would be a very good idea.

    Bookmark   December 19, 2001 at 7:46PM
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I'm an Australian based in France and having had two unsuccessful goes at using HRT (unpleasant side effects esp weight gain/bloating) I have been reading up on the Net and decided that Bi-est and progesterone cream was the answer. So I was interested to read your comments. Now I have to find a doctor in Paris who knows about Bi-estrogen - I asked my GP today and he looked blank, so will have to make an appointment with a gynae after Xmas. I am interested in trying a progesterone cream called Crinone 4% (8% is used in infertility treatments). There's a lot about it on the Net, but I'm not sure it's available yet in France - asked a pharmacist here today and he hadn't heard of it. A good explanation can be found at
I am interested in hearing from anyone who has tried this product for menopause especially combined with Bi-est and whether you used it on a continuous of cyclical basis.

    Bookmark   December 24, 2001 at 11:01AM
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zoie, you can try taking your bi-est dose all at once to see what effect it has, but you may need that split dose for a more even estrogen effect. I would recommend you give that a try before deciding to add progesterone to a once a day dose. If you find you need the twice a day estrogen, you could try using the progesterone split into twice a day doses also. The only reason to use progesterone only at night is because it may make a woman sleepy. If it does not have that side effect on you, go ahead at split your dose and take it twice a day. It is normal to have to experiment with dose amounts, times, and methods of delivery to see what works best for you. Some women do not absorb well topically, others have no problem there but do not absorb well from the gut. Your bi-est can also be mixed into a topical cream, combined with progesterone or not. I use a progesterone gel and a separate Estriol cream for topical application. I am extremely happy with this regimen, but it took me a while and several trials to find it. One of the reasons I like the topical route is because I can vary the dose easily when I feel I need a bit more or less of either hormone - just add or delete a fraction of a ml. of the cream. It is definitely worth trying to accomodate a regimen that your insurance will pay for, but if their particular theory does not fit you, fight to get them to pay for what will work for you. If you can show that you tried several ways of using the hormones and you feel best with separate doses, get your doctor to back you up and get them to make an exception for you.

to oztrade in France: The progesterone gel I use is similar to the Crinone, but is made up by my compounding pharmacist. Since I am post-meno I use it pretty much continuously. I take a break for 3 to 5 days every 4 to 6 weeks - it depends on how I feel each month. I use my Estriol cream every other day for the most part. If my hot flashes are worse, I take it every day; if they are not bothering me, I may skip the dose for a few days. If I have vaginal irritation/dryness, I apply the dose vaginally a couple of times a week.

    Bookmark   December 27, 2001 at 1:36PM
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I agree that some can take their hormones once a day (and there are some good-sounding reasons for that) while others have to take them more frequently. It seems, as with so much else menopausal, to be an individual thing. Trying it out won't hurt, and you can always go back to where you are now.

The main things to consider in the combined-dose scheme are:
1. lack of adjustability of doses individually
2. progesterone taken orally rather than transdermally seems to produce more of the sedating metabolites, which could be more noticeable in a twice-a-day scheme

And you might just check out whether a gel would have the same restrictions as a cream, in terms of your insurance. They have have cream down as non-reimbursable because it's also available otc, whereas the gel may not have that black mark against it.

    Bookmark   December 27, 2001 at 2:34PM
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Framboise, a prescription progesterone cream is not covered under most insurances? Can you provide a source for your information? Perhaps this is the case only in the case of *some* compounding pharmacies which see their far more lucrative otc market disappearing if the patient can get an effective cheaper drug by prescription.

Anne, Crinone is intended strictly for intravaginal administration. It is intended to be used in the treatment of infertility and/or secondary ammenorhea.

I reiterate my original warning to the original poster regarding her risk of endometrial cancer with her use of biest without a proper progestin/progesterone component. Doctors who sell the drugs that they prescibe are acting in violation of the AMA Code of Ethics. They have an obvious conflict of interest. Who makes the cream your doctor sells you?

    Bookmark   December 28, 2001 at 8:38AM
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No Leigh, there is no tabularization to which I can point you on this. I am simply passing along the fact that over the several years I've been following the whole hormone market, I have read accounts by quite a number of women who have had their insurance carriers refuse to cover progesterone cream specifically. It's also not uncommon to have to tussle over covering compounded hormone preparations of all kinds. I have no idea--can have no idea--at what level that "decision" is made, and, as I'm sure you're aware, much in the claims turn-down realm seems rather whimsical at first pass. Those who persevere with physician's letters and work their way up the insurance company structure sometimes meet with success, sometimes end up having to turn to another form of the hormone in order to have it covered. Given the vagaries of finding a suitable hormone regimen in the first place, it is especially galling to find the use of that regimen countermanded by regulations formulated to ease administration rather than policy-holder satisfaction, but such is the meeting ground between for-profit insurance companies and medical need.

    Bookmark   December 29, 2001 at 12:33AM
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The compounding pharmacies aren't making profits? They work to meet "medical need?" If an insurance company refuses to pay for a prescription progesterone cream *on the grounds that it is available otc,* to be consistent said insurance company would also have to refuse to pay for prescription strength ibuprofen or naproxyn, or any of the acid inhibitors (pepcid, zantac, tagamet etc) under the same rule. I don't know of anyone who has been refused these drugs under a prescription drug plan.

It may be difficult to get "compounded hormone preparations" covered under some or even most drug plans, but that has nothing to do with otc availability. The difficulty stems from the fact that these drugs have no medical studies to back up their use. Drug insurance generally doesn't cover drugs that have not been specifically FDA approved. They don't cover so-called "alternative drugs" because such drugs have not been tested for either safety or efficacy.

    Bookmark   December 29, 2001 at 8:48AM
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Dear Leigh
I have read up on Crinone on the Net and gather that there are two strengths - 4% for menopause and 8% for infertility. It's a gel to use only vaginally. I am interested in finding someone who has tried it.

    Bookmark   January 10, 2002 at 4:45AM
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Have switched to taking Bi-est with progesterone together in one pill 2x a day. A.M with smaller amount of progesterone and larger amount at night. Is working great and insurance company paid for it. They would not pay unless the progesterone was combined with the bi-est. Both are combined with oil. No problems which others seem to be having with other HRTs. I see no differnce using the progesterone in the pill vs. using the cream.

    Bookmark   January 15, 2002 at 6:40PM
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What is Bi-est exactly. Thank you. Les

    Bookmark   January 16, 2002 at 10:54AM
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It is a bio-identical estrogen consisting of Estriol and Estradiol. I take 2 doses of 1.25mg (1mg estriol and .25 estradiol)

    Bookmark   January 16, 2002 at 8:24PM
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My doctor has prescribed Biest cream and progesterone cream. Does anyone have suggestions for an online pharmacy that has these?

    Bookmark   August 4, 2008 at 1:03AM
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i still have regular period. hormone tests show Estradiol 64 ( range 60-150 pg/ml); progesterone 9.3 (range 2-25 ng/ml), total testosterone 1.6 ( range 0.3-4.2 nmol/L).... all within range yet Doctor recommended 0.8ml of 2mg bi-est, together with 1.5cm Progesterone BP 10%w/w Cream, and Supreme Energy topical cream. Do I really need all these creams?

anyone can advise? i don't have any pre-menopausal symptom...just PMS...

    Bookmark   October 7, 2008 at 6:21AM
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I was on Triest HRT for a long while due to a total hysterectomy. I was doing well. In Feb. I had a DVT in my leg and the doctor did not want me to continue the HRT. I felt horrible when I stopped it. My compounding pharmacist recommended the Bi-est progesterone cream to my doctor and they settled on .5 mg. Biest and 20 mg. progesterone. I was on 1.25 triest. I just wondered if the .5 is enough and how can I be sure I am getting all the medicine as you have to rub it into your leg or arm.

    Bookmark   August 29, 2010 at 12:38PM
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Hi i have been on Biest5 prog30 had a hysterectomy when i was very young I just started on the cream for the first time got off the others when the controversy about hormones came out ...any experiencing weight gain /

    Bookmark   March 20, 2011 at 3:59PM
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im 45 and no longer gettin my periods been tested the doc says im goin through early menapause ive been on progestrone cream now for 1month now its helpin me sleep and more carm, he also started me on biest cream now its been 1 wks i get so bad with hot flushes durin the day at work im hopin it will change now im using the cream ive put on weight my breast have got bigger pls i wont to loose weight not gain

    Bookmark   April 8, 2011 at 7:55PM
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About a 1 1/2 months ago my doctor increased my bi-est cream to 2.4 (2 clicks in the am and 2 clicks in the pm), progesterone pills (200 mg) 1 at night remained the same. I was also taking DHEA 10 mgs in the am. My DHEA level was extreemly high. All other levels were within normal range. My hair started thining, weight gain in the stomach/hips and internal itching from scalp to legs. Took a saliva test and doctor took me off the DHEA. Hair still looks thin, itching has continued and the weight has not come off. (side note - I exercise 4 to 5 times per week). Went to see a dermatologist. He said hair loss has stopped even though my hair still looks thin and he gave me pills for the itching. I believe the hair loss/thinning, weight gain and most of all the itching is due to the bi-est. I have only had one ovary removed. Can you shed some light as my doctor is not listening to me.

    Bookmark   May 18, 2011 at 6:08PM
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I have been on biest 2.5 mg/ml Prog 6% Testosterone .25% for a few months. Great relief from all menopausal symptoms (terrible hot flashes. dryness. loss of libido, unable to sleep, hip pain etc) Have wondered if this can cause wt gain but feeling so much better and getting back to the gym very regularly and so its been worth it. I have also been quite sure that having itchy hands and feet has coincided with using the cream even though I never get it on my hands. I have to say for the most part I feel 10 years younger - but just saw a show on synthetic chemicals and obesogens - that have the ability to contribute to wt gain - so eat clean girls and make your way to the gym!!

    Bookmark   January 12, 2012 at 9:24PM
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I have been on progesterone for quite a while now. I take that at night. Yesterday I started taking DHEA and a Biest. I didn't feel well, so today I just took the Biest. I feel a bit dizzy, nauseated, I have a headache, and I feel weird in my head, foggy feeling. Will these symptoms go away with time ??
My progesterone is 300mg. Biest is .5E2/.25E3. The DHEA that I didn't take today is 5mg.

    Bookmark   June 9, 2013 at 1:55PM
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