Compounded HRT · Transdermal
Estradiol Cream
A compounded transdermal estradiol cream, applied to the skin, used for provider-supervised relief of menopause symptoms.
- Transdermal, applied to the skin
- Estradiol, the main estrogen in HRT
- Provider-reviewed before prescribed
- 3-month supply
$269 total
About $90/mo · 3-month supply
Includes your provider consult and medication, shipped to you.
Provider-reviewed · Cancel anytime
Every plan includes
- Licensed provider review of your intake
- Compounded hormone therapy shipped from a licensed pharmacy when prescribed
- Unlimited messaging with your care team and provider
- Free shipping on every order
- Dose adjustments as your provider directs
What it is and how it works
Estradiol is the main form of estrogen your ovaries produce before menopause. As levels fall during perimenopause and menopause, symptoms like hot flashes, night sweats, sleep disruption, and mood changes can follow. Estradiol cream replaces some of that estrogen.
This is a transdermal cream, applied to the skin, so the estradiol is absorbed directly into the bloodstream and bypasses the first pass through the liver. Research suggests transdermal estrogen may carry a lower risk of blood clots than estrogen taken by mouth.
The cream is prepared by a licensed compounding pharmacy. A Josie provider reviews your health history and intake before any prescription is issued, and adjusts your dose over time based on how you respond.
Who it’s for
May be a fit if you
- Have hot flashes, night sweats, or other menopause symptoms
- Are in perimenopause or menopause and exploring hormone therapy
- Prefer a transdermal option over pills
- Want licensed provider oversight and ongoing support
Not appropriate if you
- Are pregnant, trying to conceive, or breastfeeding
- Have a history of breast cancer or another estrogen-dependent cancer
- Have had blood clots, stroke, or a heart attack, or have liver disease
- Have unexplained vaginal bleeding
If you have a uterus, estrogen is usually prescribed together with progesterone to protect the uterine lining. Eligibility is always determined by a licensed provider after reviewing your intake.
How to use it
- 1Your provider confirms your starting dose and where to apply the cream.
- 2Apply the measured amount to clean, dry skin as directed, usually once daily.
- 3Rotate application sites and let it absorb before covering with clothing.
- 4Wash your hands after applying, and message your care team with any questions or for adjustments.
Safety, risks & side effects
Estrogen therapy carries real risks. Review them with a licensed provider and read the full prescribing information before starting.
Boxed warning: Estrogen-alone therapy increases the risk of endometrial cancer in a woman who still has her uterus, which is why estrogen is usually combined with a progestogen in that case. Estrogens should not be used to prevent heart disease or dementia. Studies have reported increased risks of stroke, blood clots, and, in some women, breast cancer and probable dementia. Use the lowest effective dose for the shortest time consistent with your goals, as determined by your provider.
Common side effects
- Breast tenderness
- Headache
- Nausea
- Skin irritation at the application site
- Spotting or changes in bleeding
Serious risks
- Blood clots in the legs or lungs
- Stroke
- Endometrial cancer if estrogen is used without progesterone in women with a uterus
- Breast cancer
- Gallbladder disease
Do not use if you have
- Known, suspected, or history of breast cancer or estrogen-dependent cancer
- History of blood clots, stroke, or heart attack
- Unexplained vaginal bleeding
- Liver disease or pregnancy
How it compares
Frequently asked questions
What is estradiol cream?
Estradiol cream is a compounded transdermal form of estrogen, applied to the skin, used to relieve menopause symptoms such as hot flashes and night sweats under provider supervision.
Do I need progesterone with it?
If you still have a uterus, estrogen is usually prescribed together with progesterone to protect the uterine lining from the increased risk of endometrial cancer that estrogen alone can cause. If you have had a hysterectomy, estrogen alone may be appropriate. Your provider decides based on your history. Josie also offers a combined Progesterone + Estradiol Body Cream.
Why transdermal instead of a pill?
A cream absorbed through the skin bypasses the first pass through the liver. Research suggests transdermal estrogen may carry a lower risk of blood clots than oral estrogen. Your provider will help you weigh the options.
How soon will I notice a difference?
Responses vary. Some women notice fewer hot flashes and better sleep within a few weeks, while other benefits build over time. Your provider will set expectations and adjust your dose as needed.
How much does it cost, and is there a membership fee?
Estradiol Cream is provided as a 3-month plan. Your plan price includes the provider review, ongoing messaging, and shipping. There is no separate membership fee. Current pricing is shown above.
Is there a consultation fee?
There is no upfront fee to complete your intake. A $80 consultation fee applies only if a licensed provider approves your care plan and you then choose not to proceed with treatment.
Do I need an in-person appointment?
No. Josie is telehealth. You complete an online intake and a licensed provider reviews your health history and goals. If they have questions, your care team follows up by message, so there is no in-person visit required.
Which US states is Josie available in?
Josie is available in all 50 US states.
Is compounded HRT FDA approved?
No. Compounded medications are not FDA approved, and the FDA does not review them for safety, effectiveness, or quality before marketing. FDA-approved hormone therapies also exist. A licensed provider determines whether compounded hormone therapy is appropriate for you.
How do I start?
Complete the online intake. A licensed Josie provider reviews your history and, if appropriate, prescribes your plan, which is shipped from a licensed pharmacy.
Compounded hormone therapy is not FDA approved. The FDA does not review compounded medications for safety, effectiveness, or quality before marketing.
Medications are only issued when clinically appropriate after a provider evaluation. Josie does not manufacture compounded medications, and the actual product appearance may differ from website images.
What to Expect at Josie
- Complete your intake online, from anywhere
- Provider review by Josie's licensed clinicians, supervised by Dr. Ana Lisa Carr, MD
- Transparent program pricing
- Medication shipped from a licensed pharmacy or compounding pharmacy when prescribed