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Compounded · Menopause & HRT

Biest 50:50

A blended estrogen preparation — estradiol and estriol, combined 50:50, compounded for you.

Biest 50:50 is a compounded blend of two estrogens: estradiol (E2) and estriol (E3), mixed in equal parts. It's used for the same menopause symptoms many women treat with estrogen therapy — hot flashes, night sweats, and the sleep loss that comes with them. It's available with or without progesterone, so your clinician can match the formula to your body.

  • A 50:50 blend of two estrogens — estradiol (E2) and estriol (E3)
  • Available with or without progesterone
  • Compounded by a state-licensed U.S. pharmacy
  • Includes clinician oversight, dose adjustment, and support
  • Direct-to-door · monthly plan · cancel anytime before your next ship date
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Your care
Clinician-ledCare
State-LicensedCompounding Pharmacies
HIPAACompliant
Available inAll 50 US states

How it works

Simple online care, built around you.

Start your assessment

3-minute screener · No commitment

1
Complete your intake
Tell us about your health history, goals, symptoms, and what's changed. This takes less than 3 minutes.
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2
Get provider review
A licensed U.S. provider reviews your information and determines whether treatment is appropriate — typically within 24 hours.
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3
Start your plan
If eligible, your plan may include a personalized compounded hormone regimen with pharmacy coordination, ongoing oversight, and direct-to-door delivery.

Our physician partner

Medical oversight by Arora Health

Your care is reviewed and overseen by board-certified, U.S.-licensed physicians at Arora Health & Aesthetics — our independent medical partner, with clinician coverage in all 50 states.

Dr. Sean Arora, Co-Founder and CEO of Arora Health & Aesthetics

Dr. Sean Arora

Arora Co-Founder & CEO

  • Board-certified physician
  • Licensed in all 50 states

Dr. Sean Arora is a board-certified physician and the founder of Arora Health & Aesthetics, bringing deep expertise in wellness, family medicine, and telehealth innovation.

He leads one of the nation's most comprehensive medical oversight and compliance networks, supporting clinics through full-spectrum medical directorship, nationwide telehealth provider coverage, and evidence-based protocol development across peptides, hormone optimization, weight loss, regenerative medicine, and aesthetic treatments.

Known for his forward-thinking approach to patient safety and scalable clinical operations, Dr. Arora partners closely with medical spas, wellness clinics, and telehealth organizations to ensure responsible, compliant, and impactful care. Licensed in all 50 states, he is dedicated to expanding access to high-quality wellness services through innovation, leadership, and patient-centered standards.

Dr. Shannon Arora, Chief Medical Officer of Arora Health & Aesthetics

Dr. Shannon Arora

Chief Medical Officer

  • Hospital-trained physician
  • Preventive & longevity medicine

Dr. Shannon Arora is a physician dedicated to making a meaningful impact on patient health through both traditional medicine and proactive wellness care.

With experience as a hospitalist, she brings a strong clinical foundation shaped by work in hospitals and nursing homes, offering a broad perspective on patient care across diverse settings. While her early career focused on acute care, Dr. Arora recognized an opportunity to create a more proactive, personalized approach within the health, wellness, and longevity space. She now focuses on optimizing patient health through advanced wellness therapies, preventative medicine, and longevity-focused care, helping patients improve energy, confidence, and overall quality of life.

As Chief Medical Officer, Dr. Arora is passionate about advancing innovation in regenerative medicine and wellness, while helping both patients and organizations achieve better outcomes through thoughtful, patient-centered care.

Why biest

Two estrogens, blended for you.

Woman in midlife at home, relaxed

Biest is a blend of two estrogens your body makes: estradiol (E2), the most potent, and estriol (E3), a weaker estrogen. Combining them in a single preparation — here, a 50:50 ratio — is something a compounding pharmacy can prepare to a clinician's specification.

Compounding exists so a clinician can tailor the blend and dose when an approved single-estrogen product doesn't fit a particular person. To be clear: compounded biest is not FDA-approved, and it is not proven to be safer or more effective than approved estrogen products. It is used when a personalized preparation is needed, not as an upgrade over standard therapy.

Many women use biest for the same menopause symptoms as other estrogen therapy — hot flashes, night sweats, and disrupted sleep. We don't promise a specific result; your clinician monitors how you respond and adjusts, and will discuss approved alternatives with you.

Using it

A formula matched to you. Tuned over time.

1
Starting out
Your clinician chooses the form, the estrogen blend, and a starting dose based on your symptoms and history — and whether the formula with progesterone is right for you. You'll get clear directions for how and when to use it.
2
Finding your dose
Hormone therapy is dosed to the lowest amount that controls your symptoms. Apply or take biest exactly as directed, and your clinician may adjust the dose based on how you're feeling and tolerating it. Changes are gradual, not overnight.
3
Ongoing · Care, not just refills
Your plan includes clinician check-ins, dose adjustment, and side-effect support. Progesterone is built into the "with progesterone" formula — and if you have a uterus and are taking estrogen alone, your clinician will address endometrial protection.

Side effects & safety

What to know before you start.

Woman reviewing health information at home

Most common: breast tenderness, headache, nausea, bloating, or spotting, especially in the first weeks. These are often dose-related and tend to settle as your clinician fine-tunes your dose.

Worth flagging: estrogen therapy can affect the risk of blood clots, stroke, and gallbladder disease, and — for women with a uterus who take estrogen without progesterone — the risk of endometrial cancer. That's exactly why the "with progesterone" formula exists. If you have a uterus and take biest without progesterone, your clinician will address endometrial protection. Compounded biest is not FDA-approved.

Not appropriate if: you have a history of certain hormone-sensitive cancers, unexplained vaginal bleeding, active liver disease, or a history of blood clots or stroke, among other conditions. Tell your clinician about all medications and your full health history.

Questions

Answers to
common questions.

What is biest — what's in it?
A 50:50 blend of two estrogens: estradiol and estriol.
Biest 50:50 is a compounded preparation that combines two estrogens your body makes: estradiol (E2), the most potent, and estriol (E3), a weaker estrogen, in a 50:50 ratio. It's prepared by a state-licensed compounding pharmacy to a clinician's specification, and is available with or without progesterone.
Should I choose the version with progesterone?
If you have a uterus, you generally need progesterone.
Estrogen on its own can thicken the uterine lining over time. If you still have a uterus and are taking estrogen, you generally need progesterone to protect it — which is what the "with progesterone" formula provides. If you've had a hysterectomy, it's often not needed. Your clinician makes this call based on your history.
Is compounded biest safer than regular HRT?
No — it's not FDA-approved and not proven safer.
No. Compounded biest is not FDA-approved, and it is not proven to be safer or more effective than approved estrogen products. It can be useful when an approved product doesn't fit a particular person and a personalized preparation is needed. Your clinician will discuss approved alternatives so you can make an informed choice.
When am I charged?
Not until a clinician confirms your eligibility.
You're not charged when you submit. Your card is saved. A licensed clinician reviews your assessment, typically within 24 hours. If approved, you'll be notified by email before the first charge. If not approved, you're not charged.
Can I cancel?
Yes — anytime before your next ship date.
Yes. Biest is offered on a monthly plan, and you can cancel anytime before your next ship date — no long-term commitment.
Can I use my FSA/HSA?
Yes — itemized receipts provided for self-submission.
Yes. HSA and FSA cards are accepted on any plan. We also provide itemized receipts in case you need to self-submit to your benefits provider.

Find out if biest fits your picture.

The symptom-led assessment is free. If you're a candidate, your clinician typically follows up within 24 hours.

Start my assessment
Start my assessment