BiEst 80/20 (Bi-Estrogen) Cream and Troches
0.5 mg/g, 0.5 mg troche, 1.25 mg/g, 1 mg/g, 1 mg troche, 2.5 mg/g, 2.5 mg troche, 5 mg/g
Updated: 2026-04-01 · Albury Compounding Pharmacy
What is in this leaflet
This leaflet answers some common questions about BiEst 80/20 (Bi-Estrogen) Cream and Troches.
It does not contain all of the available information. It is not intended to replace the advice of your pharmacist or doctor.
Keep this leaflet with the medicine; you may need to read it again.
What bi-estrogen (estriol / estradiol 80:20) is used for
BiEst 80/20 is a compounded bioidentical hormone preparation containing two forms of estrogen: estriol (80%) and estradiol (20%).
It is used in women to:
- relieve symptoms of menopause such as hot flushes, night sweats, vaginal dryness, and mood changes
- support hormone replacement therapy (HRT) as an alternative to conventional estrogen products
- help maintain bone density in postmenopausal women
Your doctor or prescribing practitioner may prescribe BiEst 80/20 for another reason — if so, follow their advice.
BiEst 80/20 is the most commonly prescribed bi-estrogen ratio. It contains a higher proportion of estriol, which is considered a weaker estrogen, and may be preferred for women who need gentler estrogen support or who are more sensitive to estradiol.
Before you take bi-estrogen (estriol / estradiol 80:20)
When you must not use it
- Do not use BiEst 80/20 if you are allergic to estriol, estradiol, or any of the ingredients listed at the end of this leaflet.
- Do not use if you have or have had breast cancer or any estrogen-dependent cancer.
- Do not use if you have unexplained vaginal bleeding.
- Do not use if you have active deep vein thrombosis (DVT), pulmonary embolism, or a history of these conditions.
- Do not use if you have active or recent arterial thromboembolic disease (e.g. angina, heart attack, stroke).
- Do not use if you have known or suspected pregnancy.
- Do not use if you have active liver disease or liver function tests that have not returned to normal.
Before you start to use it
Tell your pharmacist or doctor if you:
- have a personal or family history of breast cancer
- have a history of endometrial hyperplasia
- have fibroids or endometriosis
- have high blood pressure
- have diabetes
- have migraines or severe headaches
- have a history of blood clots
- have liver or kidney disease
- have gallbladder disease
- have epilepsy
- have asthma
- have otosclerosis (hearing condition)
- are taking thyroid medication (estrogen can alter thyroid hormone requirements)
Taking other medicines
Tell your pharmacist if you are taking any other medicines, especially:
- anticoagulants such as warfarin (estrogen may alter their effect)
- thyroid hormones (estrogen may increase the need for thyroid replacement)
- antiepileptic medicines such as carbamazepine, phenytoin, or phenobarbital (may reduce estrogen levels)
- rifampicin or St John's Wort (may reduce estrogen levels)
- corticosteroids (estrogen may increase their effect)
- progesterone or progestogens (often prescribed together with estrogen — follow your doctor's advice)
- other hormone therapies including DHEA or testosterone
These medicines may interact with BiEst 80/20.
How to take bi-estrogen (estriol / estradiol 80:20)
How much to use
Follow the label or the instructions provided by your prescribing practitioner and pharmacist. Dosage is individualised based on your symptoms and hormone levels.
A typical starting dose is 0.5 mg to 2.5 mg of total bi-estrogen applied once or twice daily, but your practitioner may adjust this.
How to use it
Cream: Apply the prescribed amount to a thin-skinned area such as the inner wrist, inner arm, or behind the knees. Rotate application sites daily. Rub in gently until absorbed. Wash hands after application.
Troches (sublingual): Place the troche under your tongue and allow it to dissolve completely over 15–30 minutes. Do not chew, swallow whole, or eat/drink while the troche is dissolving.
When to use it
Use BiEst 80/20 at the same time each day, as prescribed.
Most women apply the cream or take the troche in the morning, but follow your practitioner's specific directions.
How long to use it
Continue using BiEst 80/20 for as long as your doctor recommends. Hormone therapy is usually reviewed at least every 6–12 months.
Do not stop suddenly without discussing with your prescribing practitioner.
If you forget a dose
If you forget to use BiEst 80/20 and it is within a few hours of your usual time, apply or take it as soon as you remember.
If it is close to your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
If you use too much (overdose)
Immediately telephone your doctor, the Poisons Information Centre (13 11 26 in Australia), or go to Accident & Emergency if you think you or anyone else may have used too much BiEst 80/20. Symptoms of overdose may include nausea, vomiting, breast tenderness, or vaginal bleeding.
While you are taking bi-estrogen (estriol / estradiol 80:20)
Things you must do
- Attend all follow-up appointments with your doctor. Regular monitoring of symptoms and hormone levels is important.
- Have regular breast examinations and mammograms as recommended by your doctor.
- Tell any healthcare professional that you are using BiEst 80/20.
- Report any unusual vaginal bleeding to your doctor promptly.
- If you are prescribed a progestogen alongside BiEst 80/20, take it as directed to protect the uterine lining.
Things you must not do
- Do not exceed the prescribed dose.
- Do not apply cream to broken, irritated, or sunburned skin.
- Do not allow others, especially children or men, to come into contact with the application site before the cream has fully absorbed.
- Do not share your medication with anyone else.
Things to be careful of
- Estrogen therapy may increase the risk of blood clots, particularly in women with other risk factors. Stay active and avoid prolonged immobility.
- Report any signs of blood clots immediately: unusual leg pain or swelling, sudden chest pain, sudden breathlessness, or sudden severe headache.
- BiEst 80/20 may cause fluid retention, which could worsen asthma, epilepsy, migraines, or heart/kidney conditions.
Possible side effects
| Common |
Less common / rare |
| Breast tenderness or swelling |
Blood clots (DVT, pulmonary embolism) |
| Headache |
Changes in liver function |
| Nausea |
Gallbladder disease |
| Bloating or fluid retention |
Elevated blood pressure |
| Spotting or breakthrough bleeding |
Allergic skin reaction at application site |
| Mood changes |
Changes in blood sugar levels |
| Skin irritation at application site (cream) |
Endometrial hyperplasia (if progestogen not used) |
Most side effects are mild and may improve as your body adjusts to the therapy.
Seek medical advice immediately if you experience:
- sudden severe headache or migraine
- sudden changes in vision or speech
- pain, swelling, or redness in the leg
- chest pain or sudden shortness of breath
- signs of an allergic reaction: rash, itching, swelling of the face/throat, difficulty breathing
Stop using BiEst 80/20 and contact your doctor if side effects are persistent or concerning.
Storage and disposal
- Store cream at room temperature (below 25 C) or in the fridge as directed. Keep the tube or jar tightly closed.
- Store troches in the fridge (2-8 C) unless otherwise directed on the label.
- Protect from direct sunlight and moisture.
- Keep out of reach of children and pets.
- Do not use after the expiry date printed on the label.
- Return any unused medicine to your pharmacist for safe disposal.
Product description
What it looks like
- Cream: white to off-white cream supplied in a tube or pump with a measured dispensing system.
- Troches: small, flavoured sublingual troches.
Ingredients
- Active ingredients: estriol and estradiol in an 80:20 ratio. Total bi-estrogen strength varies per prescription (e.g. 0.5 mg, 1 mg, 1.25 mg, 2.5 mg, 5 mg per dose).
- Inactive ingredients (cream): VersaPro Cream base or similar pharmaceutical cream base.
- Inactive ingredients (troches): SyrSpend SF base, sweetener, flavouring.
Sponsor / Further information
Prepared by Albury Compounding Pharmacy
Suite 1.5, 470 Wodonga Pl,
Albury NSW 2640
Phone (02) 6023 3666
compounding@awardpharmacies.com
This leaflet was updated on 1 April 2026.
This CMI is provided for information only and is not a substitute for professional medical advice.