Biest is a compounded form of bioidentical hormone therapy (BHT) that combines two types of estrogen: estradiol (E2) and estriol (E3). Both of these estrogens are naturally produced by the human body and provide different benefits. Estradiol is the most potent form of estrogen and has a stronger effect on tissues like bones, brain, and reproductive organs. Estriol, on the other hand, is a weaker estrogen but may provide protective effects, especially for vaginal and urinary health. Additionally, estriol has been shown to promote better skin hydration and reduce inflammation [6].
What is a Bioidentical Hormone?
Bioidentical hormones are chemically identical to the hormones naturally produced by the human body. In hormone replacement therapy (HRT), bioidentical hormones are used to restore hormonal balance, particularly in menopausal women or individuals with hormonal imbalances.
What are the Advantages of Biest Over Other Types of Hormone Replacement Therapy?
Compared to synthetic hormones, bioidentical hormones are preferred by some patients because they closely mimic the body’s natural hormones, and they may be better tolerated by certain individuals [2]. For some patients, bioidentical hormones may be better tolerated than synthetic alternatives, and they may provide more predictable results since they fit more precisely into the body’s hormone receptors.
What Symptoms are Biest Used For?
Biest is commonly used to alleviate symptoms associated with menopause and perimenopause [1]:
- Hot flashes and night sweats
- Vaginal dryness or atrophy
- Mood swings or depression
- Low libido
- Bone loss (osteoporosis)
- Sleep disturbances
By supplementing declining estrogen levels, Biest may help mitigate these symptoms and improve comfort for individuals experiencing hormonal changes.
What are the Different Administration Forms Biest Comes In?
Biest is made in several forms, including:
- Topical creams or gels
- Oral pills or capsules
- Troches or lozenges, which dissolve in the mouth for gradual absorption
- Injections, administered for controlled dosing
Biest is most commonly compounded in two primary ratios:
- 20:80 (20% estradiol, 80% estriol): 20:80 balances the stronger effects of estradiol with the gentler, more protective effects of estriol.
- 50:50 (50% estradiol, 50% estriol): This is one of the most common ratios. This is a higher concentration of estradiol, used for individuals who may need stronger estrogenic effects to deal with heavier menopausal symptoms.
However, custom ratios can be made depending on individual needs, and sometimes formulations like 10:90 (10% estradiol, 90% estriol,) are used for patients who benefit from more estriol, a gentler compound.
These various forms allow for flexibility in treatment, with different options tailored to the patient’s needs and preferences. Consult with your compounding pharmacy to see which form is available through them and right for you.
Why are There Different Ratios of Biest for People?
The ratio of Biest prescribed depends on the individual’s unique hormone levels, symptoms, and how they respond to estrogen therapy. Factors like age, severity of menopausal symptoms, health history, and specific concerns (such as bone health or vaginal health) influence the optimal ratio for each person. The ratio needed depends on where you are in life.
For example why a different Biest ratio is needed, a patient primarily seeking relief from hot flashes and bone loss may benefit from a higher estradiol content, while someone more focused on vaginal health may need a higher estriol content.
Precautions When Using Hormone Replacement Therapy:
During bioidentical hormone replacement therapy (BHRT), probiotics like Key Biotic may improve estrogen breakdown, as they support gut health and help ensure proper estrogen metabolism and elimination (removal from the body) [4]. Additionally, supplementing with a B complex vitamin is essential, as estrogens can deplete B vitamins, which are crucial for energy production, mood regulation, and supporting overall hormonal balance [3].
Conclusion
Biest, a bioidentical hormone therapy combining estradiol and estriol, provides a personalized approach to treating menopausal and hormone-related symptoms. By mimicking the body's natural hormones, Biest can reduce side effects and enhance the effectiveness of hormone replacement therapy. Different ratios are tailored to the specific needs of each individual, offering flexibility in treatment based on symptoms and health goals.
If you’re interested in learning more about Biest and if bioidentical hormone therapy is right for you, schedule a hormone consultation with us today.
References
- Cleveland Clinic. (2021, June 28). Hormone therapy for menopause: Types, benefits & risks. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms
- Holtorf K. (2009). The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?. Postgraduate medicine, 121(1), 73–85. https://doi.org/10.3810/pgm.2009.01.1949
- Kim, K., Mills, J. L., Michels, K. A., Chaljub, E. N., Wactawski-Wende, J., Plowden, T. C., & Mumford, S. L. (2020). Dietary Intakes of Vitamin B-2 (Riboflavin), Vitamin B-6, and Vitamin B-12 and Ovarian Cycle Function among Premenopausal Women. Journal of the Academy of Nutrition and Dietetics, 120(5), 885–892. https://doi.org/10.1016/j.jand.2019.10.013
- Stevenson, S., & Thornton, J. (2007). Effect of estrogens on skin aging and the potential role of SERMs. Clinical interventions in aging, 2(3), 283–297. https://doi.org/10.2147/cia.s798
- Thomas, B. (2022, October 5). Common Menopause Symptoms. [Infographic]. HotTea Mama. https://www.hotteamama.com/blogs/news/48-symptoms-of-menopause
- Zou, S., Yang, X., Li, N., Wang, H., Gui, J., & Li, J. (2023). Association of probiotic ingestion with serum sex steroid hormones among pre and postmenopausal women from the NHANES, 2013-2016. PloS one, 18(11), e0294436. https://doi.org/10.1371/journal.pone.0294436
