Estradiol Cream Vs. Oestra, by Inner Balance
- Peggy B. - Experienced HRT Patient Reviewer
- 21 hours ago
- 5 min read
The current common FDA approved standard of care to treat menopause symptoms is a combination of three hormone products. This isn't always what's prescribed, but it's a lot of what I see based on my experience.
A systemic Estradiol product that treats the whole body (could be a patch, pill or topical cream/gel)
A vaginal Estradiol product to treat vaginal dryness and vaginal atrophy
A Progesterone product/pill (needed if you still have a uterus) helps with sleep, balances estrogen, supports brain health
This combo when prescribed by a licensed clinician can be picked up at your local pharmacy and will likely be covered by your prescription insurance.
Estrogen Vs. Estradiol
The three main types of estrogen are Estradiol (E2), the most potent and abundant during reproductive years; Estrone (E1), dominant after menopause, made from adrenal and fat tissue; and Estriol (E3), the primary estrogen during pregnancy, produced by the placenta, and weaker than estradiol but important for fetal development. A fourth type, Estetrol (E4), is also produced during pregnancy.
Estradiol is just one of the four forms of estrogen and predominantly the one that is prescribed for menopause hormone replacement therapy.
Estradiol (E2)
Main role: Most potent estrogen, crucial for female reproductive health, bone health, and secondary sex characteristics.
Produced by: Ovaries (primarily), adrenal glands, fat, brain.
When it's dominant: During the reproductive years (from menarche to menopause).
Estrone (E1)
Main role: Weaker than estradiol; becomes the main estrogen after menopause, contributing to health in postmenopausal women.
Produced by: Adrenal glands and adipose (fat) tissue from androgens.
When it's dominant: After menopause.
Estriol (E3)
Main role: Weakest estrogen but vital for pregnancy, supporting fetal growth and development.
Produced by: The placenta in large amounts during pregnancy.
When it's dominant: During pregnancy.
Estetrol (E4)
Main role: Another estrogen produced exclusively during pregnancy.
Estradiol Level in Women Menopause
Many Hormone Replacement Therapy clinicians practice evidence based medicine care. This means they prescribe what's typically the "standard of care" based on your symptoms. Then based on how you feel going forward, that will determine if they need to tweak your dose or formulation.
Some HRT specialists will insist that you have your estrogen levels tested, but keep in mind those levels vary throughout the day and even an hour. An estrogen level or number is a just a snapshot in time of your levels. You could take another test an hour later and the levels could be completely different.
I' m not saying don't get bloodwork, just know that it could vary and it's not the end-all of where you are or what should be prescribed to you by a licensed clinician.
In post-menopause, estradiol levels typically fall very low, often below 10-30 pg/mL, while during perimenopause, levels become highly erratic, swinging wildly from high to low (like premenopausal ranges) before settling down, making a single "average" difficult, though studies show medians around 3-4 pg/mL but with huge variation, often <10 pg/mL to 40 pg/mL or more depending on the specific time.
Estradiol Vaginal Cream Vs. Topical Estadiol Cream
The difference between a vaginal estradiol cream and a topical cream is what it's meant to treat. Estradiol Vaginal cream is typically a very low dose of estradiol and only enters and impacts the vagina. Topical creams are meant to be rubbed on your inner thighs or arms and are meant to be systemic (whole body).
However, in speaking with lots of woman and even including my personal experience, topical creams don't always absorb as needed and women don't get the desired whole body results or the menopause relief they are looking for.
Many then begin to experiment with other estradiol formulations. My current regimen and favorite way to get my estradiol is from Oestra by Inner Balance. It's delivered vaginally which according to Dr. Sarah Daccaratt, the founder and CEO of Inner Balance is a more encompassing way to get our hormones. She says it mimics how our bodies made and delivered hormones in our 20's.
Estradiol Patch Cost
The Estradiol Patch also known as the Estrogen Patch is by far, one of the most popular formulations for HRT to be prescribed. For women who don't get the desired results from topical creams they will gravitate to the patch or if you are like me, you might look for something "new and improved" to ensure you are getting the best of what science has to offer.
The Estradiol Patch is more expensive than topical creams, but they are also in many cases more effective and provide a more systemic (whole body) dose of estradiol.
The last time I picked up my Estradiol patch prescription, a 90-day supply was $32. I also paid another $60 for the Progesterone Pills and Estradiol Vaginal Cream, so $90ish for all three products for a 90-day supply.
How much Estradiol in Oestra by Inner Balance
Oestra by Inner Balance because of its vaginal delivery method means it doesn't need to be as "strong" as a patch or cream when it comes to its chemical make-up. In order for your skin to absorb the estradiol from a cream or patch, it has to be a stronger dose, with only some of the estradiol actually getting into your blood stream and system.
However, with Oestra each pump contains 3 mg of Estradiol and 100 mg of Progesterone. Yes, you lose a bit in measuring it out and in administration. Dr. Sarah Daccaratt has taken that into account when she designed the pump jars for Oestra and tested how much of the cream needed to be disbursed to ensure we get our full dose of 3 mg of Estradiol and 100 mg of Progesterone with each pump. Also, it means you only need one product as Oestra replaces all three prescriptions that most HRT clinicians prescribe.
Oestra is $199 per month for the first six months. Starting with month seven, the cost decreases to $99 per month and stays there forever. Even if your dose is increased from one pump to two pumps, and you need double the product, the price doesn't increase.
Estradiol Cream Vs. Oestra, Inner Balance
I felt equally good on the Estradiol patch as I do on the Oestra Cream by Inner Balance. However, I do get better sleep with Oestra than I got with the patch. The patch is covered by prescription insurance whereas Oestra by Inner Balance is not.
Only you can weigh out which might be the best option for you. I'm always the one who wants to try the "new" thing so when I discovered Oestra by Inner Balance and read Dr. Sarah's notes on it's effects on menopause symptoms, specifically sleep, I had to try it. Today, I'm a believer.
Check out MyMenopauseRX if you want to try the patch and use your insurance. But, if you are like me and want the 'newest and greatest' HRT on the market, then I'd give Oestra a try. They offer a six-month guarantee if you are not convinced after six months that it is working for you.
Be sure to see the Trusted Providers Page to see the seven online HRT providers that I've tried and tested. I have full blogs and price sheets on my website.
