For prescribers & women’s health clinics
Demand for estradiol patches has risen sharply since the menopausal hormone therapy label changes, and many patients are having trouble filling them. HHS says it is now working with manufacturers, physicians and pharmacy leaders on access, and on helping physicians understand other options and how to prescribe them. Here is how compounded estradiol works with us: what we prepare, what the prescription needs, and how it reaches your patient.
PCAB accredited · Licensed in all 50 states + DC
What’s driving demand
A short summary of what has changed since late 2025, drawn from public announcements.
On November 10, 2025, HHS announced that boxed warnings about cardiovascular disease, breast cancer and probable dementia would come off menopausal hormone therapy labeling. The boxed warning for endometrial cancer stays on systemic estrogen-alone products.
More women started talking with their prescribers about hormone therapy, and many patients are now having trouble filling their usual estradiol patch. Patches remain available, but a particular brand or strength can be hard to find from one pharmacy to the next.
In September 2026, HHS Secretary Robert F. Kennedy Jr. met with manufacturers, distributors, physicians and pharmacy leaders. HHS said the aim is more reliable access to estradiol patches, and helping physicians understand other viable options and how to prescribe them.
What we prepare
Every preparation is compounded for a named patient, in the strength and base you write, at our PCAB-accredited pharmacy in Johnson City, Tennessee.
Estradiol on its own, as a hypoallergenic cream or in an olive oil base topical, at the strength you write.
Estradiol and estriol together, in the ratio and strength you specify. No manufactured Bi-Est product exists, so it is made to your order.
Estriol as a topical or vaginal preparation. No manufactured estriol product is sold in the United States.
Estriol vaginal creams, including estriol with DHEA, and a hyaluronic acid vaginal base, when local therapy is what you prescribe.
Oral progesterone capsules, or progesterone as a hypoallergenic cream or olive oil base topical, when your regimen includes it.
Hypoallergenic bases, and preparations without the ingredients a patient needs to avoid. A pharmacist reviews every formulation before it is made.
For your patients: estradiol patch alternatives · bioidentical hormone therapy · suggested labs for hormone health · what a 503A pharmacy is
Writing the prescription
A compounded prescription describes the preparation itself, so it carries a little more detail than one for a manufactured product. If you have not written one before, our pharmacists are glad to talk you through hormones, bases and dosage forms first.
Our e-prescribing and fax details are on the prescriber page.
Estradiol, estriol, or Bi-Est with the ratio you want.
A hypoallergenic cream, an olive oil base topical, or a vaginal preparation.
The strength is always yours to set. A topical is applied as you direct, rather than worn for several days like a patch.
Under Section 503A, a compounded preparation should not be essentially a copy of a commercially available product. Note on the prescription the change you are making for this patient and why it makes a significant difference for them, such as a strength or combination that is not manufactured, or an ingredient they need to avoid.
For women’s health & telehealth clinics
If your clinic is growing its menopause and hormone therapy work, we can be the pharmacy behind it, in all 50 states and the District of Columbia.
Plan your estradiol, Bi-Est, progesterone and vaginal preparations with our formulation development team before launch.
Hormone therapy fulfillmentSend prescriptions through a direct API connection, e-prescribing or our provider portal.
API integrationWhite-label or branded packaging, with the pharmacy-approved prescription label.
White-label fulfillmentCommon questions
Straight answers before you write.
Estradiol patches have not been placed on the FDA’s drug shortage list. Regulators say patches remain available and that all six manufacturers are working to increase supply, but a particular brand or strength can be hard to fill at a given pharmacy.
No. Transdermal patches are made on specialized manufacturing equipment, and no compounding pharmacy makes them. We prepare estradiol as a topical or vaginal preparation.
No. It is a different dosage form, applied as you direct rather than worn for several days, and it is not an equivalent product. Whether it is appropriate for a patient is your clinical decision.
It needs a new prescription. A compounded prescription describes the preparation itself: the hormone, the base, the strength, the quantity and the directions.
The change you are making for the patient and why it makes a significant difference for them, such as a strength or combination that is not manufactured, or an ingredient they need to avoid. That documentation is part of how a compounded preparation is prescribed under Section 503A.
Yes. Our pharmacists are glad to talk with prescribers about hormones, bases and dosage forms before a prescription is written. Call 423-975-0597.
We have a 48-hour compounding time on most preparations. Shipping time is additional.
We are licensed in all 50 states and the District of Columbia, so we can ship to your patients wherever they live.
Ready when you are
Prescribers can send a compounded estradiol prescription today. Clinics planning a hormone therapy program can tell us about it here, or go straight to clinic onboarding.
Sources
Compounded preparations are not reviewed or approved by the FDA for safety or efficacy. References to FDA approval on this page refer only to commercially manufactured products. This page is general information for prescribers and clinics; prescribing decisions rest with the treating clinician.