Topical Hormone Therapy for Women: What You Need to Know About Biest and Testosterone

As women approach menopause, many start to notice frustrating changes — low energy, disrupted sleep, mood swings, weight gain, decreased libido, and more. These are not just signs of “getting older” — they are signals that your hormones may be out of balance.

At Blue Sky MD, we specialize in helping women feel like themselves again using personalized hormone replacement therapy (HRT). 

While bioidentical pellet therapy remains our most popular and convenient option, topical hormone creams can be a great alternative for women who want a non-invasive, flexible approach. Let’s walk through what this therapy involves, and why it might be right for you.

What Is Topical Hormone Therapy? 

Topical hormone therapy is a custom-compounded cream applied to the skin, usually to the inner forearms or thighs. At Blue Sky MD, we often use a combination of two hormones: 

• Biest (a 50:50 blend of estradiol and estriol, both forms of estrogen) 

• Testosterone (yes, women need this too!) 

This combination helps restore natural hormone balance and relieve symptoms of estrogen and testosterone deficiency. 

What Are the Benefits of Topical Hormone Therapy? 

There are several benefits to topical hormone therapy that set it apart from other forms of HRT. Women using topical hormone therapy often report improvements in: 

• Hot flashes and night sweats 

• Sleep quality 

• Energy and focus 

• Mood and anxiety 

• Sex drive and intimacy 

• Muscle tone and metabolism 

• Hair and skin health 

Estrogen supports your brain, bones, and heart, while testosterone helps with strength, mental clarity, and libido. When these hormones are restored to natural, balanced levels, the changes can feel life changing.

What Are the Potential Side Effects of Topical Hormone Therapy for Women? 

Topical testosterone may sometimes lead to acne, facial hair, or hair thinning in sensitive individuals. This happens because some of the hormone can convert to a stronger form called DHT in the skin. But don’t worry — we manage this by: 

• Starting with low doses and increasing slowly 

• Rotating where you apply the cream 

• Monitoring your hormone levels carefully 

• Adjusting the formula as needed 

Most women tolerate topical hormone creams very well, especially when it’s tailored to their unique needs.

Topical vs. Pellets: Which Is Better? 

At Blue Sky MD, we love the consistency and convenience of hormone pellets — tiny implants placed under the skin that release hormones for 3–6 months. But topical creams are: 

• Non-invasive 

• Easy to start or stop 

• Ideal for women wanting to test the waters before committing to pellets 

• A great choice for those with sensitive skin or changing needs 

That said, topical therapy requires daily use, and it may take a little more time to find the perfect dose.

How Do We Monitor Your Hormones at Blue Sky MD? 

When you begin hormone replacement therapy at Blue Sky Md, our main goal is check your baseline labs and track how your body responds. We start with a lab panel, which involves drawing a blood sample that we can analyze. By taking periodic blood samples, we can monitor hormone levels in the blood, including: 

• Estrogen and testosterone levels 

• SHBG (a protein that carries hormones) 

• DHT (if acne or hair issues arise) 

• And overall wellness markers like cholesterol and liver function 

Your care is individualized and closely monitored to ensure you’re getting the safest and most effective treatment. If at any time you’re feeling unwell or notice symptoms emerging or not disappearing after treatment, we can make quick adjustments to treatment.

Final Thoughts from Dr. LaMond 

Hormone therapy is not one-size-fits-all. At Blue Sky MD, we believe every woman deserves to feel vibrant, strong, and mentally clear — at every stage of life. 

Whether you’re just starting to explore hormone replacement or looking for a flexible alternative to pellets, topical therapy with Biest and testosterone is a safe, effective option we trust and recommend. 

If you’re curious whether it’s right for you, we’re here to help you navigate the journey — with science, compassion, and support every step of the way. Get started by contacting us today to set up your first appointment.

— 

Dr. David LaMond 
Medical Director, Blue Sky MD