How can I buy estrogen cream over the counter?

Close-up image of Jules Walters

Jules Walters • Published: July 31, 2023

After menopause, levels of the female hormone estrogen hit the floor. One way to relieve menopause symptoms, like dry skin, is to buy estrogen cream over the counter.

Before menopause, women typically naturally produce about 350 picograms of estrogen per milliliter (pg/ml), measured in blood. After menopause, that number plummets to less than 10 pg/ml. Yep, that’s hitting the floor.

This guide explains the different kinds of estrogen creams available over the counter – and by prescription – and how they work as part of menopause skin care.

What are the different kinds of estrogen cream?

Estrogen creams come in two main types: bioidentical hormones, which mimic what we produce naturally, and phytoestrogens from plants.

Phytoestrogens, particularly from soy, are not as strong as bioidentical estrogens; so, if you want to get going with a small change, phytoestrogens could be a good place to start.

Where do I use estrogen cream?

In the 2000s, estrogen creams like Estrace, started to treat vaginal dryness, a common symptom of menopause. The cream used a tiny amount (0.01%) of a type of estrogen called estradiol to help thicken skin locally.

More recently, women have decided to use estrogens in cream in other areas, like on their face and neck. If it can work on vaginal tissues, then why not elsewhere? Sounds like a good idea.

I’ve used a bioidentical hormone in a cream called M4 from Alloy for the past few months and seen a big difference. Estrogen supports collagen production, and my skin now feels stronger.

Do you need a prescription for estrogen cream? It depends

Creams like Estrace are prescription medications, as they use a bioidentical hormone, which means you need a doctor to order them.

More recently, telehealth companies that specialize in menopause like Alloy, ByWinona, Midi and Evernow have made prescriptions for menopause more easily available.

If you’re going to use a bioidentical hormone that is just like the estrogen we make naturally – then yes, you will need a prescription.

Menopause telehealth companies employ doctors who will screen you through an online form, and the cream will arrive in the post. You don’t even need to leave home to get one.

For example, ByWinona has an estrogen body cream with progesterone that is sold as an anti-aging body cream.

Examples of estrogen creams over the counter

If you want to try an estrogen from plants, a phytoestrogen, which is weaker than human estrogen but still has an effect – then no, you don’t need a prescription. You can get this kind of estrogen cream over the counter.

But don’t expect to see these kind of creams in Walgreens or CVS. It’s still too specialized, and you’ll need to try online providers like the two below to get an estrogen cream over the counter.

Quicksilver Scientific makes two phytoestrogen products: Bi-Est+ serum, which uses two kinds of estrogens from soy: estriol (1mg per pump) and estradiol (0.25mg per pump). It also makes Estriol+, which uses just estriol from soy (0.5mg per pump of serum).

Paula’s Choice also makes a Phytoestrogen Elasticity Renewal Serum using phytoestrogens from soy.

A short history of estrogen treatment

It is worth knowing that estrogen replacement therapy (ERT), also known as hormone replacement therapy (HRT) or more simply hormone therapy (HT), has had a roller coaster reputation over the past 50 years.

Creams using estrogens work locally and don’t affect your whole body. So that’s a much easier decision than hormone therapy, which affects your whole body. In hormone therapy, the estrogens are taken in a pill or through a patch.

One of the earliest hormone therapies, called Premarin, so called as it was derived from pregnant horse urine (I’m not kidding) became one of the biggest selling drugs in the US in the 1990s.

Doctors were writing prescriptions for the millions of women, complaining about symptoms of menopause. Hot flashes and night sweats no longer had to be endured. And hormone therapy was reported to also have great side benefits, significantly reducing the risks of hip fractures, colon cancer and Alzheimer’s. That was the high.

Then came the low. In 2002, a big study called the Women’s Health Initiative (WHI) was published. Media headlines misrepresented the dangers of HRT, claiming the data showed that estrogen therapy increased the risk of breast cancer, heart disease and stroke, among other things. Bad news travelled fast.

HRT hit the brakes and millions of women came off hormone therapy almost immediately. Doctors stopped prescribing and we went into a dark winter. A whole generation of women went without the many benefits of estrogen post-menopause.

A rebalancing in hormone therapy

So, where are we now? In 2006, the WHI reported an update on the same group of women using hormone therapy. They found no increased risk of breast cancer for women on combined estrogen-progestin treatment; now the standard hormonal therapy for most women.

But good news doesn’t travel as fast as bad news. As the saying goes: a lie can travel halfway around the world before truth has put its boots on. So this reinterpretation of the WHI longer-term results is still not as well known as the first scary headlines.

The North American Menopause Society now says that hormone therapy is the most effective option for treating hot flashes. So, if you are suffering from the symptoms of menopause, it is definitely worth a conversation with your doctor about hormone therapy that goes beyond a cream.

If you want to do more of your own research on hormone therapy, it is worth reading this reassessment of menopause management, published in the New England Journal of Medicine in 2016. Women on hormone therapy in their 50s were less likely to die from heart disease, cancer or anything else, than women who did not take hormone therapy.

How to decide if estrogen cream over the counter is for you?

You could start by measuring your hormone levels. Companies like InsideTracker can order a blood test that includes measuring hormone levels.

Menopause specialist companies like Evernow say that there is no need to test for hormone levels as they’re treating menopausal symptoms and not hormone levels. Measurement is up to you.

I’ve had my hormone levels measured through a blood draw and yep, like every other woman post menopause, my hormones – including estrogen – had hit the floor.

You could start with a phytoestrogen cream over the counter, which doesn’t need a prescription, and see if it makes any difference. And you could take pictures of your skin before and after, using the cream as a reference.

Just be aware you’ll probably need to use the cream for a couple of months before you see a difference. Or you could go to one of the menopause specialist companies, and try a bioidentical hormone in a cream that does need a prescription. There are choices. You don’t have to accept dryness and discomfort as part of life after menopause.