Instructions for the use of Bio-Identical Hormone Creams

National Custom Compounding recommends the following procedure for the use of bio-identical products that has prescribed:


It is important to use only the thin skin down the front of the body as the ‘outside ‘skin is too thick for the creams to be absorbed. It is also essential that an area the size of a small plate be used so the cream can cover as much skin as possible with dose prescribed.


The cream is usually applied after a shower while the skin is freshly washed. If your cream contains oestrogen (biest or triest) it is important to have an interrupter cycle of using the cream, your body’s cells are used to having a break from your hormones when you have your periods. Although we do not expect that you will have any bleeding, it is still a good thing for cells to get a break.

We recommend that any creams containing oestrogen are applied from the 1st of each calendar month to the 25th or 28th inclusive. The stop the cream and restart on the 1st of the following month. If you follow your own 25 day system, we have no idea whether you are on or off the cream on the date of the test, so it is better to follow the calendar.

If you start your first month on the cream later than the 15th of the month, we recommend going through until the 25th of the following month to get a reasonable start. Then follow the usual 1st-25th system as usual.

Most common mistakes made by using creams:

  • Not using enough cream to ‘save ‘it. The cream needs to be a full dose of 1 gram to be effective at the dose prescribed.
  • Using the cream on too small an area of skin. The skin area needs to be the size of a large dinner plate or an A4 piece of paper. Small area application will waste the cream and not give an effective dose.
  • Using the cream on ‘outside’ skin. The hormones are absorbed through the skin directly into the blood stream. They therefore need to be applied to the thinnest skin available, e.g. along the inside of the whole length of the arms, or to the inside of the thighs or belly.
  • Not using enough different sites of the cream.

Background Information

A cream may be prescribed as it has a few advantages over other forms of drug delivery. A cream is to be applied to an unexposed area of the body (as it allows the best absorption) such as the inner or outer thigh or the inside of the arm. Ensure you rotate the areas of application for best results.

Before application, place a small amount on the inside of the arm and leave for about 5 minutes. If you find that there is no reaction (the skin is not red or irritated) then you may proceed with the application.

Apply as directed by the doctor and discontinue use if there is a reaction to the cream (very rare). Creams are compounded to your specific dose. The active ingredient(s) are combined in a suitable base which is a very smooth, non-greasy, fragrance free, paraben free and hypoallergenic moisturising cream.

Apply your prescribed dosage over a large surface area and rub in for 60-120 seconds to ensure dosage is well absorbed.

Wash hands thoroughly after use and before coming into contact with other people or pets as cream can be absorbed through others skin.

Measuring the cream:

One ML (One full syringe OR one level white spoonful) is equivalent to 1 gram of cream. If you misplace the syringe or plastic spoon, 1 gram is equal to ¼ of a level teaspoon.

Using the cream jar:

  • Unscrew the small white cap and take the end of the syringe(plunger) completely out and place on the bench and place the tip of the syringe into the “pink” hole at the top of the jar (some pressure will need to be applied here).
  • Holding it upright, push from the bottom up ensuring you hold onto the syringe. You will see the cream moving up the syringe. Once it reaches the line at the top of the syringe you place the end back into it and measure out the dose you require.
  • Alternatively, if you cannot use the accurate syringe you may use the white spoon provided. One level spoonful= 1 ml


Store in a cool area away from direct sunlight.