Over-the-counter estrogen creams typically contain bio-identical, or plant-based estrogen called phytoestrogen. As with prescription creams, they are supposed to relieve common symptoms of menopause, such as hot flashes, vaginal dryness and mood swings. The American College of Obstetricians and Gynecologists cautions that there has been insufficient research on the effectiveness and safety of over-the-counter estrogen creams, and they are not regulated by the FDA. Discuss using over-the-counter hormone products with your medical provider.
Bio-Identical Hormone Creams
Bio-identical hormone creams are often marketed as bio-identical hormone replacement therapy (BHRT). Bio-identical hormone creams are often compounded with estrogen, estriol or phytoestrogen, progesterone and androgen. Estriol had not yet been FDA-approved in 2010, although it is not illegal to dispense it over the counter. The FDA cautions that BHRT is not a recognized medical term, but a marketing phrase. It advises that consumers should be cautious about claims that these creams are safer than prescription estrogen creams, and that they may carry the same health risks and side effects as creams your doctor prescribes. In 2008, the International Academy of Compounding Pharmacists issued a press release stating that women should be given the choice to purchase over-the-counter bio-identical hormone creams, and that estriol was legal, safe and effective.
Although estriol isn't FDA-approved for prescription use, you can still buy estriol creams legally over the counter. Estriol is a relatively weak form of estrogen, and according to an article on the Women's Health website, it has fewer side effects than other estrogen treatments. When applied vaginally, estriol cream can reduce vaginal dryness. Women's Health reports that a study also indicated that estriol cream may significantly improve the appearance of facial skin, reducing the size of pores and fine wrinkles. It's also been used in Europe to treat menopausal symptoms.
Soybeans contain phytoestrogens, a weak form of plant-based estrogen. While dietary soy in the form of food or supplements may be helpful in reducing menopausal symptoms, there is not enough evidence yet to prove that they are effective when applied as a cream or gel. However, soy estrogen cream is widely available over the counter. It is often combined with wild yam, which contains natural progesterone and is thought to complement the estrogen.
- ACOG: Frequently Asked Questions About Hormone Therapy
- FDA: Bio-Identicals: Sorting Myths from Facts
- IACP: Senators Join Thousands of Patients, Doctors, Pharmacists in Supporting Women's Access to Critical Hormone Treatments
- Women's Health: Estriol: The Friendly Estrogen
- Harvard Health Publications: What are bioidentical hormones?