How to Apply Hormone Creams Correctly: Tips for Better Absorption and Accurate Hormone Testing

By Dr. Christa Waymire | Dragonfly Menopause Care | Chanhassen, Minnesota

If you're using hormone replacement therapy (HRT) creams during perimenopause or menopause, you might be surprised by how much the little things matter!

At Dragonfly Menopause Care, we've noticed that where you apply your hormone creams, how consistently you apply them, and even how you prepare for saliva hormone testing can affect your results.

Our goal is to help you find the hormone levels that work best for your body. Here are some important tips to help you get the most out of your hormone therapy.

1. Does It Matter Where You Apply Hormone Creams?

Yes! Where you apply your hormone creams can affect how much hormone your body absorbs.

I generally recommend applying hormone creams to your arms, legs, or lower back. However, the most important thing is to remain consistent with your general application area.

For example, if you've been applying your Biest estrogen cream to your upper arms, don't suddenly switch to the inside of your elbows, behind your knees, or your abdomen.

Different areas of skin can absorb hormones differently, particularly areas with thinner skin.

We've even seen hormone levels increase despite lowering a patient's dose, simply because she changed where she was applying her cream!

Should You Rotate Hormone Cream Application Sites?

Yes! You should move your cream around within the same general application area.

For example:

• If you apply your cream to your arms, rotate between different spots on your arms.

• If you apply it to your legs, move the application spot slightly each day.

• If you use your lower back, rotate the application spot within that general area.

The key is to avoid making significant changes to the part of your body where you apply your hormones.

You want to rotate the specific application spot while keeping your overall application area consistent. This helps us avoid unexpected changes in absorption when we're evaluating your hormone levels.

2. When Is the Best Time to Apply Hormone Creams?

I generally recommend applying hormone creams in the morning, especially Biest estrogen and testosterone creams, because they can be stimulating for some women.

However, if applying your creams at night is the only thing that works with your schedule, that's okay!

Here are a few additional reminders:

Testosterone cream: I recommend applying testosterone to your legs when possible, preferably where the area will be covered by clothing. The lower back is anothr option.

Remember to rotate the specific application spot within the same general area.

Biest estrogen cream: Consistency in both your application area and daily routine is important.

Progesterone cream: Unlike oral progesterone, progesterone cream is generally not sedating and can also be applied in the morning.

3. How Can You Prevent Contamination During Saliva Hormone Testing?

Saliva hormone testing is one of the tools we use at Dragonfly Menopause Care to help personalize hormone therapy.

However, hormone creams can sometimes contaminate saliva samples and make the results

difficult to interpret.

This is particularly important if you're using multiple hormone products, including:

• Biest estrogen creams containing estradiol and estriol

• Vaginal or vulvar estriol/testosterone creams

• Facial creams containing estriol

• Other topical hormone preparations

Stop Certain Hormone Creams Before Testing

At Dragonfly, we recommend temporarily stopping vaginal or vulvar estriol/testosterone creams and estriol-containing facial creams 7-10 days before your saliva hormone test to help prevent contamination.

I know nobody wants to give up their anti-aging skincare, even temporarily!

But we also don't want you to have to repeat a saliva test because the sample was contaminated.

4. How Should You Prepare Your Home for Saliva Hormone Testing?

Something many women don't realize is that hormone creams can transfer from your hands to household surfaces.

You might touch your hormone cream, then touch your bathroom faucet, and later touch that faucet again before touching your face.

That creates an opportunity for hormone residue to contaminate your saliva sample.

In the days leading up to testing, I recommend:

• Thoroughly wiping down bathroom counters, sinks, faucets, and frequently touched surfaces.

• Washing your hands carefully after handling hormone creams.

• Avoiding touching your face or saliva collection supplies after handling hormones.

• Considering wearing gloves when applying your creams during the two days before testing.

• Changing your bedsheets and pillowcases.

• Carefully following your saliva testing kit instructions.

These little steps can make a big difference in getting useful test results the first time!

5. Why Is Hormone Testing Important During Perimenopause and Menopause?

We can do our best when we test!

Our goal at Dragonfly is to help you find the right hormone doses for your individual body—not too little, not unnecessarily high, but the levels that help you feel your best.

And that can take some adjusting!

This is especially true during perimenopause, when your ovaries are still producing hormones, but those hormone levels can fluctuate significantly.

You're a bit of a moving target!

Honestly, I'd test you every month if that were practical, especially during perimenopause.

The more information we have about your hormone levels and how you're feeling, the better we can personalize your treatment.

Testing helps us evaluate your response to hormone creams and make dose adjustments to get your levels just right for you.

And believe me, I understand the inconvenience! I take these tests myself, and my own hormone doses get adjusted based on my results, just like yours.

6. Why Should You Request Hormone Cream Refills Through Dragonfly?

If you're receiving compounded hormone creams through Purescripts Pharmacy, please request your refills directly through Dragonfly Menopause Care.

We've established this process with the pharmacy so we can review your prescriptions before they're filled.

Sometimes your dose needs to change based on your symptoms or recent hormone testing.

We don't want you paying for a prescription that may no longer be right for you!

When you're getting close to needing a refill, simply send us a message through Dragonfly, and we'll take care of it.

Personalized Hormone Replacement Therapy at Dragonfly Menopause Care

Finding the right hormone balance is a process!

There are creams to apply, hormone tests to complete, and sometimes several adjustments along the way. That's especially true during perimenopause, when your own hormones are constantly changing.

At Dragonfly Menopause Care, we're committed to providing excellent, individualized care guided by your symptoms and hormone levels.

We want your hormone therapy to be personalized to you, with doses that help you feel your best while avoiding unnecessarily high hormone exposure.

The more accurately we can evaluate your levels over time, the better we can fine-tune your treatment.

Thank you for working with us through this process. We put a tremendous amount of time and effort into helping each of you feel your best, and we appreciate the trust you've placed in us.

We're in this together!

Dr. Waymire, Dr. Manders, and the Dragonfly Menopause Care Team