How much to use, what's in it, how to use the spray, looking after the bottle, and when to call the doctor.
Each tier is named for the total you apply each day, across both sprays.
Neither the tier name nor the figure on the label is a spray count — the label does not print one. Your dose is two sprays unless your provider tells you otherwise.
Because estradiol doses are small. Writing them in micrograms (mcg) avoids a string of decimal places, which is where dosing errors tend to creep in.
If you are comparing against a previous prescription written in milligrams, check the units before you compare the numbers.
The pump is metered — it delivers the same measured 0.20 mL every time it is pressed. Your prescription is built from two of those measured amounts.
Both sprays together are one dose, applied one after the other at the same site. Applying only one spray gives you half your prescribed dose.
This spray is applied every day, so a skipped day is a day with no dose at all.
Do not change your dose to compensate. Tell your care team how many days you missed and follow the direction they give you.
Estradiol — the pure active pharmaceutical ingredient, and the only active ingredient in the spray.
Every Keen spray is formulated with the pure API — one molecule per spray, unless the product is explicitly a combination. Your Estradiol Spray Rx is a single-molecule preparation, delivered by the Hypospray® transdermal platform.
Your daily routine
Clean and dry the skin
Wash the area with water and pat it dry. Apply only to healthy, unbroken skin — no cuts, rashes, or irritation.
Hold the bottle one to two inches away
Measure it the first few times until the distance is familiar.
Apply all your sprays as one dose
One after the other, at the same site.
Rub it in for two to three seconds
Rub gently until it is absorbed. Do not skip this step.
Let it dry for two to five minutes
Wait before putting clothing over the area.
Same time every day
Pick a time you can keep, and apply at that time on each dosing day.
Approved sites
You do not need to alternate sides or rotate between sites. Use whichever listed site is easiest for you to reach and to keep uncovered while it dries.
Give it two to five minutes to dry before clothing covers the area. Let it air-dry.
Dressing before it dries is one of the four things that quietly reduce how much of your dose reaches you. The others are applying fewer sprays than prescribed, skipping dosing days, and not rubbing it in.
Yes — once per bottle, when you first open it.
Priming a new bottle
Open the bottle
Pump twice
These first two pumps prime the mechanism.
On the third pump it is primed
From here it delivers a full metered dose.
Priming is a one-time step for each new bottle. You do not repeat it daily.
Your dose is unaffected. This is a metered pump: it dispenses the same measured amount whether the pattern is a fine mist or a stream. Only the spray pattern has changed. Do not re-dose, and do not skip a dose, because of how it looks.
It happens when air reaches the nozzle quickly after use and a little solution dries in the tip.
Clearing the nozzle
If it still will not clear after both steps, message your care team rather than continuing with a bottle you are unsure about.
Yes — but it must travel in your carry-on. Never put it in checked baggage.
The reason is mechanical rather than administrative: pressure changes in the hold can damage the pump mechanism, and a damaged pump no longer delivers a measured dose.
Keep it in its original labelled bottle. For questions about travelling with a prescription — particularly internationally — message your care team before you travel.
Your follow-up blood test is the measure. Your provider re-checks your levels and reads them alongside how you have been doing — that is the conversation this is built around, and it is why the lab work is part of the membership rather than an extra.
What helps you get a clean read
If it is not going the way you expected after several consistent weeks, that is worth raising rather than sitting with. Do not change your dose on your own — tell your provider what you are noticing and let them adjust it.
Everyone responds differently, and your provider is the person who can say what your own numbers mean. Nothing here predicts a result for you.
If you have a uterus, yes — systemic estrogen is prescribed alongside a progestogen. Estrogen on its own stimulates the lining of the uterus, and sustained stimulation raises the risk of the lining overgrowing. The progestogen is what prevents that.
This is the one boxed warning the FDA kept when it revised menopausal hormone therapy labelling in November 2025. The warnings for heart disease, breast cancer and probable dementia are being removed. The endometrial cancer warning on systemic estrogen-alone products stays.
What this means for you
If you have a uterus and you are using this spray without a progestogen, message your care team through the member portal to confirm that is intended.
Yes — before it dries. This spray is absorbed through the skin, and anything that touches the treated area before it has dried can pick up medicine that was meant for you.
Until it has dried
Once it has dried and you have washed your hands, ordinary contact is not a concern.
Message your care team if
Anything about your dose, your labs, your symptoms, or whether the therapy suits you goes to your provider through the member portal — that is the only channel that should carry clinical detail.
If you are having a medical emergency, call 911. Do not use the portal for anything urgent.
Compounded preparation dispensed under a licensed prescriber and pharmacy. Not an FDA-approved drug product and not interchangeable with FDA-approved estradiol products. No cross-route conversion is stated or implied. All dosing decisions are made by the prescribing provider.
For membership, labs, billing and how to reach your care team, see the general questions.
All frequently asked questions →