As a Menopause Society Certified Provider, I stay current with research and regularly attend webinars and conferences. There are many expert researchers and physicians discussing whether there is any need to check estradiol levels.

This is in response to online forums stating that estradiol levels of 80–100 pg/mL are needed for bone protection. According to hormone researcher Dr. Sue Davis, this is “nonsense and not evidence-based.” This misinformation is based on an older study. The way estradiol is measured today is different, and laboratory assays may be affected by other circulating hormones. Additionally, if a woman is taking oral estrogen, a significant amount is converted to estrone, which is not reflected by a standard estradiol level.

What strength of estradiol patch helps decrease bone loss?
An estradiol patch delivering as little as 14 mcg/day helps decrease bone loss. A 50 mcg/day patch has been shown to stop bone loss in approximately 95% of women.

What is the best dose of estrogen for women?
Truly, the most effective dose of estrogen for peri- or menopausal women is the dose needed to adequately relieve menopausal symptoms.

Will increasing the estrogen dose help more (result in less bone loss) than a lower dose?
Not all bone loss is due to low estrogen levels. Bone loss is multifactorial and may be influenced by genetics, physical activity, nutrition, and adequate protein intake. Estrogen is not a silver bullet for preventing bone loss. Simply increasing a woman’s estrogen dose does not assure additional bone protection.

The online chatter is not supported by the best available scientific evidence.

To sum this up, bone is exquisitely sensitive to even low doses of estradiol. Routine estradiol blood levels are generally not helpful for determining bone protection. As I often say, more does not necessarily mean better.

I hope this helps.