You may edit out doses...
blood levels and medication are ok ..
Concerning levels of estrogen you might talk to them to stay away from menopausal levels.
Menopausal levels are 60-80 pg/ml. It might be connected with risk to bone density, low libido and low level of activity. Menopausal people usually don't have a youthful level of activity.
A doctor/endo should know this.
Usually they may be afraid of higher estrogen levels because:
-some non bioidentical forms of estrogen may be dangerous with higher levels.
This can be avoided if bioidentical estrogen is applied. Cis people have high leves naturally for example during pegnancy without adverse effects.
Second there may be blood clotting if estrogen is taken orally.
The liver has estrogen sensors in the arteries from the digestive tract and then raises clotting factors if estrogen is swallowed.
This can be avoided with sublingual intake, and with other forms of intake, like gels, patches, implants or injections.
Many endos strive for levels of estro of 180-200 pg/ml or above.
I would see no reason for them not to, and to keep people well away from any menopausal levels.
But decisive is also how people feel. But imo levels below 150 pg/ml should be avoided.
Some people feel well then and have good feminization, some people fell well with higher levels still from injections and implants, where levels can be much higher.
If levels are not high enough it might be tried to raise estrogen levels first.
Possibilities could be as said sublingual bioidentical estrogen, patches, gel, implants or injections.
With sublingual intake levels rise fast and then drop hours later. So spreading the daily dose throughout the day in a few small doses may help keep levels more steady, which might affect mood.
Patches make for more steady levels, there is a difference in effectivity because peoples skins are different.
Its also possible to use one patch for stable levels and sublingual pills for higher levels.
Adding bioidentical progesterone might help also. There are studies showing for fully developed breast tissue it may be necessary. It may also help with mood. It can be cycled, for 10,14 or 20 days a month for example. Watch for mood then.
You may discuss all of this with them ... maybe print and discuss ...
hugs
