Wow! My estrogen level dropped from over 300 down to 20 normal male level. Anyone know why that would happen?
Depends when blood is drawn but that is quite a difference! Did you make any change to your HRT since last time or any change in general?
Hey,
I had a drop from my latest blood draw (around 120 down to 70) but I didn't take my hormones the morning of the drawing. My endo said it was nothing to worry about. However, this is quite a drop. Did you do anything differently. That could account for the changes. And how do you take you meds? Are you consistent with the times and method? And have you talked to your doctor about it and get their opinion?
OK, that has happened to me. I have a few questions....
1. What time of day was your last two draws? (morning, at the same time is best)
2. Did your blood analysis go to the same laboratory? (there are some really bad labs out there)
3. Is our doctor open to a re-analysis? (Sh*t happens during analysis – about 1 in 97 will be wrong)
4. Are you taking your E the same way each time? I'm guessing your on oral and some types of food can change adsorption characteristics and from there, the blood levels.
5. Are you doing your T-blocker consistently?
Let's face it, if it were something major, you would be dead already so relax a little.
As for me, I'm intersexed and the messed up E levels was what started the search. But only after we answered all of the questions first.
Hugs,
Jen
Quote from: KayXo on May 29, 2014, 04:09:50 PM
Depends when blood is drawn but that is quite a difference! Did you make any change to your HRT since last time or any change in general?
No change. The only thing I can think of is that they didn't bother actually checking that since they saw male and maybe figured it wasn't important so they just reported a normal level. Or the Oestrogel I was taking I purchased off Amazon and maybe it's fake or just not any good. But I have to say it looks legitimate. It came in the right box, the right tube with the pamphlet and everything. So who knows.
Quote from: Amy1988 on May 29, 2014, 05:12:37 PM
Or the Oestrogel I was taking I purchased off Amazon and maybe it's fake or just not any good.
This or it is expired. I wouldn't take anything I didn't get from a legitimate pharmacy. :)
Quote from: Amy1988 on May 29, 2014, 05:12:37 PM
No change. The only thing I can think of is that they didn't bother actually checking that since they saw male and maybe figured it wasn't important so they just reported a normal level. Or the Oestrogel I was taking I purchased off Amazon and maybe it's fake or just not any good. But I have to say it looks legitimate. It came in the right box, the right tube with the pamphlet and everything. So who knows.
I'm doing the Divigel - very similar. Mix each packet before applying by squeezing the unopened tube from each end. Spread it out - about 5" per tube/packet. Let it dry completely before getting dressed or going to bed. Time post application can make a difference. There should be an expiration date on the box so check it.
Quote from: JLT1 on May 29, 2014, 04:34:19 PM
OK, that has happened to me. I have a few questions....
1. What time of day was your last two draws? (morning, at the same time is best)
2. Did your blood analysis go to the same laboratory? (there are some really bad labs out there)
3. Is our doctor open to a re-analysis? (Sh*t happens during analysis – about 1 in 97 will be wrong)
4. Are you taking your E the same way each time? I'm guessing your on oral and some types of food can change adsorption characteristics and from there, the blood levels.
5. Are you doing your T-blocker consistently?
Let's face it, if it were something major, you would be dead already so relax a little.
As for me, I'm intersexed and the messed up E levels was what started the search. But only after we answered all of the questions first.
Hugs,
Jen
1: the first draw was I think in the afternoon probably after I had already applied the estrogel. The second draw was early in the morning 8:00AM before I applied it. So not consistent at all.
2: I'm not sure but I went to two different doctors at different places and even different states but both were affiliated with Carolina health systems.
3: he's going recheck in 3 months now that I'm using estrogel pump purchased at a real pharmacy and not from Amazon.com ::)
4: I apply at about the same time each day but it was a topical gel in a tube not a pump like I have now so it was hard to meter.
5: I never had a T blocker til now.
Quote from: Jessica Merriman on May 29, 2014, 05:16:38 PM
This or it is expired. I wouldn't take anything I didn't get from a legitimate pharmacy. :)
The date is good. For the first test I was taking estrogel I purchased from Inhouse pharmacy which gave me the good results but second test was from Amazon purchase.
I know very little about the gels, so I can't comment on that. I would just exercise caution when buying medication from an outside vendor on amazon, especially for something like this. Good luck and hope it works out.
Quote from: Amy1988 on May 29, 2014, 05:12:37 PMOr the Oestrogel I was taking I purchased off Amazon and maybe it's fake or just not any good.
I'm sorry but this to me is really strange. HRT is no less serious than any other medical complication and should both monitored AND facilitated by a medical professional, hopefully an endocrinologist who's experienced in transgender related treatment. Hormones are no less important than any other medications. You cannot fully trust or verify the purity of any medication bought from anything else other than accredited pharmacies, as well as no matter how much you've, "researched" you cannot safely diagnose or conduct your own hormonal healthcare. I don't even believe (off the top of my head) that oestrogel is a proper substance for hormone replacement/supplementation, it's a weak topical agent meant for women experiencing hot flashes, not people with complete estrogen depletion.
Quote from: teeg on May 29, 2014, 06:31:38 PM
I'm sorry but this to me is really strange. HRT is no less serious than any other medical complication and should both monitored AND facilitated by a medical professional, hopefully an endocrinologist who's experienced in transgender related treatment. Hormones are no less important than any other medications. You cannot fully trust or verify the purity of any medication bought from anything else other than accredited pharmacies, as well as no matter how much you've, "researched" you cannot safely diagnose or conduct your own hormonal healthcare. I don't even believe (off the top of my head) that oestrogel is a proper substance for hormone replacement/supplementation, it's a weak topical agent meant for women experiencing hot flashes, not people with complete estrogen depletion.
Well the estrogel I'm currently taking was prescribed by a doctor who is experienced in transgender care. He did tell me however that if the next blood test shows low levels he may place me on pill form. I don't really want pill form because the gel is much safer but I will if I have to. Also my levels were high at the first check while on a gel form.
Don't want to hijack your thread but I am having similar issues. I was on pill form for the first few months of my transition. My endo switched me to estrogel. Just got my first level check since then and I am nearly back into male ranges. It is rather depressing. I really just don't know. I think it is time for a new endo. Or see about injections.
Quote from: Hayley on May 29, 2014, 08:17:41 PM
Don't want to hijack your thread but I am having similar issues. I was on pill form for the first few months of my transition. My endo switched me to estrogel. Just got my first level check since then and I am nearly back into male ranges. It is rather depressing. I really just don't know. I think it is time for a new endo. Or see about injections.
I don't understand it either. I've only used the gel and at one time my E levels were over 300 on the gel form. I'll see how this new stuff does.
Estrogel is a topical gel typically used to provide an additional daily balance. My estradot patches provide the daily dose and never had issues. However my endo is highly clued up and advised that I should never apply estrogel on same day to the arm which will have blood drawn. The reason was that the topical cream can remain localized and spike the blood sample drawn.
If you know your getting a test make sure the HRT protocol is followed properly for a day or two before hand. That way they can see the true values.
Quote from: Amy1988 on May 29, 2014, 06:53:15 PM
I don't really want pill form because the gel is much safer but I will if I have to.
My endo specialises in trans patients and put me on pills. I asked him about the "dangers" because I am well over 40 years old. He told me that the dangers relate to premarin and ethyl estradiol neither of which are used any more. He told me that modern medications are bioidentical and put no strain on the liver.
So I can believe an Endo with experience of thousands of trans patients or .... people on the internet.
As long as you are on Estradial Valerate or HemiHydrate then you have nothing to worry about.
Quote from: Amy1988 on May 29, 2014, 06:53:15 PMI don't really want pill form because the gel is much safer but I will if I have to.
"Safety" of bypassing the liver in my opinion is a non issue. As long as you don't have pre-existing liver complications it won't effect you in the slightest. In fact, I had been taking estradiol (tablets) sublingually and recently discovered huge discrepensies in my levels, seen here https://www.susans.org/forums/index.php/topic,165617.msg1432836.html#msg1432836 (https://www.susans.org/forums/index.php/topic,165617.msg1432836.html#msg1432836).
Topical estrogens could be compared to sublingual administration in terms of level variance. Such varying levels can't be healthy for the body or progress.
Quote from: teeg on May 30, 2014, 11:53:12 AM
"Safety" of bypassing the liver in my opinion is a non issue. As long as you don't have pre-existing liver complications it won't effect you in the slightest. In fact, I had been taking estradiol (tablets) sublingually and recently discovered huge discrepensies in my levels, seen here https://www.susans.org/forums/index.php/topic,165617.msg1432836.html#msg1432836 (https://www.susans.org/forums/index.php/topic,165617.msg1432836.html#msg1432836).
Topical estrogens could be compared to sublingual administration in terms of level variance. Such varying levels can't be healthy for the body or progress.
I go back to see the doctor next week and I think they will probably do more blood work. If my E level is still low then it will be obvious that I'm not absorbing it and he wii probably put me on pill form.
All,
I am the endocrine expert at a Fortune 50 Industrial Company that has 55,000 products and sales of $31 billion. I have PhDs in Analytical Chemistry, Inorganic Chemistry and Molecular Toxicology. Part of my job is to make sure nothing we produce interacts with the endocrine system. That means I know a lot about how it works and how it works in conjunction with metabolism.
Last I looked (about 8 months ago) there were 18 estrogen types available for use. All had purported advantages and disadvantages. You and your doctor have to find a delivery mechanism and a type of estrogen that works for you. You also have to determine the levels you should be at as there is no real agreement out there in the medical community. This is in part because the effectiveness of E is also dependant on the levels of T and possibly progesterone (plus others that no one talks about but that I have to worry about) so things get complicated. A rule of thumb in the medical community seems to be female normal if progesterone is included. Female normal +20% E and -50% T if no progesterone. Injections are tried and true. Pills can be good but may not be. Blah, blah, find the one that works.
As far as "bioidentical hormones" From Harvard Medical Publications – 2006 – "The interest in a more natural approach to hormone therapy has focused attention on bioidentical hormones — hormones that are identical in molecular structure to the hormones women make in their bodies. They're not found in this form in nature but are made, or synthesized, from a plant chemical extracted from yams and soy. Bioidentical estrogens are 17 beta-estradiol, estrone, and estriol. (Estradiol is the form of estrogen that decreases at menopause.) Bioidentical progesterone is simply progesterone. It's micronized (finely ground) in the laboratory for better absorption in the body.
Bioidentical hormone therapy is often called "natural hormone therapy" because bioidentical hormones act in the body just like the hormones we produce. But here again, that tricky word natural muddies the waters. Pregnant mares' urine is natural, but Premarin is not bioidentical, at least not to human estrogen. The same goes for Cenestin, which is made from plants but is not bioidentical.
Technically, the body can't distinguish bioidentical hormones from the ones your ovaries produce. On a blood test, your total estradiol reflects the bioidentical estradiol you've taken as well as the estradiol your body makes. On the other hand, Premarin is metabolized into various forms of estrogen that aren't measured by standard laboratory tests. Proponents of bioidentical hormones say that one advantage of bioidentical estrogen over Premarin is that estrogen levels can be monitored more precisely and treatment individualized accordingly. Skeptics counter that it hardly matters, because no one knows exactly what hormone levels to aim for, and symptoms, not levels, should be treated and monitored." To me, there is identical and non-identical. Then there is what I am concerned about..how reactive is that substance when compared to estradiol, esterone and estriol?..what is the bioavailability compared to estradiol, esterone and estriol? Plus another 20 or so other questions. A person can crank around doses of things to get more or less the same effect. Which is what doctors are doing - for good or bad.
Me? I use a "bioidentical" estrogen cream. I do have a metabolic disorder. It's one of the problems DES sons sometimes have. I'm also allergic to the acrylates that are used in patches. The sublingual method should work but I'd like to see data from controlled trials not guesses made by a doctor. I'd do injections if I needed to but the cream is working fantastic – for me.
Jen
Quote from: JLT1 on May 30, 2014, 04:48:26 PM
All,
I am the endocrine expert at a Fortune 50 Industrial Company that has 55,000 products and sales of $31 billion. I have PhDs in Analytical Chemistry, Inorganic Chemistry and Molecular Toxicology. Part of my job is to make sure nothing we produce interacts with the endocrine system. That means I know a lot about how it works and how it works in conjunction with metabolism.
Last I looked (about 8 months ago) there were 18 estrogen types available for use. All had purported advantages and disadvantages. You and your doctor have to find a delivery mechanism and a type of estrogen that works for you. You also have to determine the levels you should be at as there is no real agreement out there in the medical community. This is in part because the effectiveness of E is also dependant on the levels of T and possibly progesterone (plus others that no one talks about but that I have to worry about) so things get complicated. A rule of thumb in the medical community seems to be female normal if progesterone is included. Female normal +20% E and -50% T if no progesterone. Injections are tried and true. Pills can be good but may not be. Blah, blah, find the one that works.
As far as "bioidentical hormones" From Harvard Medical Publications – 2006 – "The interest in a more natural approach to hormone therapy has focused attention on bioidentical hormones — hormones that are identical in molecular structure to the hormones women make in their bodies. They're not found in this form in nature but are made, or synthesized, from a plant chemical extracted from yams and soy. Bioidentical estrogens are 17 beta-estradiol, estrone, and estriol. (Estradiol is the form of estrogen that decreases at menopause.) Bioidentical progesterone is simply progesterone. It's micronized (finely ground) in the laboratory for better absorption in the body.
Bioidentical hormone therapy is often called "natural hormone therapy" because bioidentical hormones act in the body just like the hormones we produce. But here again, that tricky word natural muddies the waters. Pregnant mares' urine is natural, but Premarin is not bioidentical, at least not to human estrogen. The same goes for Cenestin, which is made from plants but is not bioidentical.
Technically, the body can't distinguish bioidentical hormones from the ones your ovaries produce. On a blood test, your total estradiol reflects the bioidentical estradiol you've taken as well as the estradiol your body makes. On the other hand, Premarin is metabolized into various forms of estrogen that aren't measured by standard laboratory tests. Proponents of bioidentical hormones say that one advantage of bioidentical estrogen over Premarin is that estrogen levels can be monitored more precisely and treatment individualized accordingly. Skeptics counter that it hardly matters, because no one knows exactly what hormone levels to aim for, and symptoms, not levels, should be treated and monitored." To me, there is identical and non-identical. Then there is what I am concerned about..how reactive is that substance when compared to estradiol, esterone and estriol?..what is the bioavailability compared to estradiol, esterone and estriol? Plus another 20 or so other questions. A person can crank around doses of things to get more or less the same effect. Which is what doctors are doing - for good or bad.
Me? I use a "bioidentical" estrogen cream. I do have a metabolic disorder. It's one of the problems DES sons sometimes have. I'm also allergic to the acrylates that are used in patches. The sublingual method should work but I'd like to see data from controlled trials not guesses made by a doctor. I'd do injections if I needed to but the cream is working fantastic – for me.
Jen
Where can I find a list and description of the 18 estrogen types you mentioned. My doctor is probably only familiar with just a few.
HI!!!
Go to RxList.com - search estrogen. Scroll down. Given the number of estrogen types and delivery methods, it works out to 87 possible combinations (but that includes a couple vaginal gels). They do 20 at a time. Here are the first 20....
Brand Name: Prempro, Premphase
Generic Name: Conjugated Estrogens, Medroxyprogesterone AcetateBrand Name: Cenestin
Generic Name: Synthetic conjugated estrogensBrand Name: Premarin
Generic Name: Conjugated EstrogensBrand Name: Duavee
Generic Name: Conjugated Estrogens and Bazedoxifene TabletsBrand Name: EEMT
Generic Name: Esterified Estrogens and Methyltestosterone TabletsBrand Name: Enjuvia
Generic Name: Synthetic Conjugated Estrogens, BBrand Name: Delestrogen
Generic Name: Estradiol valerateBrand Name: Estratest
Generic Name: Esterified Estrogens and MethyltestosteroneBrand Name: Menest
Generic Name: EstrogensBrand Name: Premarin Injection
Generic Name: Conjugated Estrogens for InjectionBrand Name: Premarin Vaginal Cream
Generic Name: Conjugated Estrogens Vaginal CreamBrand Name: Activella
Generic Name: Estradiol, Norethindrone AcetateBrand Name: Femhrt
Generic Name: Norethindrone Acetate, Ethinyl EstradiolBrand Name: Climara Pro
Generic Name: Estradiol, Levonorgestrel TransdermalBrand Name: EstroGel
Generic Name: Estradiol GelBrand Name: Esclim
Generic Name: Estradiol TransdermalBrand Name: CombiPatch
Generic Name: Estradiol, Norethindrone Acetate Transdermal SystemBrand Name: Estrace Vaginal Cream
Generic Name: Estradiol Vaginal CreamBrand Name: Alora
Generic Name: Estradiol Transdermal SystemBrand Name: Angeliq
Generic Name: Drospirenone and Estradiol
Quote from: JLT1 on May 30, 2014, 09:54:54 PM
HI!!!
Go to RxList.com - search estrogen. Scroll down. Given the number of estrogen types and delivery methods, it works out to 87 possible combinations (but that includes a couple vaginal gels). They do 20 at a time. Here are the first 20....
Brand Name: Prempro, Premphase
Generic Name: Conjugated Estrogens, Medroxyprogesterone AcetateBrand Name: Cenestin
Generic Name: Synthetic conjugated estrogensBrand Name: Premarin
Generic Name: Conjugated EstrogensBrand Name: Duavee
Generic Name: Conjugated Estrogens and Bazedoxifene TabletsBrand Name: EEMT
Generic Name: Esterified Estrogens and Methyltestosterone TabletsBrand Name: Enjuvia
Generic Name: Synthetic Conjugated Estrogens, BBrand Name: Delestrogen
Generic Name: Estradiol valerateBrand Name: Estratest
Generic Name: Esterified Estrogens and MethyltestosteroneBrand Name: Menest
Generic Name: EstrogensBrand Name: Premarin Injection
Generic Name: Conjugated Estrogens for InjectionBrand Name: Premarin Vaginal Cream
Generic Name: Conjugated Estrogens Vaginal CreamBrand Name: Activella
Generic Name: Estradiol, Norethindrone AcetateBrand Name: Femhrt
Generic Name: Norethindrone Acetate, Ethinyl EstradiolBrand Name: Climara Pro
Generic Name: Estradiol, Levonorgestrel TransdermalBrand Name: EstroGel
Generic Name: Estradiol GelBrand Name: Esclim
Generic Name: Estradiol TransdermalBrand Name: CombiPatch
Generic Name: Estradiol, Norethindrone Acetate Transdermal SystemBrand Name: Estrace Vaginal Cream
Generic Name: Estradiol Vaginal CreamBrand Name: Alora
Generic Name: Estradiol Transdermal SystemBrand Name: Angeliq
Generic Name: Drospirenone and Estradiol
Wow! That's a lot. Thanks I'll take a look at RXlist.
Quote from: teeg on May 30, 2014, 11:53:12 AM
Topical estrogens could be compared to sublingual administration in terms of level variance. Such varying levels can't be healthy for the body or progress.
Gel or patch delivers a much more constant stream of estradiol than sublingual with estradiol to estrone ratio being about 1:1 consistently.
Quote from: ytxwmb on May 30, 2014, 10:17:52 AM
My endo specialises in trans patients and put me on pills. I asked him about the "dangers" because I am well over 40 years old. He told me that the dangers relate to premarin and ethyl estradiol neither of which are used any more. He told me that modern medications are bioidentical and put no strain on the liver.
So I can believe an Endo with experience of thousands of trans patients or .... people on the internet.
As long as you are on Estradial Valerate or HemiHydrate then you have nothing to worry about.
I've always mentioned this but always got criticized. :( Finally, a doctor that confirms this! Thank goodness. :) And besides, the issue seems to be much more the clotting than liver strain as every time the estrogen passes through the liver, proteins/enzymes production is affected influencing coagulation.
Quote from: JLT1 on May 30, 2014, 04:48:26 PM
The sublingual method should work but I'd like to see data from controlled trials not guesses made by a doctor.
There have been several studies about sublingual administration of estradiol in women. I saved a few of those and have the full studies. Sublingual works! But, just that levels vary a lot on them and thus, can cause neurological symptoms due to fluctuations.
Quote from: JLT1 on May 30, 2014, 09:54:54 PM
HI!!!
Go to RxList.com - search estrogen. Scroll down. Given the number of estrogen types and delivery methods, it works out to 87 possible combinations (but that includes a couple vaginal gels). They do 20 at a time. Here are the first 20....
Brand Name: Prempro, Premphase
Generic Name: Conjugated Estrogens, Medroxyprogesterone AcetateBrand Name: Cenestin
Generic Name: Synthetic conjugated estrogensBrand Name: Premarin
Generic Name: Conjugated EstrogensBrand Name: Duavee
Generic Name: Conjugated Estrogens and Bazedoxifene TabletsBrand Name: EEMT
Generic Name: Esterified Estrogens and Methyltestosterone TabletsBrand Name: Enjuvia
Generic Name: Synthetic Conjugated Estrogens, BBrand Name: Delestrogen
Generic Name: Estradiol valerateBrand Name: Estratest
Generic Name: Esterified Estrogens and MethyltestosteroneBrand Name: Menest
Generic Name: EstrogensBrand Name: Premarin Injection
Generic Name: Conjugated Estrogens for InjectionBrand Name: Premarin Vaginal Cream
Generic Name: Conjugated Estrogens Vaginal CreamBrand Name: Activella
Generic Name: Estradiol, Norethindrone AcetateBrand Name: Femhrt
Generic Name: Norethindrone Acetate, Ethinyl EstradiolBrand Name: Climara Pro
Generic Name: Estradiol, Levonorgestrel TransdermalBrand Name: EstroGel
Generic Name: Estradiol GelBrand Name: Esclim
Generic Name: Estradiol TransdermalBrand Name: CombiPatch
Generic Name: Estradiol, Norethindrone Acetate Transdermal SystemBrand Name: Estrace Vaginal Cream
Generic Name: Estradiol Vaginal CreamBrand Name: Alora
Generic Name: Estradiol Transdermal SystemBrand Name: Angeliq
Generic Name: Drospirenone and Estradiol
Of this list, there are really 5 types of estrogen and there is even a sixth which is sometimes prescribed to menopausal women, estriol. The 5 types are Ethinyl Estradiol (usually found in birth control pills), Equilin estrogens (found in Premarin), Estrone (or Estrone Sulfate, the conjugated/inactive form that is later converted to Estrone), 17 beta Estradiol and Estradiol Valerate (which only becomes active when converted to 17 beta estradiol in the body).
In the human body, there are 3 estrogens. Estradiol being the strongest, then Estrone and finally Estriol which is much weaker. Estradiol and Estrone convert back and forth to each other. Estrone converts to Estriol. In pre-menopausal women, usually, there is twice as much as Estradiol than Estrone. During pregnancy, all 3 estrogens are high, with Estradiol still being the predominant one. At menopause, Estrone is the dominant estrogen.
Kay,
You are correct; there are five types of estrogen on the list. My 18 number was the types of estrogen used to manufacture pharmaceuticals. For example, conjugated estrogens are used in pills (like Premarin). However, they are metabolized to estradiol in the body. Conjugated estrogens are supposed to pass through the stomach better. I have a hunch is marketing....
Hugs girl,
Jen
Quote from: JLT1 on May 31, 2014, 09:35:01 AM
For example, conjugated estrogens are used in pills (like Premarin). However, they are metabolized to estradiol in the body.
Actually, the most predominant estrogens in Premarin are Estrone and Equilin (horse) estrogens. There ends up being very little estradiol in the body.
Hugs :)
Quote from: KayXo on May 31, 2014, 09:30:13 PM
Actually, the most predominant estrogens in Premarin are Estrone and Equilin (horse) estrogens. There ends up being very little estradiol in the body.
Hugs :)
Premarin is >50% Esterone (actually esterone sulfate) and 15-20% Equilin (Equilin Sulfate). The bulk of the esterone sulfate is converted into estrone and then into estradiol (when estradiol levels are low).
Right. But, in the overall picture, estradiol seems to play a weaker role. Isn't it Estrone Sulfate and not Esterone?
Good catch on the spelling error....I'd have never made it through college or grad school without spell check.
You could be correct or you might not be. I don't know. There can be changes in the distribution of estrogens depending on things like diet. Premarin though makes me uneasy. If you look at the estrogen metabolism map, Estrone can convert to estradiol, Estrone sulfate (which is easy to eliminate) and 2-OH-estradiol (thats the breast cancer estrogen). Given both rapid uptake and rapid elimination, the dose has to be high. Given variability in metabolism, the 2-OH-estradiol formation is quite probable and could be at relatively high levels. The manufacturer has been sued for causing cancer but won. Still, it just bothers me.
Hugs
Jen
Studies have shown that Premarin alone (without Provera) actually decreases breast cancer risk.
I don't think much estrone ends up being converted to estradiol; if that was the case, then orally, there should be much more estradiol on oral estradiol (i.e. Estrace, Estrofem, Elleste Solo, Progynova, etc). Estrone to Estradiol ratio ends up being 5:1. And about that 2-OH-estradiol causing breast cancer, I'm personally not convinced. I think it's more the lack of estrogen and/or the cycles that might contribute to increased breast cancer risk based upon all the evidence I've come across.
In blood panels... Which are the E-levels we are to actually look for.. or is it all of them?
Usually, E2 or estradiol (the strongest estrogen) is the one doctors are most interested in. But doctors disagree about what levels are good, it also depends on the individual's sensitivity and some doctors just don't care.