There is a lot of literature available about the increased risks of long term oral estradiol, and most doctors would recommend switching to transdermal therapies, but your post seems to be more about post surgery HRT strategies?
I am a believer of using minimum medications, and post my surgery 5 years ago, my doctor and I have been slowly lowering my dosage. I am in my 70's, but our plan is not to go to post menopausal levels many doctors aim for, and this is because I do experience menopausal symptoms if my levels fall too low. The standards many doctors rely on are for cis women, and most are based on an outdated report ( the Women's Health Initiative) which is written around older synthetic hormones which have greater health risks than modern bio identical hormones.
So, we need to let our doctors know our expectations, like feeling healthy and not suffering menopause symptoms, and develop a hormone plan to achieve this. My doctor has switched me to inserted pellets as they provide the most even delivery, and best of all, only need to be inserted around once per year. My care is more based around how I am feeling rather than arbitrary levels prescribed for 'average' cis women.
Best wishes for your surgery and recovery! My surgeon made me cease hormones for my perioperative period, and I had severe menopausal symptoms in hospital including headaches and night sweats, which complicated my post surgery care as it can also indicate infection (which didn't happen). Current advice is to not cease hormone treatment in the perioperative period so you have the best post surgery recovery. Also, hormone interruption has been linked to post op depression. Make sure you discuss this with your surgeon well before your surgery date. My surgeon in Melbourne changed his policy on this after my surgery as I gave him the papers with current recommendations.
Hugs,
Allie
