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Trough estradiol levels and MADRS Tooltip Montgomery–Åsberg Depression Rating Scale scores with 1 mg sublingual micronized estradiol 3 to 8 times per day (3 to 8 mg/day total; mean 4.8 mg/day total) in women with postpartum depression. [8] Blood was drawn specifically in the mornings before the first dose of sublingual estradiol for the day. [8]
In the normal menstrual cycle, estradiol levels measure typically <50 pg/mL at menstruation, rise with follicular development (peak: 200 pg/mL), drop briefly at ovulation, and rise again during the luteal phase for a second peak. At the end of the luteal phase, estradiol levels drop to their menstrual levels unless there is a pregnancy.
A higher dosage of estradiol gel containing 1.5 mg estradiol per daily application has been found to produce mean estradiol levels of 40 to 100 pg/mL and estrone levels of 90 pg/mL, while 3 mg per day has been found to result in respective mean estradiol and estrone levels of 60 to 140 pg/mL and 45 to 155 pg/mL. [15]
Mean estradiol levels during 1 to 8 mg/day oral estradiol therapy alone or in combination with 100 to 200 mg/day spironolactone in transgender women. [ 3 ] Percent change in estradiol (E2), estrone (E1), LH, and FSH levels over a 24-hour period following a single dose of 2 mg oral estradiol in women.
In another study, a dosage of 1 mg/day oral micronized estradiol in healthy older men, which increased circulating estradiol levels by a relatively high amount of 6-fold (to 159 pg/mL), estrone levels by 15-fold (to 386 pg/mL), and SHBG levels by 17%, was found to suppress total testosterone levels by 27% (to 436 ng/dL) and free testosterone ...
Estradiol levels with 50 to 100 μg/day transdermal estradiol patches applied to the forearm and to the scrotum in a crossover study in 2 men with prostate cancer. [14] In 35 men treated continuously with one 100 μg/day estradiol patch scrotally, the mean estradiol level was ~500 pg/mL (range ~125–1,200 pg/mL).
“It just circulates in the bloodstream at a much lower level than in men,” says Somi Javaid, MD, a board-certified ob-gyn and founder of HerMD, a women-focused healthcare center.
Although promoted as a way of customizing treatment, hormone therapy does not require customization; [38] the use of testing to determine the number of hormones administered could result in the dose being higher than the minimum recommended level to alleviate symptoms, [2] [8] or the administration of unnecessary hormones to asymptomatic women ...
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