During HRT, providing sufficient estradiol aims to lower FSH to around 20-30 to control vasomotor symptoms, cardiovascular risk factors, and bone loss.

“what we're doing is we're giving her enough estradiol that her FSH usually ends up hovering around 20 to 30. again that's still a pretty high level of FSH um meaning that's still got the brain thinking I want more estradiol but you don't need to give maximum amounts of estradiol we're simply trying to control the vasomotor symptoms so the hot flashes the night sweats the vaginal symptoms atrophy dryness and perhaps most importantly cardiovascular risk factors and Bone risk factors”