Low estradiol levels (less than 5 pg/mL) may indicate ineffective biestrogen therapy.

“We'll check their levels. And I don't know if you find this, but their estradile level is essentially zero. It's less than five. And I'm saying, listen, I think you're just using fancy lotion. I think you're paying a lot of money to put nice lotion on you. And I don't know that it's protecting your bones. And if we're using this to protect your bones or to stop your hot flashes or to help with your sexual health, maybe we use the formulations that are a little bit better studied and that, you know, I know are absorbing in your body because I can prove it.”