08/31/2026
One pattern I am seeing with new patients coming into my practice is that many are already taking bioidentical hormone replacement therapy (BHRT) and report that they “feel good.” While feeling better is absolutely important, it is only one piece of the bigger picture.
Hormone therapy may be used for more than symptom relief. Depending on the individual, appropriate estrogen therapy can also play an important role in supporting bone health and helping prevent the accelerated bone loss that occurs with estrogen deficiency during and after menopause.
This is why I believe it is important to periodically evaluate whether your hormone therapy is truly optimized for your individual goals, not simply whether your hot flashes are gone or whether you feel better day to day.
For some patients, I use DUTCH testing as one additional tool to evaluate hormone metabolism and estrogen exposure. When evaluating dried urine estradiol, I may look for levels around or above 0.7 ng/mg as part of the overall clinical picture when bone support is one of our treatment goals. However, there is no single hormone number that is appropriate for every woman, and results must always be interpreted in the context of your age, symptoms, medical history, route and dose of hormone therapy, and individual risk factors.
The goal is to make sure that your treatment plan is supporting both how you feel today and your long-term health goals.
If you are currently on BHRT, feel well, but have never had your treatment plan reevaluated, it may be worth asking: Are my hormones simply controlling my symptoms, or is my treatment truly optimized for my overall health goals?
Jacqueline Trcka