Do You Really Need an Estradiol Blood Test During Menopause?
At Sirona Health, we know that navigating menopause can feel like stepping into a maze of symptoms, tests, and conflicting advice. One question we often hear is:
“Should I have my estradiol levels checked to see if my HRT is working?”
The latest guidance from the British Menopause Society (BMS) sheds light on this topic—and the answer may surprise you.
Why Measuring Estradiol Isn’t Always Helpful
Hormone Replacement Therapy (HRT) is designed to relieve symptoms like hot flushes, night sweats, mood changes, and sleep disturbances by restoring estrogen levels. However, the BMS highlights that a single estradiol blood test often tells us very little about how well your treatment is working.
Why?
Estradiol levels fluctuate naturally, especially during the perimenopause, making one-off tests misleading.
There is no “ideal” estradiol level for symptom relief or long-term health protection.
The same estradiol dose can affect women very differently due to genetics, metabolism, and other factors.
For women using oral estrogen, most of it is converted into another form (estrone), which isn’t measured by a standard estradiol test.
Instead of focusing on a number, how you feel is the real measure of success.
A Holistic Approach Works Better
At Sirona Health, we tailor your HRT to your unique symptoms and health needs rather than chasing a blood test result.
If symptoms persist, we may:
Adjust your HRT dose or delivery method (patch, gel, tablet, spray).
Consider other factors such as stress, sleep, and lifestyle.
Offer holistic health assessments to address the full picture of your well-being.
What About Bone and Heart Health?
The BMS confirms that HRT helps protect bone density and reduce fracture risk, even at low estrogen levels. There is no clear threshold of estradiol needed for this benefit. Similarly, while HRT can reduce cardiovascular risk when started early, blood estradiol levels don’t determine this protective effect.
When Might Estradiol Testing Be Useful?
Estradiol blood tests can have a role for younger women with premature ovarian insufficiency (POI) or certain cases of hypogonadism. Even then, results are always interpreted alongside symptoms, bone health, and overall well-being.
Your Menopause Journey, Your Way
If you’re wondering whether your HRT is working—or whether you need it at all—our Women’s Health Consultations and Holistic Health Assessments are designed for you.
Dr. Georgina Standen, our expert in women’s health and menopause, will help you create a plan that addresses both symptoms and long-term health, without unnecessary tests or confusion.
Ready to take control of your menopause journey?
Book your consultation at www.sironahealth.co.uk/appointments.
About the Author
Dr Georgina Standen is a Women’s Health GP and Medical Director of Sirona Health. She specialises in menopause care, hormonal health, and holistic health assessments for women navigating midlife. Dr Standen combines evidence-based medicine with personalised, compassionate care.