Yes Tempest - the inter-individual variation is enormous in how much women absorb estradiol from the different methods! In fact have just checked my go to source paper for all of this and this is the same for patches and tablets ie lack of consistency between individual women - and also depends on other external factors.
I hadn't come across the info about estradiol being “held†in the skin so that's interesting. This source paper I usually quote from about absorption and which I have posted about before, suggests up to a 10 fold (!) difference in serum levels between some individual women!! Re gel absorption – this also depends on skin area and down to individual technique too because this same paper says that about 10 % of the dose is absorbed by the skin during the 2 min until it dries. I have the quotes and the paper ref if anyone wants them.
"Owing to the large individual differences in the resorption and metabolism, there are considerable interindividual variations in the course and height of the serum concentrations of sex steroids in women treated with the same preparation. The coefficients of variation are usually in the range between 30 and 60%. The interindividual variations are mainly due to genetic or acquired differences in the intestinal and hepatic metabolism,while the intraindividual variations from day to day may be caused by external factors like diet, alcohol or drug consumption, smoking, physical activity, stress, etc., which may cause rapid and transitory changes in peripheral or splanchnic blood flow, absorption or metabolism. Certain diseases, e.g. disorders of the thyroid gland, may also affect estrogen metabolism."
"Using patch or gel, there are large interindividual variations in the estradiol levels, which may differ by up to a factor of 10, and, in as much as 30% of the patients treated with a 50 mg patch, the estradiol concentrations are low. There are also considerable short-term intraindividual changes in the estradiol levels"
"The application of a hydro-alcoholic gel containing estradiol results in a rapid penetration of the estrogens into the stratum corneum; this stops after drying of the gel on the skin. As the absorption is proportional to the surface of application, deviations from the instructions may cause variations in the estrogen level and clinical efficacy. About 10% of the dose is absorbed by the skin during the 2 min until drying. The estradiol is stored in the stratum corneum and permeates through the epidermis into the dermal capillaries according to the concentration gradient between the stratum corneum and blood. This diffusion lasts for 2–14 h."
If you do not experience symptoms on the dose you are taking but these return when stopping or reducing then the oestrogen level is likely to be adequate for protection against osteoporosis I presume - without measuring levels. However if you are post-menopausal and symptoms do not return when you reduce oestrogen or stop, and you need to maintain oestrogen levels for osteoporosis protection - then this surely can only be ascertained through measuring blood serum levels when you take oestrogen - so that you know they adequate. Interesting Meeka because I would have assumed from the amount you are using that your levels would be much higher!
Don't forget girls that there is Sandrena gel if you are using oestrogel and not getting good levels. Sandrena is more concentrated so more likely to get more oestrogen into your system from a given amount of gel! I think oestrogel is more popularly prescribed?
Hurdity x