Hi Pippa
I'm not an expert on this but estradiol hemihydrate is two molecules of 17B estradiol joined together with a water molecule. Because it is readily converted into 17B estradiol in the body it's considered the same active ingredient. In terms of using one form or another in different HRT products - I Have no idea whether companies have changed from using the single molecule 17 B estradiol to the hemihydrate - or whether it is just a difference in labelling. Either way the amount of estradiol in any product will be exactly the same so the same concentration (and the biochemistry of it all is beyond me - long time since my degree!).
Here is what it says on Wikipedia:
"Hemihydrate
A hemihydrate form of estradiol, estradiol hemihydrate, is widely used medically under a large number of brand names similarly to estradiol.[166] In terms of activity and bioequivalence, estradiol and its hemihydrate are identical, with the only disparities being an approximate 3% difference in potency by weight (due to the presence of water molecules in the hemihydrate form of the substance) and a slower rate of release with certain formulations of the hemihydrate.[169][170] This is because estradiol hemihydrate is more hydrated than anhydrous estradiol, and for this reason, is more insoluble in water in comparison, which results in slower absorption rates with specific formulations of the drug such as vaginal tablets.[170] Estradiol hemihydrate has also been shown to result in less systemic absorption as a vaginal tablet formulation relative to other topical estradiol formulations such as vaginal creams.[171] Estradiol hemihydrate is used in place of estradiol in some estradiol products."
I'm wondering if as you say, your oestrogen dose is too high - as you are 70 you should be able to function on far less than someone younger and ideally be flush and sweat free from a much lower dose. Certainly I wouldn't want to have high blood oestrogen levels at 70 only because there hasn't been much research I don't think in long term use in older women? Just realised I might have misunderstood your post - when you said you oestrogen level was low at 69, I thoigh you meant age 69 - maybe you meant pmol/l, ie the actual oestrogen reading? That would be low - but a one off result doesn't necessarily mean it's correct...
Having said that - it is much harder if you have had surgical menopause with no ovaries. Do you or have you taken any testosterone or not felt you needed it?
Have you thought of patches - I feel these may give you a more stable dose than chopping and changing with different gels and Lenzetto - all of those types of HRT are far more likely to be variable because of rubbing or spreading the gel on your body and the area covered may vary and the amount absorbed dependent also on your skin, thickness and temperature....?
Sorry I can't really help and hope all goes well with your consultation appt
Hurdity x
