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[Zoe]

Ellie - thanks for this. Hopefully the BMS will update its guidance to say exactly what it means but respect the judgement of suitably qualified menopause specialists.

The amounts of oestrogen involved in 1 pump of oestrogel, for example, are very small. 1 pump is roughly equivalent to 25mcg, which should raise blood levels by approx 100 pmol/l. BUT it all depends on how someone absorbs it.
Some women just won't get that amount of oestrogen from it.

I agree with the BMS that blood levels are not much use in perimenopause so symptoms are the issue. And this is why an individualised approach is necessary. I can only speak to my own experience of a very vigilant private menopause specialist.

[Emma]

Dr Currie has posted on this here
https://www.menopausematters.co.uk/forum/index.php?topic=64312.msg889860#msg889860