Why You Shouldn’t Rely on Estradiol During Perimenopause

As a hormone specialist here in Scottsdale, one of my core missions is to educate, enlighten, and empower women—especially those navigating the often-overlooked transitions of perimenopause and menopause.

There is a staggering amount of misinformation out there. Much of it is outdated, incomplete, or simply not discussed at all. I recently received a call from a woman in perimenopause who had been researching hormone therapy. She was curious about estradiol and had been analyzing her lab values, hoping to determine the right path forward. While I deeply respect the initiative it takes to advocate for your own health, there’s a critical piece many women—and even some providers—miss when it comes to this phase of life.

During perimenopause, estradiol levels fluctuate significantly, often from one day to the next. This unpredictability makes it risky—and clinically inappropriate—to base treatment solely on lab values. If we were to add estradiol during this time, especially when levels may already be high one day and double the next, it can be like pouring gasoline on a fire. One serious concern? An overstimulated endometrial lining, which may lead to complications such as endometrial hyperplasia or even cancer.

This is why progesterone is so important. Even if estradiol isn’t being prescribed yet, many women in perimenopause benefit tremendously from bioidentical progesterone. It helps calm the nervous system, ease anxiety, improve sleep, reduce hot flashes, and support clearer thinking. The form of progesterone we use is molecularly identical to what your body naturally produces—meaning it’s both safe and familiar to your system.

Later, if and when estradiol is introduced during menopause, progesterone remains essential. It plays a protective role—not just for the uterus, but for the breasts and brain as well.

This particular caller had been gathering information from ChatGPT and other AI tools. And while I believe AI can be an incredible resource, it’s important to remember that it pulls information indiscriminately from across the internet—some of it accurate, some of it not. 

When it comes to your health, you deserve advice that’s personalized, evidence-based, and guided by a licensed expert who understands your full picture. If you’re navigating perimenopause or menopause and are unsure of what steps to take, I’d love to connect with you one-on-one. Hormone therapy is not one-size-fits-all. Your care should reflect you. You don’t have to go through this alone—and you deserve more than confusing information and guesswork. Let’s walk this journey together, schedule your consultation with me today or give me a call at (480) 589-3999.