Two of my doctors like to add Estriol to the mix. It is a weaker estrogen, supported by some Japanese studies for overall health-heart, brain, bones, etc. but doesn’t help vasomotor symptoms as much, which I’ve never had. I was 13 years past hysterectomy and removal of one ovary and four years past removal of last ovary, which I think had ceased functioning two years prior to beginning hrt. I use NTX serum and urine and P1NP to monitor. We will also use a 24 hr. Urine from Rhine Labs to monitor hormone levels rather than just serum. But, I will also look at serum hormone levels. All approved by oncologist, cardiologist, endocrinologist, but prescribed by Obgyn and functional med dr. Hope that helps!