My first transdermal 0.025mg blood test will be on June 27th. My doctor said, she only expects this blood test to show a minimal estradiol increase. Part of the plan is not to flood my system with systemic estrogen and let my body adjust slowly. As much as I would like to start the .05 right now it's probably prudent to do it this way since I haven't had significant levels of estrogen for years. In your reply to "Did the topical cream give you a meaningful blood level" When I was using a topical estradiol cream (compounding with some testosterone) my concern was stopping my hot flashes. I did not have any bone loss at this time. So, as far as meaningful levels to support bone I don't know. I have learned that topical systemic estradiol creams are inefficient at providing a steady level of estrogen and transdermal patches are superior. I have not had a CTX. I'm unclear if it's necessary. I will ask my endocrinologist your question on May 1st.
The research shows that .05 mg 2x a week is the lowest transdermal patch dose effective in slowing down bone loss or preserving bone level. Effective estradiol blood serum levels are between 40 and 80 with 50-60 being a good range. Depending on the person you may need a higher dose to get these serum levels. As a side note, the last time I used transdermal patches they didn't stay on very well since I was in the pool a lot and like to take long baths. This time I'm wearing a Max Hold waterproof band-aid over the patch.