I think Dr Gersh would prefer I was on .05 but I'm a hold out. I might just stay on the .037, have a dexa in 2 years and reevaluate then. Or if I don't see any breast tenderness, I might increase my dose. It's really a balancing act of keeping risks as low as possible and maintaining bone. When I first went on hormones I was told by several of my doctors that .025 was enough to maintain. Building bone is another story and I think in menopause it's quite difficult. Just think that in our lifetimes, we have estrogen in our bodies generally until our early 50s but we stop building bone by about age 30. So, supplementing with estrogen after menopause will do more to maintain than build but the higher doses may have a greater effect on increasing density. There are still a lot of unknowns about long term use and starting HRT past menopause so I feel most comfortable with the lower dose. That said, .05 is still considered a low dose so I may be considering it.

Here is a great video interview with Dr Risa Kagan, a gynecologist well informed on hormone use. Unfortunately she no longer sees patients. She discusses dosing in the video.
https://gbmc.webex.com/recordingservice/sites/gbmc/recordinghttps://gbmc.webex.com/recordingservice/sites/gbmc/recording/e6111214853f103bbf7e005056811e38/playback