One of the inadvertent mistakes I often see in hormone replacement therapy involves a patient who believes her current dosage is not working effectively. She stops using the tablet/topical cream/vaginal cream/sublingual troche for a month or longer and then requests hormone testing from her physician to correct her dosage. The hormone levels at that time are going to reflect her baseline and not deliver any information at all about the ineffective dosage. Baselines (hormone levels prior to any treatment) for post-menopausal women show high FSH, low estradiol and low progesterone. In addition, if the patient has gone more than 60 days without her hormone replacement, her symptoms may also evolve and change. So, the original symptoms or concerns can get lost and not addressed.
Instead of discontinuing, the patient should continue the current medication and report all symptoms to the physician. The physician may adjust the dosage based on the symptoms alone or request further testing. This testing will be done while the patient is on the current dosage so the physician can gather more information about the current therapy and make informed decisions to correct the dosage.
Another factor to keep in mind would be any initiation or change in dosing can take up to 60 days for full symptomatic effect so changing dosage or testing prior to that time would not be productive.