Estradiol monitoring in women on menopausal hormone therapy remains one of the more contested — and underutilized — practices in clinical menopause care. In this session, Drs. Sarah Glynne and James Simon build the clinical case for when and why estradiol level assessment matters: from optimizing symptom relief and avoiding undertreatment to informing individualized dosing decisions and managing safety in complex patients, including those with a breast cancer history. Drawing on both the evidence base and extensive clinical experience across distinct practice settings, they will offer a practical, nuanced framework for integrating estradiol monitoring into hormone therapy management — and examine what the data actually supports versus where clinical judgment must fill the gaps.
James A. Simon, MD, CCD, MSCP, IF, is a Clinical Professor of Ob/Gyn at George Washington University in Washington DC, specializing in gynecology, reproductive endocrinology, menopausal, and sexual health at his private practice, IntimMedicine Specialists®. With over 400 completed clinical research trials, Dr. Simon has received grants from prestigious sponsors such as the NIH and the AHA. Notably, he served as Sprout Pharmaceuticals’ Chief Medical Officer during the development of the first FDA-approved medication for women’s sexual health. Dr. Simon holds the unique distinction of being the only physician to have served as President of both the North American Menopause Society (NAMS), currently The Menopause Society (TMS), and the International Society for the Study of Women’s Sexual Health (ISSWSH). Nicknamed “The Menopause Whisperer” by Washingtonian Magazine, he has also received numerous accolades, including selection as one of "Top Washington Physicians" and “The Best Doctors in America,” and the NAMS-Leon Speroff Outstanding Educator Award. Dr. Simon is an accomplished author with over 800 publications, including the book, Restore Yourself: A Woman’s Guide to Reviving Her Sexual Desire and Passion for Life".
Sarah Glynne, MBChB, MRCOG, is an experienced GP and Menopause Specialist. Based at The Portland Hospital in London, she is trained to provide consultation across all aspects of menopause care and to support women with complex menopause-related health needs. She has a special interest in menopause care for women with a history of breast cancer.
Dr Glynne graduated from Imperial College School of Medicine with first-class Honours in Physiology (BSc), and distinctions in Pathology and Surgery. She undertook general medical training at Northwick Park Hospital and University College Hospital before switching to a career in General Practice in 2005. She is an accredited member of both the Royal College of Physicians and the Royal College of General Practitioners. In 2016, she completed a Master of Science (MSc) degree in allergy and immunology at Imperial College, passing her exams with distinction. Since 2020, her practice and academic interests have focused solely on menopause.
Dr. Glynne is active in research and has published extensively on clinical outcomes in women treated with hormone replacement therapy (HRT), including testosterone, and the role of HRT after breast cancer diagnosis. She co-authored two chapters in the 2025 book Principles of Precision Hormone Therapy for Healthy Aging. She contributed to the updated British Society of Sexual Medicine Position Statement on the Management of Genitourinary Syndrome of the Menopause (GSM). She served as a clinical advisor for the recently published NICE technology appraisal on the use of fezolinetant for the treatment of menopausal vasomotor symptoms (ID5071). She is currently working with Professor Jayant Vaidya, Professor of Breast Surgery and Oncology, setting up a clinical trial to study breast cancer and non-breast cancer outcomes in women who choose to take HRT after breast cancer (the Menopausal Hormone Therapy Outcomes After Breast Cancer trial, or MENO-ABC trial). More information about the study can be found here: https://www.londonbreastcancer.com/meno-abc-trial.
Dr. Glynne is passionate about teaching and education and has created several patient resources to support shared decision-making and patient-centered menopause care. She is a member of the British Menopause Society, The Menopause Society (aka the North American Menopause Society), and the International Menopause Society.