nyaowowooo, as my opinion the “underdosed” are measureable, despire estrogen insenstivity is rare, but we have different sensitivity anyway, the body when thinks hormones are enough will suppress HPG axis so hypothalamus like “ugh we havee enough hormones, gonna shut off GnRH production” and then pituary gland LH/FSH production as well, which will turn off gonads, BUT!! measuring gonad supression only by “high E2”, “low T” is completly incorrect, i found funny how doctors often forget about measuring LH, and despire zero LH the testosterone can be still elevated, because some ppl have stuff like backdoor producion from adrenal glands, disease like adrenal hyperplasia just exist

SHBG also interesting stuff, but its can be completly depends on just hormone spikes, women with rare estrogen insentivity syndrome can have 3000pg of estradiol but still have 40nmol of SHBG