Low estradiol during perimenopause does not necessarily necessitate supplementation and can be determined on an individual basis. In perimenopausal women, ovarian function decreases and estrogen level drops. Due to differences in body type, living environment and mental state, some women do not have obvious symptoms of perimenopausal syndrome such as hot flashes, night sweats, headache and palpitations. Or they may have mild symptoms, which can be relieved through psychological counseling, lifestyle modification and other general treatments. These women do not need estrogen supplementation. For some women, estrogen supplementation is recommended because low estrogen levels produce significant perimenopausal symptoms such as hot flashes, sleep disturbances, vaginal pain, and difficulty having sexual intercourse, which seriously interfere with daily work and life. Contraindications such as sex hormone-dependent tumors; suspected or confirmed breast cancer need to be excluded before using estrogen supplementation therapy. Low estradiol in perimenopause should be promptly consulted and appropriate treatment should be given under the guidance of specialized doctors. Do not use medication privately, as this may cause discomfort to the body.