PSA
NHS England sets a very restrictive estradiol level target range for trans fem patients.
This arbitrary range is 400 to 600 pmol/L (~109 to ~163 pg/mL)
This restrictive range is below the level required for monotherapy, so will require a blocker for anyone with testosterone-producing gonads
It is ALWAYS valid to manipulate your estradiol dose before a test, so it looks like your level is within this range.
For those unaware, estradiol monotherapy typically involves keeping your estradiol above 200-250 pg/mL (~734 to ~918 pmol/L) in order to suppress gonadal testosterone production.
As it doesn't require a blocker, you can avoid the risks & side effects associated with these.
NHS England doesn't offer estradiol injections & doesn't support monotherapy.
As such, if you require suppression of gonadal testosterone production, you'll need to request a blocker.
As standard, NHS England used to offer trans patients GnRH agonists like triptorelin (Decapeptyl®). These are often referred to as puberty blockers & have a very good safety profile, plus they're super effective.
However, NHS England seems to be trying to cut costs recently by instead offering NO blocker or, at best, offering the awful spironolactone.
It is again always valid to fake common side effects from such drugs in order to get a better one.
You deserve high quality healthcare.