"Sensitivity and meta-regression analysis revealed that the dose/type of T used, in particular the possibility of aromatization, explained the heterogeneity in findings observed on bone density and HDL-cholesterol among studies"
This is a 12 year study which they didn't keep estradiol under control. A huge variable they're not taking into account.
Here's a more recent study of effects of TRT on cardiovascular system. But again no mention of estridol levels and/or management.
https://jamanetwork.com/journals/jama/fullarticle/2603929

Personally, my PCP nor two separate endocrinologist even mentioned estradiol. Learned that from you guys and and I'm so grateful.