this, there's no clinical data to support a testosterone to E2 ratio simply put 100 is high
There is no clinical data at all for managing asymptomatic e2 elevation on supraphysiological T. Absence of evidence is not evidence of absence.
AIs can exert side effects independent of their serum e2-lowering effects (e.g by affecting peripheral and localised aromatisation)
High androgenicity can also antagonise some but not necessarily all e2 effects. Just look at the guys running mast who experience low e2 symptoms despite high e2 in serum.
In my opinion, e2 should be managed based on: Non-E2 biomarkers > feels > e2 levels
Some people unironically suppress their e2 despite feeling worse for doing so, and despite hurting other biomarkers such as their lipids.
In my opinion, the people who believe in a ratio are nitwits, and the people who believe in absolute e2 levels are also nitwits.
E2 exerts many effects, many of which can be measured and/or felt. That is where your attention should go. If your BP and lipids are the same regardless of e2, and if you experience no change in symptoms regardless of e2, then get your e2 at the high end of the normal range and call it a day. High-normal is your best bet, but biomarkers and feels triumph 100% of the time.
SHBG levels, androgen receptor sensitivity, and estrogen receptor sensitivity can all have huge variations between individuals. So any target ratio or absolute value is completely meaningless without it being individualised to you yourself.
I appreciate that people like clean advice. “20:1 ratio bro” is clean advice. “In range bro” is clean advice. “Go at the high end of normal, then titrate your e2 up and down and assess biomarkers and symptoms and reassess periodically over the course of a few years to find what works for you” is not clean advice. It’s complicated, and it takes time, but it is the best advice.