Estrogen for Bone Density: What It Can — and Can’t — Do
By The HRT Index Editorial Team · Published June 25, 2026 · Last verified: June 25, 2026
Educational research — not medical advice, and not reviewed by a clinician. Sources are linked throughout and listed at the end.
Estrogen for bone density works — but the details decide everything. Only systemic estrogen (the kind that reaches your whole body) meaningfully protects bone, and only somesystemic products are FDA-approved for it — it depends on the exact product. It fits best for women under 60 or within 10 years of menopause who also have menopause symptoms. Low-dose vaginal estrogen is not a bone treatment. And if you already have osteoporosis, a bone-specific medicine usually comes first.
Those distinctions are the whole reason this page exists. Most pages get them wrong — here’s what’s actually true, and how to tell where you fit.
Estrogen may be worth discussing if you:
- ✓Have hot flashes, night sweats, or other body-wide menopause symptoms and a bone worry
- ✓Are younger than 60, or within about 10 years of your last period
- ✓Went through early, premature, or surgical menopause
- ✓Want bone protection as one benefit inside a fuller menopause plan a clinician has reviewed
This page should not send you straight to online HRT if you:
- ⚠Already have osteoporosis or a fragility fracture — that usually needs a bone-specific treatment assessment first
- ⚠Are thinking about estrogen only to prevent future disease, with no menopause symptoms
- ⚠Use only low-dose vaginal estrogen — that treats dryness, not bone
- ⚠Have any bleeding after menopause, or a history (breast cancer, blood clots, stroke, liver disease) that needs a clinician’s review first
Quick read: where to start, based on you
| Your situation | The right first conversation |
|---|---|
| Early postmenopause + bothersome symptoms + bone concern | Talk about systemic menopause hormone therapy |
| Vaginal dryness or urinary symptoms only | Local vaginal treatment — plus a separate bone check |
| Diagnosed osteoporosis or a recent fragility fracture | An osteoporosis treatment assessment, not HRT alone |
| Age 65+, or younger with risk factors | Bone screening or risk assessment first |
The right online HRT provider isn’t the same for every woman — it depends on your symptoms, your age and whether you have a uterus, your medication route preference, your risk history, your insurance or cash-pay situation, and your state. Some situations belong with an in-person clinician first. Use The HRT Index’s Find My HRT Path tool to match your situation to the right provider — and to flag when online care isn’t the right starting point.
Not sure which situation applies to you? The HRT Index’s free quizmatches your symptoms, timing, and risk history to a starting point — and flags when in-person care should come first.
Find My HRT Path →Free · No diagnosis · No pressure
Why does estrogen affect your bones at all?
Estrogen helps control how fast your body breaks down old bone. When estrogen drops at menopause, that breakdown speeds up and you lose bone — fastest in the first few years after your final period. Replacing systemic estrogen slows the breakdown, which is why it protects bone while you take it.
Think of your skeleton as a construction site that never closes. One crew removes old bone. Another crew lays down new bone. For most of your life, the two stay roughly balanced.
Estrogen is one of the managers keeping the “removal crew” in check. When estrogen falls at menopause, that crew speeds up and the “building crew” can’t keep pace. The result is thinner, weaker bone — and the loss is quickest in the years right around your last period. (Endocrine Society) Add estrogen back, and you slow the removal crew down again. It’s a real, measurable effect — and the numbers are better than a lot of people expect.
Does estrogen actually increase bone density?
Yes. Systemic estrogen slows bone loss and modestly raises bone mineral density. In the Women’s Health Initiative — the largest trial of its kind — oral estrogen-plus-progestin raised hip bone density 3.7% over three years, versus 0.14% on placebo. But the benefit comes from specific products studied, and it lasts only while you keep taking it.
One term first, because we’ll use it a lot. Bone mineral density (BMD)is the amount of mineral packed into your bone at the spots a scan measures. It’s a major predictor of fracture risk — but not the whole story (your age, past fractures, and fall risk matter too).
Here’s the strongest evidence. These numbers come from the Women’s Health Initiative (WHI) — two large, randomized U.S. trials (JAMA, 2003; Journal of Bone and Mineral Research, 2020) — plus a meta-analysis that pooled many studies.
What the WHI hormone-therapy trials found
| Measure | What the trials showed |
|---|---|
| Regimen actually tested | Oral conjugated estrogen + medroxyprogesterone (women with a uterus), or oral estrogen alone (women after hysterectomy) — not patches, gels, sprays, or rings |
| Any clinical fracture (estrogen + progestin) | 8.6% on treatment vs 11.1% on placebo over ~5.6 years (hazard ratio 0.76) |
| Hip and spine fractures | Each about a third lower while on treatment |
| Hip bone density | +3.7% over 3 years vs +0.14% on placebo |
| Pooled across studies | Total fractures about 26% lower (relative risk 0.74); about 45% lower in women under 60 — a subgroup finding, not a guarantee for every regimen |
One honest limit on these numbers: they come from specific oralregimens. They don’t automatically transfer to every estradiol patch, gel, spray, tablet, or ring. That matters more than it sounds — and it’s the heart of a section further down.
What happens to bone after you stop
Bone loss generally resumes after you stop systemic estrogen, and fracture protection fades — how fast depends on the regimen, how long you took it, and your starting risk. One representative estradiol label says it plainly: bone mass declines again after treatment stops (FDA label). An older study found a roughly 55% higher hip-fracture ratein women who stopped hormone therapy versus those who kept taking it, with the gap showing up around two years out. This is not a reason to avoid estrogen — it’s a reason to plan the transition before stopping, not after.
Can estrogen treat osteoporosis, or only prevent it?
Estrogen is FDA-approved to prevent postmenopausal osteoporosis — not to treat it once you have it. And the products that carry the prevention indication add a caveat: if bone protection is your only reason, your clinician should weigh non-estrogen options first and reserve estrogen for women at significant risk.
This one distinction reshapes who estrogen is right for.
- Prevention means slowing the bone loss that comes with menopause, before you’ve crossed into osteoporosis. That’s estrogen’s lane.
- Treatment means managing diagnosed osteoporosis. That’s usually led by a bone-specific drug — though, as you’ll see below, hormone therapy can still play a role for some women under specialist care.
So if your scan is normal or shows osteopenia and you’re newly menopausal, estrogen is squarely in the prevention conversation. If your scan already says osteoporosis, the conversation shifts.
Who should consider estrogen for bone density?
Systemic estrogen most often makes sense for a woman who also needs menopause-symptom relief, is younger than 60 or within 10 years of menopause, and has no major risk factor that rules it out. It’s especially relevant after early or premature menopause. It’s a weaker first choice when bones are the only concern.
Find the row that sounds like you. (This is a decision aid, not a diagnosis — your clinician makes the call.)
The estrogen-for-bone decision map
| If this is you… | What the evidence suggests | Your next step |
|---|---|---|
| Bothersome menopause symptoms; under 60 or within 10 years of menopause; no major risk flag | Systemic HRT may relieve symptoms and prevent bone loss, after an individual review (The Menopause Society, 2022) | Discuss systemic HRT → take the matching quiz |
| Early, premature, or surgical menopause (including primary ovarian insufficiency — when ovaries stop working before 40) | HRT is often recommended at least until the average age of natural menopause (~51–52), partly to protect bone (The Menopause Society) | See a clinician experienced in early menopause |
| No menopause symptoms; considering hormone therapy only for general disease prevention | The USPSTF recommends against hormone therapy used solely to prevent chronic conditions in women without symptoms (USPSTF) | Skip the provider step; get a risk assessment / screening |
| Considering estrogen only to prevent osteoporosis | The FDA-approved products say to consider non-estrogen medicines first and reserve estrogen for women at significant risk (FDA labels) | Discuss whether a bone-specific drug fits better |
| Diagnosed osteoporosis, high fracture risk, or a recent fragility fracture | A bone-specific medicine usually leads; HRT stays a selected option for some women under 60 with symptoms, low clot risk, and no contraindication, when bisphosphonates or denosumab aren’t appropriate (Endocrine Society) | Start an osteoporosis-treatment assessment |
| Only vaginal or urinary symptoms, treated with low-dose vaginal estrogen | That’s a local treatment — it doesn’t protect bone | Treat the local symptoms; handle bone separately |
| You have a uterus and want systemic estrogen | You’ll generally need a progestogen too, to protect the uterine lining (or Duavee) | Ask about uterine protection |
| Starting estrogen after 60, or more than 10 years past menopause | Not off-limits, but the risk-benefit balance is less favorable and needs a closer look. (Continuing therapy you already use is a separate decision — it’s not automatically stopped at 60 or 65.) | Get an individual review, ideally in person |
| History of breast cancer, blood clot, stroke/heart attack, or liver disease | These need a clinician-led decision; some are reasons not to use systemic estrogen | Start with an in-person clinician |
Not sure which row is yours?
Your symptoms, age, uterus status, and risk history change the answer — and a general guide can’t sort that for you. See which path fits your situation with the free Find My HRT Path quiz. It points you toward online care, local treatment, or an in-person visit — and flags when you should start with a doctor in person.
→ Find My HRT PathWhen is estrogen not the right first treatment for bone loss?
Estrogen isn’t the automatic answer to every low bone score. If you have no menopause symptoms and you’re thinking about it purely to prevent future disease, guidelines push back. And if you already have osteoporosis or a recent fracture, a bone-specific medicine usually needs to lead — estrogen alone may not be enough.
Three situations call for caution.
You already have osteoporosis or a fragility fracture
A fragility fracture is a break from low-energy trauma — typically a fall from standing height or less. If that’s happened, or a scan already says “osteoporosis,” your situation is more urgent, and a patch by itself often isn’t the plan. Bone-specific drugs were built for exactly this.
You’re considering estrogen only to “prevent disease”
If you feel fine and you’re eyeing estrogen as a general shield, here’s the straight talk: the U.S. Preventive Services Task Force recommends against hormone therapy used solely to prevent long-term conditions after menopause (USPSTF). Important — that does not apply to using estrogen for menopause symptoms, or for early/surgical menopause. Those are different decisions.
Your history needs a clinician’s eyes first
Some things change the route or take systemic estrogen off the table: bleeding after menopause, a past or current estrogen-sensitive cancer, a prior blood clot, a stroke or heart attack, serious liver disease. These need clinician-led assessment — sometimes an in-person exam or records review — before systemic treatment begins.
Our one honest admission
Systemic estrogen protects bone — but it is not an all-purpose osteoporosis drug, and the benefit fades when you stop. If your main problem is established osteoporosis, a recent fracture, or very high fracture risk, estrogen alone is usually not the right lead, and pushing it on you would do you a disservice.
But notice what that admission does not say. It doesn’t say estrogen is weak or risky for everyone. For a woman who also has real menopause symptoms and is within about 10 years of menopause, estrogen is one of the few options that protects bone andeases hot flashes, night sweats, and the sleep wreckage that comes with them — at the same time. A bone-only drug can’t do that. If that’s you, this is a genuinely good fit. If it’s not — if osteoporosis is your headline problem — we’d rather point you to the right care than keep you here.
Is estrogen the right bone strategy for you?
We built a short, private checker that turns everything above into a personalized next step. It doesn’t diagnose you, name a dose, or tell you you’re “approved” for anything — no website can do that safely. It matches your answers to the right kind of conversation.
It asks about: your age, years since your last period, whether you have a uterus, your symptoms, whether you’re considering only vaginal estrogen, your bone-scan history, any prior fracture, early/surgical menopause, and key risk flags. Only afterthose clinical questions does it ask about insurance, cash-pay, and state — so commercial details never steer the medical answer.
It returns one of: screening first · systemic HRT may fit — discuss it · this is a local-treatment path, not a bone path · osteoporosis-treatment path · see someone in person first.
→ Build my pre-consult HRT path (for results where online menopause care may fit)
→ See what to bring to an in-person bone visit (for osteoporosis, fracture, or safety-flag results)
Free · No diagnosis · No pressure
Which forms of estrogen actually protect bone?
Bone protection needs systemic estrogen — the kind that reaches your whole body. But here’s the twist almost nobody tells you: being systemic is not the same as being FDA-approved for bone. Some systemic gels, sprays, and rings deliver estrogen body-wide yet were only approved for hot flashes. The products that carry the osteoporosis-prevention indication are mainly oral estradiol tablets, several patches, and certain estrogen-plus-progestin or estrogen-plus-bazedoxifene products.
This is the original analysis at the heart of this page. We read each product’s current FDA-approved label and checked one thing: does this exact label list “prevention of postmenopausal osteoporosis”?“Systemic” tells you the drug travels through your bloodstream. “Approved for bone” is a separate, narrower question — and the two don’t always match.
The U.S. estrogen form & FDA-label check
| Product / form | Exposure | Label lists osteoporosis prevention? | Note |
|---|---|---|---|
| Representative oral estradiol tablet (generic / Estrace) | Systemic | Yes | Also says weigh non-estrogen options if bone is your only reason |
| Vivelle-Dot estradiol patch | Systemic | Yes | Several other estradiol patches carry it too — confirm the exact product |
| Prempro (estrogen + progestin) | Systemic | Yes | Women with a uterus; same “consider non-estrogen options” note |
| Duavee (conjugated estrogens + bazedoxifene) | Systemic | Yes | Protects uterus without a separate progestogen; reserve for significant risk if bone is the only goal |
| Divigel estradiol gel | Systemic | No indication found | Approved for hot flashes — not bone |
| EstroGel estradiol gel | Systemic | No indication found | Approved for hot flashes and vaginal symptoms — not bone |
| Evamist estradiol spray | Systemic | No indication found | Approved for hot flashes — not bone |
| Femring estradiol acetate ring | Systemic, despite vaginal route | No indication found | A systemic ring; approved for hot flashes and vaginal atrophy |
| Estring low-dose ring | Primarily local, low systemic absorption | No indication found | Local treatment for vaginal atrophy — not a bone product |
| Bijuva (estradiol + progesterone) | Systemic | No indication found | Approved for hot flashes — not bone |
| Compounded estrogen | Varies | Not FDA-approved | The FDA doesn’t review compounded drugs for safety, effectiveness, or quality before they’re sold, and has no evidence they’re safer or more effective than approved products |
Source: each product’s current FDA label via DailyMed / Drugs@FDA, checked June 2026. “No indication found” does not mean a systemic product has zero effect on bone— it means the exact label checked does not list osteoporosis prevention as an approved use.
Why does this matter so much? Because a woman can be handed a systemic estrogen gel for hot flashes, assume it’s also “covering her bones,” and never have the bone conversation she actually needed. Now you know to ask: is this exact product approved for bone, or am I getting bone protection some other way?
Patch, pill, gel, or ring — which questions should you bring to your consult? The free Find My HRT Path quiz builds your route-and-product questions so you walk in ready — it doesn’t pick a drug for you, it gets you prepared.
Find My HRT Path →Free · No diagnosis · No pressure
Does vaginal estrogen help bone density?
Low-dose local vaginal estrogen should not be counted on to protect your bones. Products like Estring are made for local vaginal symptoms and produce much lower whole-body exposure than systemic therapy. Femring is the exception that proves the rule: it’s a vaginal ring, but it’s systemic — so the word “vaginal” alone doesn’t tell you whether the exposure is local or body-wide.
This is where even careful readers get tripped up. Two products are both “vaginal rings,” and they are not the same:
| Estring | Femring | |
|---|---|---|
| Route | Vaginal ring | Vaginal ring |
| Exposure | Mostly local, low systemic absorption | Systemic (whole-body) |
| Labeled for | Vaginal atrophy (local symptoms) | Hot flashes + vaginal atrophy |
| Approved to prevent osteoporosis? | No | No |
Same shape, same insertion, completely different reach. And as the label check shows, neither one’s current FDA label lists osteoporosis prevention.So even the systemic ring isn’t a labeled bone product.
If low-dose vaginal estrogen is your only hormone treatment, don’t stop it because of this article — it’s doing an important job for the symptoms it was made for. Just don’t assume it’s guarding your bones. Talk to your clinician about whether you need bone screening based on your age and risk. For the full picture on local therapy, see our guide to vaginal estrogen.
What are the risks of systemic estrogen for bone density?
Systemic estrogen has real risks, and they vary by the product, the route, your age, how close you are to menopause, how long you use it, whether a progestogen is added, and your health history. Known risks include blood clots, stroke, gallbladder disease, breast cancer with some estrogen-plus-progestin regimens, and — for a woman with a uterus on estrogen alone — endometrial cancer. Patches and gels may carry lower clot risk than pills, but nothing here is risk-free.
A few specifics worth understanding (The Menopause Society; FDA):
- Blood clots and stroke are the risks most tied to how estrogen is delivered. Pills pass through the liver first; transdermal estradiol (patches, gels, sprays) skips that first pass and, in observational studies, appears to carry lower clot and stroke risk than oral estrogen — though it’s not zero, and head-to-head trial evidence is limited.
- Breast cancer risk is mainly linked to estrogen-plus-progestin regimens used over time. Risk varies by the specific regimen and how long it’s used; estrogen-alone therapy showed a different pattern in the WHI.
- Endometrial (uterine) cancer is the reason a woman with a uterus needs a progestogen (or Duavee) alongside systemic estrogen.
- Gallbladder disease is also more common with oral estrogen.
What the 2026 FDA label change actually did
On February 12, 2026, the FDA updated the labels of an initial six menopausal hormone therapy products — removing the cardiovascular-disease, breast-cancer, and probable-dementia statements from the most prominent “boxed” warning, while keeping the endometrial-cancer warning for systemic estrogen-alone products. (FDA) That was nota blanket change to every product, which is exactly why this page checks each label one by one. It reflects a re-reading of the evidence — it does not mean systemic estrogen is risk-free.
Can online menopause care prescribe estrogen for bone density?
Yes — for the right situation. A telehealth menopause clinician can prescribe systemic estrogen (and progestogen if needed) to a woman whose goal includes bone protection alongside symptom relief, provided you fall in the right profile and live in a state where the provider is licensed. The limitation is your situation: if osteoporosis is your primary concern, established bone disease or a recent fracture should start with an in-person evaluation.
Affiliate disclosure: The HRT Index earns a commission if you click and purchase from providers linked below. Read our full disclosure →
Midi Health
Menopause specialist telehealth · Insurance-accepted · Patch, pill, gel routes
- ✓Accepts many major insurance plans — may cost $0 out-of-pocket for visits
- ✓Prescribes FDA-approved systemic estrogen (patches, pills, gels) + progestogen
- ✓Menopause-trained clinicians, not generalists
- ✓Available in most U.S. states
Verified June 2026 · Does not replace an osteoporosis specialist if you have established bone disease
Sesame Care
Cash-pay OB/GYN visits · No subscription · Transparent pricing
- ✓Pay-per-visit, no monthly fee — OB/GYN visits typically $30–$90
- ✓Access to OB/GYN clinicians who can discuss systemic HRT
- ✓Good option for cash-pay patients or those without menopause-specialist coverage
Verified June 2026 · Confirm state availability before booking
Not sure which provider fits your profile? The Find My HRT Path quiz routes you to the right type of care before you spend money on a consult — including flagging when in-person care should come first.
Estradiol patch shortage (2026)
The American Society of Health-System Pharmacists (ASHP) has listed estradiol transdermal system patches as being in shortage. The shortage bulletin was last updated April 22, 2026 and is subject to change. If your patch is unavailable, your prescriber can discuss alternative systemic routes (gel, spray, pill) based on your situation.
What this means practically:if your exact patch product isn’t in stock, don’t switch to vaginal-only estrogen under the assumption it covers your bones — it doesn’t. Ask your clinician about a temporary substitute that keeps you systemic. This page will be updated monthly against the ASHP shortage list.
Last checked: June 2026 · Source: ASHP shortage list (ashp.org)
Frequently asked questions
Can estrogen reverse osteoporosis?
Not reliably. Systemic estrogen can raise bone density and lower fracture risk, but it is approved to prevent bone loss, not to reverse established osteoporosis. If you already have osteoporosis, your plan may need a bone-specific drug.
Can estrogen treat osteoporosis, or only prevent it?
FDA-labeled use is prevention, not treatment. Hormone therapy remains a selected option for some women under 60 or within 10 years of menopause with symptoms, low clot risk, and no contraindication, when standard osteoporosis drugs are not appropriate — under clinician guidance. (Endocrine Society)
Is an estrogen patch better than a pill for bones?
Both can be systemic and support bone, and some patch and oral labels include osteoporosis prevention. The better route depends on the exact product, your risks, and your preferences. Patches skip the liver, which observational evidence suggests may lower clot and stroke risk versus pills — though it is not risk-free.
Does progesterone increase bone density?
Do not count on progesterone as your bone treatment. In a systemic plan for a woman with a uterus, its main job is protecting the uterine lining. The bone-active ingredient is the estrogen.
Does vaginal estrogen protect bones?
Low-dose local vaginal estrogen does not. It treats local vaginal and urinary symptoms with little whole-body exposure. Femring is a vaginal ring but is systemic — yet even its label does not include osteoporosis prevention. (Menopause Society)
Is Femring the same as Estring?
No. Both are vaginal rings, but Estring is low-dose and mostly local, while Femring delivers estrogen to the whole body. Neither is FDA-approved to prevent osteoporosis.
What are the risks of estrogen for bone density?
Systemic estrogen carries risks that vary by product, route, age, timing, duration, and history — including blood clots, stroke, gallbladder disease, breast cancer with some estrogen-plus-progestin regimens, and endometrial cancer from unopposed estrogen in a woman with a uterus. Transdermal forms may carry lower clot risk than pills, but none are risk-free.
How long does estrogen take to improve bone density?
There is no universal timeline, and bone changes are tracked over longer stretches than hot-flash relief. How often you re-scan depends on your goal and starting risk. Your clinician sets the schedule. (Endocrine Society)
Do I lose bone after stopping HRT?
Yes. Bone loss generally resumes after stopping systemic estrogen, and fracture protection fades. How fast varies by regimen and duration, so stopping should include a clinician-led bone plan — not an abrupt solo decision.
How long can I stay on estrogen for my bones?
There is no automatic stop at 65. Duration is a shared decision, reweighed over time, with the lowest effective dose for your goals and a plan for the transition if you stop.
Can I start estrogen after age 60?
Starting after 60, or more than 10 years past menopause, usually calls for a closer individual review, because the average risk-benefit balance is less favorable. Continuing therapy you already use is a separate decision and is not automatically stopped at 60 or 65.
Is estrogen enough if my T-score is −2.5 or lower?
Do not assume so. A score in the osteoporosis range shifts the decision toward a full osteoporosis-treatment assessment, which may lead with a bone-specific drug.
Can estrogen be used after a fragility fracture?
A fracture calls for prompt osteoporosis evaluation. Some women may still use HRT, but it should not be the stand-alone default after a fragility fracture.
Is compounded estrogen good for bone density?
There is no FDA-approved bone use for compounded estrogen. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are sold, and says it has no evidence that compounded bioidentical hormones are safer or more effective than approved products. (FDA)
Is bioidentical estrogen safer?
FDA-approved estradiol is chemically identical to the estradiol your body makes. “Bioidentical” is not an FDA approval category, and compounded is a separate question from molecular structure. Safety depends on the product and your situation, not the label.
Should I stop HRT before a DEXA scan?
No. Do not change a prescribed treatment for a scan unless your treating clinician tells you to.
Sources
- U.S. Food and Drug Administration — Menopause (women’s health topics): approved indications for osteoporosis prevention, compounded “bioidentical” hormone guidance. Checked June 2026.
- FDA — FDA Approves Labeling Changes to Menopausal Hormone Therapy Products (February 12, 2026); November 10, 2025 labeling-change request.
- FDA DailyMed / Drugs@FDA — current prescribing information for estradiol tablet (generic/Estrace), Vivelle-Dot, Prempro, Duavee, Divigel, EstroGel, Evamist, Femring, Estring, Bijuva. Checked June 2026.
- The Menopause Society — 2022 Hormone Therapy Position Statement (bone loss and fracture prevention; timing; risk stratification).
- Endocrine Society — Pharmacological Management of Osteoporosis in Postmenopausal Women (clinical practice guideline); patient materials on menopause and bone loss.
- U.S. Preventive Services Task Force — Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women (2022).
- Women’s Health Initiative — Writing Group, Risks and Benefits of Estrogen Plus Progestin / fracture and BMD outcomes (JAMA, 2003); Cauley et al., WHI skeletal review (Journal of Bone and Mineral Research, 2020); pooled/meta-analysis of menopausal hormone therapy and fracture (28 studies, ~33,000 women).
- Discontinuation/durability — Menopause (2023) and earlier hip-fracture-after-cessation cohort data.
- American Society of Health-System Pharmacists — Estradiol Transdermal System shortage bulletin (updated April 22, 2026).
- Provider details — joinmidi.com (pricing/insurance) and sesamecare.com, checked June 2026.