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Objectives To compare the distribution of estradiol levels between women with a hysterectomy and ovarian conservation and women with an intact uterus. Methods A large cross-sectional study of women aged between 40 and 69 years, residing in Melbourne, Australia. Estradiol levels were available for 152 women with a hysterectomy and ovarian conservation and 1423 women with an intact uterus. All of the women were 'never-users' of hormone replacement therapy. Results For women under 55 years of age, we observed that those with a hysterectomy and ovarian conservation had slightly higher estradiol levels compared with those with an intact uterus after adjustment for age, body mass index, smoking status and alcohol intake (ratio of geometric means of estradiol levels = 1.24; 95% confidence interval = 1.00-1.53). For women who were 55 years or greater, the distribution of estradiol levels varied little by hysterectomy status. Conclusions Our data do not suggest that women with hysterectomy and ovarian conservation have markedly different estradiol levels compared to women with an intact uterus. [ABSTRACT FROM AUTHOR]