Serum estradiol measurement is used, among other things, in the following cases:
- Assessment of hypogonadism and oligo-amenorrhea in women
- Evaluation of ovarian status, including follicle development, in assisted reproduction protocols (e.g., IVF)
- Combined with luteinizing hormone measurement to monitor estrogen replacement therapy in hypogonadal menopausal women
- Assessment of feminization, including gynecomastia, in men
- To diagnose estrogen-producing neoplasms in men and, to a lesser extent, in women
- For the laboratory diagnostic approach (among other tests) of early and late puberty in women and, to a lesser extent, in men
- For the laboratory diagnostic approach (among other tests) of sex steroid hormone metabolism disorders (e.g., aromatase deficiency and 17α-hydroxylase deficiency)
- As a complementary test in the investigation of osteoporosis to assess the risk of fractures in postmenopausal women
- Monitoring of hormone replacement therapy in women after menopause
- Monitoring of anti-estrogen therapy (e.g., treatment with aromatase inhibitors)
More information
Estrogens, which include estradiol, estriol, and estrone, are found in the body in various forms. As estrogens are produced by the adrenal cortex, ovaries, and testes, determining estrogen levels can be used to evaluate all three glands.
Estradiol (E2, 17 beta-estradiol) is the most active form of estrogen in stimulating endometrial growth. It also suppresses the production of follicle-stimulating hormone (FSH) and stimulates the production of luteinizing hormone (LH). The conversion of testosterone produces estradiol. Estradiol levels are used to evaluate ovarian function and to diagnose the causes of early puberty in girls and gynecomastia in men. It is often used to determine if amenorrhea is the result of menopause, pregnancy, or some other medical condition. In patients with infertility problems, estradiol measurements are taken before IVF. Estradiol measurement can also be used to monitor the effectiveness of hormone replacement therapy.
Estriol (E3) is usually measured during pregnancy to evaluate the placental function and fetal health. Estriol, together with alpha-fetoprotein (AFP) and chorionic gonadotropin (HCG), are measured together as an "alpha test or triple test" to assess the risk of a pregnant woman carrying a fetus with genetic abnormalities, such as Down syndrome.
Estrone (E1) is derived from converting androstenedione, mainly in the adrenal cortex. Its function is not clearly understood, but elevated estrone levels without concomitantly high progesterone levels have been associated with an increased risk of endometrial cancer. Estrone levels can be used to help diagnose ovarian cancer, Turner's syndrome, hypopituitarism, gynecomastia (in men), and menopause.
Possible Interpretations of Pathological Values
- Increase: Adrenal hyperplasia, adrenal tumors, cirrhosis, estrogen-secreting ovarian tumors, liver failure, Klinefelter syndrome, normal pregnancy, early adolescence, renal failure, testicular tumors
- Decrease: Amenorrhea, anorexia nervosa, vigorous exercise, hypogonadism, hypopituitarism, menopause, ovarian failure, Stein-Leventhal syndrome, Turner syndrome
- Medications that may increase estrogen levels: Ampicillin, diethylstilbestrol, estrogen, hydrochlorothiazide, meprobamate, oral contraceptives, phenazopyridine, prochlorperazine, tetracycline
- Medications that may decrease estrogen levels: Clomiphene, dexamethasone, estrogen inhibitors
See also
