E2 (Estradiol)
Understanding E2 (Estradiol)
What is E2 (Estradiol)?
An E2 (Estradiol) test measures the amount of estradiol, a form of estrogen hormone, in the blood. This test is used to assess reproductive health, diagnose hormone-related conditions, monitor fertility treatments, and evaluate certain health conditions such as menstrual irregularities, infertility, and menopausal symptoms.
Estradiol, or E2, is the body's primary and most potent form of estrogen. It is vital for developing and maintaining female reproductive tissues, regulating the menstrual cycle, follicle development, ovulation, pregnancy, bone health, and overall well-being.
E2 levels fluctuate throughout the menstrual cycle, with peak levels occurring during the follicular phase (before ovulation) and gradually decreasing after ovulation. Also, estradiol levels are typically lower in postmenopausal women than in premenopausal women due to decreased ovarian function. Hence, measurement of estradiol levels with the help of an E2 (Estradiol) test helps evaluate ovarian function, menstrual irregularities, and menopausal status.
Abnormal estradiol or E2 levels may be observed in various hormonal disorders, including PCOS, hyperthyroidism, hypothyroidism, and adrenal gland disorders, making an E2 (Estradiol) test a valuable tool to diagnose these disorders and monitor hormone replacement therapy. Abnormal estradiol levels may also indicate decreased ovarian reserve or ovarian dysfunction affecting fertility. This test is, therefore, valuable for fertility assessments to evaluate ovarian reserve, predict response to fertility treatments such as in vitro fertilization (IVF), and monitor fertility treatment protocols.
No special preparation is required for an E2 (Estradiol) test. You can eat and drink as per your daily routine. Your doctor may recommend this test if you experience symptoms related to hormone imbalances, such as irregular menstrual periods, infertility, hot flashes, mood changes, or symptoms of menopause.
Inform your doctor if you take any medications, supplements, and birth control pills before the test, as they can interfere with your test results. It is important to note that estradiol levels can vary throughout the day and woman's menstrual cycle. As a result, the doctor may ask you to get your blood test at a particular time of day or at a specific time in your cycle.
Reference ranges may vary between laboratories. Normal estrogen results depend upon the gender and age of the person tested. In women, test results can also rely on pregnancy. Talk to your doctor about your specific test results. The results will help them determine your medical condition and whether medication/supplements will be required to manage it.
What is E2 (Estradiol) used for?
An E2 (Estradiol) test is done to:
- Evaluate ovarian function, menstrual irregularities, and menopausal status.
- Monitor the health of the placenta during pregnancy.
- Diagnose hormonal disorders, including PCOS, hypogonadism, hyperthyroidism, hypothyroidism, and adrenal gland disorders.
- Assess puberty development in males and females.
- Monitor treatment response in women taking hormone replacement therapy after menopause.
- Evaluate ovarian follicle development, predict response to fertility treatments such as in vitro fertilization (IVF), and monitor fertility treatment protocols.
- Evaluate the lack of secondary sexual features, muscle mass, and causes of gynecomastia (enlarged breasts) in men.
What does E2 (Estradiol) measure?
An E2 (Estradiol) test measures estradiol levels, a hormone produced in men and women. It helps assess early or delayed puberty, menstrual problems, symptoms associated with menopause, or certain cancers like ovarian cancer. This test provides valuable information about ovarian function and aids doctors in evaluating menstrual issues, such as abnormal bleeding or missed periods. The test can also assess the health of the testes, ovaries, or adrenal glands. Most diseases associated with estrogen/estradiol, such as PCOS, infertility, some cancers, etc., can be prevented by lifestyle modifications, menopausal hormone therapy, or other supplements such as calcium, vitamin D, and micronutrients.
Interpreting E2 (Estradiol) results
Interpretations
High levels of Estradiol may indicate:
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Puberty before time (precocious puberty) in girls
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Ovarian tumors in females
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Tumors of adrenal glands in men and women
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Gynecomastia (enlarged breasts) in men
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Testicular tumors
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Delayed puberty in males
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Hyperthyroidism in men and women
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Cirrhosis in men and women
Low levels of Estradiol may indicate:
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Hypopituitarism
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Hypogonadism in females (the abnormal function of ovaries)
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Following menopause
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Conditions in which female sexual characteristics are underdeveloped, like Turner’s Syndrome
Answers to Patient Concerns & Frequently Asked Questions (FAQs) about E2 (Estradiol)
Frequently Asked Questions about E2 (Estradiol)
Q. Why do I need an E2 (Estradiol) test?
Q. What happens if my estradiol is too low?
Q. How to fix low estradiol levels?
Q. Can I get pregnant with high estradiol levels?
Q. What might affect my estradiol test results?
Q. How does an Estradiol test for fertility?
Q. What other tests might be required if my Estradiol test results are not normal?
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References
- Estradiol (Blood) [Internet]. Rochester, NY: University of Rochester Medical Center; [Accessed 05 Oct. 2023]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=estradiol
- Hariri L, Rehman A. Estradiol [Internet]. Treasure Island, Florida: StatPearls Publishing; 2023 Jan. [Accessed 05 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549797/
- Sriprasert I, Kono N, Karim R, Hodis HN, Stanczyk FZ, Shoupe D, Mack WJ. Factors Associated With Serum Estradiol Levels Among Postmenopausal Women Using Hormone Therapy. Obstet Gynecol. 2020 Oct;136(4):675-684. [Accessed 05 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529896/
- Hariri L, Rehman A. Estradiol. 2023 Jun 28 [Internet]. Treasure Island, Florida: StatPearls Publishing; 2023 Jan. [Accessed 05 Oct. 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/31747204/
- Mittal S, Gupta P, Malhotra N, Singh N. Serum estradiol as a predictor of success of in vitro fertilization. J Obstet Gynaecol India. 2014 Apr;64(2):124-9. [Accessed 05 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984655/
- Schulster M, Bernie AM, Ramasamy R. The role of estradiol in male reproductive function. Asian J Androl. 2016 May-Jun;18(3):435-40. [Accessed 05 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854098/
- Huitrón-Bravo G, Denova-Gutiérrez E, Talavera JO, Moran-Villota C, Tamayo J, Omaña-Covarrubias A, Salmerón J. Levels of serum estradiol and lifestyle factors related with bone mineral density in premenopausal Mexican women: a cross-sectional analysis. BMC Musculoskelet Disord. 2016 Oct 19;17(1):437. [Accessed 05 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069822/
- Bacciottini L, Falchetti A, Pampaloni B, Bartolini E, Carossino AM, Brandi ML. Phytoestrogens: food or drug? Clin Cases Miner Bone Metab. 2007 May;4(2):123-30. [Accessed 05 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781234/#:~:text=Phytoestrogens%20rich%20foods-,Phytoestrogens%20are%20present%20in%20many%20human%20foodstuffs%20including%20fruits%20(plum,II).
- Ahuja M. Age of menopause and determinants of menopause age: A PAN India survey by IMS. J Midlife Health. 2016 Jul-Sep;7(3):126-131. doi: 10.4103/0976-7800.191012. [Accessed 05 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051232/
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