Definition
- Most active of endogenous estrogens, primarily produced in ovaries with additional amounts produced by adrenal glands and testes (in men).
- Other names: estradiol 17 beta, E2.
- Normal range: see Table 16.29.
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TABLE 16 " “29Normal Range of Values for Estradiol, UnconjugatedView LargeTABLE 16 " “29Normal Range of Values for Estradiol, Unconjugated Sex and Condition Reference Range (pg/mL) Males <20 " “47 Postmenopausal females <20 " “40 Nonpregnant females: Midfollicular 27 " “122 Periovulatory 95 " “433 Midluteal 49 " “291
Use
- Of value, together with gonadotropins, in evaluating menstrual and fertility problems in women
- In the evaluation of gynecomastia or feminization states due to estrogen-producing tumors, menstrual cycle irregularities, and sexual maturity in female patients and in monitoring of human menopausal gonadotropin (Pergonal) therapy
Interpretation
Increased In
- Feminization in children
- Estrogen-producing tumors
- Gynecomastia
- Hepatic cirrhosis
- Hyperthyroidism
Decreased In
- Primary and secondary hypogonadism
- PCOs
- Eating disorders, anorexia nervosa.
Limitations
- Oral contraceptives inhibit physiologic increase.
- Estradiol values from pregnant females may be affected by high levels of estriol such as those present in the second and third trimesters of pregnancy.
- Current estradiol assays are sensitive for women of child-bearing age and induction of ovulation monitoring. In contrast, levels in postmenopausal women, men, and prepubertal children <20 pg/mL are not adequate.
- HPLC-MS methods are sensitive and specific compared to immunoassays, and lack of standardization and analytical variations makes test results need to be interpreted with caution.