Definition
- Estrogens are involved in development and maintenance of the female phenotype, germ cell maturation, and pregnancy. They also are important for many other, non " gender-specific processes, including growth, nervous system maturation, bone metabolism/remodeling, and endothelial responsiveness. The two major biologically active estrogens in nonpregnant humans are estrone (E1) and estradiol (E2). A third bioactive estrogen, estriol (E3), is the main pregnancy estrogen but plays no significant role in nonpregnant women or men.
- Normal range: see Table 16.31.
TABLE 16 " 31Normal Ranges of EstrogensView LargeTABLE 16 " 31Normal Ranges of Estrogens Estradiol (Tandem Mass Spectrometry) Reference Intervals: Children (pg/mL) Tanner Stage Male Female I <8 <56 II <10 2 " 133 III 1 " 35 12 " 277 IV and V 3 " 35 2 " 259 Age (y) Male Female 7 " 9 <7 <36 10 " 12 <11 1 " 87 13 " 15 1 " 36 9 " 249 16 " 17 3 " 34 2 " 266 Reference Intervals: Adults (pg/mL) ≥18 y Male Female 10 " 42 Premenopausal: Early follicular: 30 " 100 Late follicular: 100 " 400 Luteal: 50 " 150 Postmenopausal: 2 " 21 Estrone (Tandem Mass Spectrometry) Reference Intervals: Children (pg/mL) Tanner Stage Male Female I <7 <27 II <11 1 " 39 III 1 " 31 8 " 117 IV and V 2 " 30 4 " 109 Age (y) Male Female 7 " 9 <7 <20 10 " 12 <11 1 " 40 13 " 15 1 " 30 8 " 105 16 " 17 1 " 32 4 " 133 Reference Intervals: Adults (pg/mL) ≥18 y Male Female 9 " 36 Premenopausal: Early follicular: <150 Late follicular: 100 " 250 Luteal: <200 Postmenopausal: 3 " 32 pg/mL Estrogens, Total (By Calculation) Reference Intervals: Children (pg/mL) Tanner Stages: Male Female I 1 " 11 1 " 86 II 1 " 19 3 " 169 III 3 " 61 23 " 351 IV and V 4 " 62 8 " 341 Age (y) Male Female 7 " 9 <10 1 " 48 10 " 12 1 " 19 2 " 116 13 " 15 3 " 62 15 " 333 16 " 17 4 " 64 6 " 354 Reference Intervals: Adults (pg/mL) 18 y Male Female 19 " 69 Premenopausal Early follicular: 30 " 250 Late follicular: 200 " 650 Luteal: 50 " 350 Postmenopausal 5 " 52
Use
- Overall status of estrogens in females or males
- Must be interpreted according to phase of the menstrual cycle
Interpretation
Increased In
- Estrogen-producing tumors (e.g., granulosa cell tumor, theca-cell tumor, luteoma), secondary to stimulation by hCG-producing tumors (e.g., teratoma, teratocarcinoma)
- Pregnancy
- Gynecomastia
Decreased In
- Ovarian failure
- Primary hypofunction of the ovary:
- Autoimmune oophoritis is the most common cause; usually associated with other autoimmune endocrinopathies (e.g., Hashimoto thyroiditis, Addison disease, type 1 DM); may cause premature menopause
- Resistant ovary syndrome
- Toxic (e.g., irradiation, chemotherapy)
- Infection (e.g., mumps)
- Tumor (primary or secondary)
- Mechanical (e.g., trauma, torsion, surgical excision)
- Genetic (e.g., Turner syndrome)
- Menopause
- Secondary hypofunction of the ovary: disorders of the hypothalamic " pituitary axis