Estrogen tests may be used for a variety of reasons
- Estrone levels may be elevated in patients with polycystic ovarian syndrome and endometriosis. Tests may be used to aid in the diagnosis of an ovarian tumor, Turner syndrome, andhypopituitarism. In males, it may help in the diagnosis of the cause of gynecomastia or in the detection of estrogen-producing tumors.
- Estradiol levels are used in evaluating ovarian function. Estradiol levels are increased in cases of early (precocious) puberty in girls andgynecomastia in men. Its main use has been in the differential diagnosis of amenorrhea – for example, to determine whether the cause is menopause, pregnancy, or a medical problem. In assisted reproductive technology (ART), serial measurements are used to monitor follicle development in the ovary in the days prior to in vitro fertilization. Estradiol is also sometimes used to monitor menopausal hormone replacement therapy. A doctor may sometimes order a total estrogens test. This test measures estrone and estradiol together but does not measure estriol.
- Estriol may sometimes be ordered serially to help monitor a high risk pregnancy. When it is used this way, each sample should be drawn at the same time each day. An unconjugated estriol test, one that measures estriol that is not bound to a protein, is one of the components of the triple or quad screen. Decreased levels have been associated with various genetic disorders including Down syndrome, neural tube defects, and adrenal abnormalities. It is ordered during pregnancy, along with maternal alpha-fetoprotein (AFP maternal), human chorionic gonadotropin (hCG), and inhibin-A tests, to assess the risk of carrying a fetus with certain abnormalities.
When is it ordered?
A doctor may order an estrone or estradiol, along with other tests, when a woman has symptoms such as pelvic heaviness, abnormal vaginal bleeding, abnormal menstrual cycles, is experiencing infertility, and when a female’s sex organs are developing earlier or later than normally expected. A doctor may also order estrone and/or estradiol when a woman is having hot flashes, night sweats, insomnia, and/or amenorrhea, symptoms of menopause. When a woman is taking hormone replacement therapy, her doctor may periodically order estrone levels to monitor treatment.
When a woman is experiencing fertility problems, her doctor may use estradiol measurements over the course of the menstrual cycle to monitor follicle development prior to in vitro fertilization techniques (timed with a surge in estradiol). Estradiol testing may also be ordered when a man shows signs of feminization, such as gynecomastia, that may be due to an estrogen-producing tumor.
During pregnancy, a doctor may order serial estriol samples to look for a trend, a rise or fall in the estriol level over time. Unconjugated estriol is often measured in the 15th to 20th week of gestation as part of the triple screen or quad screen.
What does the test result mean?
Increased or decreased levels of estrogens are seen in many metabolic conditions. Care must be used in the interpretation of estrone, estradiol, and estriol results because their concentrations will vary on a day-to-day basis and throughout the menstrual cycle. A doctor who is monitoring a woman’s hormones will be looking at trends in the levels, rising or lowering over time in conjunction with the menstrual cycle or pregnancy rather than evaluating single values. Test results are not diagnostic of a specific condition but give the doctor additional information about the potential cause of a person’s symptoms or status. Below are conditions where one might see an increase or decrease of estrogen levels.
Increased levels of estrogens are seen in:
- Normal menstrual cycle
- Early (precocious) puberty
- Gynecomastia
- Tumors of the ovary, testes, or adrenal glands
- Hyperthyroidism
- Cirrhosis
Decreased levels of estrogen are seen in:
- Turner syndrome
- Hypopituitarism
- Hypogonadism
- Failing pregnancy (estriol)
- Eating disorder anorexia nervosa
- After menopause (estradiol)
- PCOS (Polycystic ovarian syndrome, Stein-Levanthal syndrome)
- Extreme endurance exercise
Is there anything else I should know?
Blood and urine results are not interchangeable. Your doctor will choose which estrogen and sample type to test for based upon what she is looking for.
Beyond daily and cycle variations, illnesses such as hypertension, anemia, and impaired liver and kidney functions can affect estrogen levels in the body.
Some drugs, such as glucocorticosteroids, ampicillin, estrogen-containing drugs, phenothiazines, and tetracyclines can increase estrogen levels in the blood. Glucose in the urine and urinary tract infections can increase levels in the urine. Drugs that may decrease levels include clomiphene and oral contraceptives.
Common Questions
Do all males have estrogens?
Yes. Although they are present in amounts far less than in women, they are present and are needed for hormonal balance and the function of other glands.
What are estrogen receptors?
Estrogen receptors are proteins, located on cells from certain tissues, that bind with estrogen. One risk factor for breast cancer is the presence of excess estrogen. This excess exposure to estrogen seems to stimulate cancer cell growth, especially if the tumor contains estrogen receptors. Drugs that block the effect of estrogen may slow the rate of growth of such cancers. See the article on Estrogen receptors for more on this.
What are phytoestrogens and environmental estrogens?
Phytoestrogens are estrogen-like compounds from plant sources. The two main classes are isoflavones, found in soy products, and lignans, found in whole grains and some fruits and vegetables. It has been proposed that these products could be used as an alternative to hormone replacement therapy (HRT). Initial studies have shown the relief of some menopausal symptoms, such as hot flashes, but there is more research yet to be done.
Environmental estrogens are chemicals, either natural (such as plant sources) or man-made (such as the insecticide DDT), that mimic the effect of estrogen and may cause disorders such as infertility, overgrowth of the endometrial lining, premature breast development, and feminization in young males. They tend to stay in the body for long periods of time and are being studied for their long-term effects
Where can I find more information on estrogen?
Your doctor may have educational information about estrogen. There is also a great deal of information on the internet. Some of the best and newest information is provided by government sources and various national organizations.
How to order your Estrogen Tests
- Call or Email us to request your test.
- Pay online or on the phone.
- You’ll receive your test/s at the address you provide.
Reference ranges and what they mean
With all this talk of reference ranges, you may notice that few of the test descriptions on this web site include the reference range. There are several reasons for this:
- In general, reference ranges are specific to the laboratory that produces the test results. For many analytes, different laboratories use different kinds of equipment and different kinds of testing methods. This means that each laboratory must establish its own reference ranges using data from its own equipment and methods. The laboratory must supply your test result with an accompanying reference range on the laboratory report. Consequently, there is no such thing as a standard reference range. Of course, each test does have a theoretical reference range that we could include on this site, which can be found in many books and other online sources, but it may have little diagnostic meaning for you. You and your doctor should apply the reference range supplied by the laboratory performing the test.That being the case, however, for a few specific tests, such as the electrolytes, there is a high degree of consistency if not standardization, among clinical laboratories in the methodologies and procedures used for these particular tests. These laboratory methods have been in use for many years now so their reference ranges have been well-established and typically reflect numbers that are very similar to the theoretical reference range. Because of this greatly reduced variability in the reference ranges for these select number of tests, their reference ranges are included on this site. The source of the range for each test is Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, a well-respected and authoritative textbook on the subject that is used by medical professionals.
- You may notice that the few select reference ranges listed here are specific for adults only and there are no ranges included for children or adolescents. The reason is that from infancy through adolescence, a child’s body goes through many changes and growing cycles. Several things that are tested in a laboratory such as chemical levels, hormones, etc. vary greatly as a child goes through the different growth stages. The laboratory where your child’s sample is tested has established reference ranges for the different stages of child development. Theoretical reference ranges exist for children, but they are numerous and do not lend themselves to easy interpretation, so they are not included on this site. The best source of information regarding your child’s lab test results is your child’s doctor.
- For a few other analytes, such as cholesterol and glucose, there has been a major effort to standardize the laboratory test methods and report formats. The result has been the establishment of a set of cut-off numbers that are different from reference ranges in that they reflect clinical decision points rather than a statistically “normal” range. We have included the published targets in our discussions of these few tests.
- We want you to be informed, but we don’t pretend to take the place of communication with your doctor. We want you to understand what the test is for, but because we can’t be aware of all the factors that could affect your test results, we can’t interpret the results without more information. If you need further explanation of your results, you should talk to your doctor. This remains true even for those tests, such as the components of the basic metabolic panel (BMP), for which we have included reference ranges. Remember, a reference range is merely a guide for your doctor. He or she will interpret the result in the context of your medical history and current presentation – something that no web site is yet able to do.
