Biomarkers

Estrogen

Estrogen plays a vital role in reproductive and overall health. Imbalances can lead to problems such as mood swings, fertility disorders, and even some cancers. Regular testing allows these conditions to be monitored and managed effectively.

What is estrogen?

Estrogen is a key hormone produced in both men and women, although it plays a particularly critical role in female reproductive health.

It belongs to a group of hormones known as steroid hormones, which are essential for the regulation of numerous body functions.

Estrogen is responsible for the development of female secondary sexual characteristics, such as breast growth, and contributes to the regulation of the menstrual cycle.

Beyond reproductive health, estrogen has other important functions, including:

  • Bone health: It helps maintain bone density and prevents bone loss.
  • Heart health: It supports cardiovascular health by regulating cholesterol levels.
  • Mood regulation: Estrogen influences brain chemistry, impacting mood and mental health.

Measuring estrogen levels helps doctors detect hormonal imbalances, assess fertility, diagnose certain cancers, and identify problems associated with menopause or other hormonal disorders.

The types of estrogens

Estrogen is not a single hormone, but a group of compounds that play crucial roles, especially in the reproductive system. The three main types of estrogen are:

  • Estradiol (E2): The most powerful form for premenopausal women. It is essential for menstrual cycle regulation, reproductive health, and bone density. It is commonly measured in blood and urine tests because of its clinical importance.
  • Estrone (E1): The main estrogen after menopause, with moderate activity. It is sometimes tested to assess hormonal status or therapy needs.
  • Estriol (E3): The weakest form, mainly produced during pregnancy to support fetal development. It is rarely measured outside of pregnancy.

When is an estrogen test recommended?

For women, estrogen tests are often part of regular checkups or fertility evaluations. In men, they may be needed to explore health issues related to hormonal imbalances.

Here are some cases where an estrogen test may be recommended:

  • Persistent pelvic pain
  • Abnormal menstruation
  • Unexplained weight changes
  • Unusual breast enlargement (for men and women)
  • Prolonged mood swings or mood swings
  • Low libido
  • Monitoring of hormone replacement therapy (HRT)
  • Menopausal symptoms, such as hot flashes or night sweats
  • Gynecomastia in men (increase in breast tissue)
  • Fertility issues or pregnancy concerns

How is the estrogen test done?

Estrogen levels can be measured using a variety of methods depending on the medical context.

The test usually involves collecting a sample from the body, which is then analyzed to determine hormonal levels.

Common methods for measuring estrogen:

  • Blood test: The most common method, involving taking blood from a vein to analyze the levels of estrogen in the blood.
  • Urine test: Estrogen can also be detected in a urine sample, although this method is used less frequently.
  • Saliva test: A method that is sometimes used for non-invasive hormone testing.

These tests are sometimes part of larger hormonal panels, such as a reproductive panel or fertility assessment. They may also be included in endocrine function tests.

Preparations for the test:

  • On an empty stomach: In some cases, it may be necessary to fast for several hours before a blood test.
  • Test time: For women, test time is important because estrogen levels fluctuate during the menstrual cycle. Your doctor may advise you to do the test on a specific day in your cycle.
  • Medications: Tell your doctor about any medications you are taking, as some may affect estrogen levels.

What are normal estrogen levels?

The most commonly measured form is estradiol (E2) because it provides important clinical information about hormonal health. Estrogen levels vary depending on gender, age, and, for women, the phase of the menstrual cycle.

In the blood

Here are the typical ranges for estradiol:

  • Children:
    Under 10 years: < 15 pg/mL
  • Adult men:
    10-50 pg/mL
  • Adult women:
    • Follicular phase: 20-350 pg/mL
    • Mid-cycle peak: 150-750 pg/mL
    • Luteal phase: 30-450 pg/mL
    • Post-menopause: ≤ 20 pg/mL

In the urine

Typical reference ranges for urinary estradiol (measured in mcg/24 hours):

  • Children:
    Under 10 years old: 0—6
  • Adult men:
    0—6
  • Adult women:
    • Follicular phase: 0—13
    • Mid-cycle peak: 4—14
    • Luteal phase: 4—10
    • Post-menopause: 0—4

Note: These ranges may vary depending on the laboratory and the specific test methods used.

What do abnormal estrogen levels mean?

High estrogen levels

High levels of estrogen may indicate an imbalance or an underlying health condition.

Causes of high estrogen levels:

  • Some medications
  • Chronic inflammatory diseases
  • Autoimmune disorders
  • Hypothalamo-pituitary dysfunctions
  • Breast or ovarian cancer

Recommendations:

  • Consult a doctor to identify the cause.
  • Reduce alcohol consumption.
  • Maintain a healthy weight.
  • Manage stress.
  • Limit exposure to endocrine disruptors.

Low estrogen levels

Low estrogen levels are common during menopause but can also be the result of other factors.

Causes of low estrogen levels:

  • Ovarian agenesis
  • Menopause
  • Removal of the ovaries
  • Hypothalamo-pituitary dysfunction
  • Ovarian aplasia

Recomendations:

  • Consult a health professional.
  • Consider hormone replacement therapy (HRT).
  • Incorporate phytoestrogen-rich foods into your diet.
  • Practice regular exercise.