County Pathology Ltd

A Complete Pathology and Blood Testing Service

Test NameOestradiol
Used ForAll applications that require moderately sensitive measurement of oestradiol: evaluation of hypogonadism and oligo-amenorrhea in females; assessing ovarian status, including follicle development, for assisted reproduction protocols (eg, in vitro fertilisation), in conjunction with lutenising hormone measurements; monitoring of oestrogen replacement therapy in hypogonadal premenopausal women; evaluation of feminisation, including gynecomastia in males; diagnosis of oestrogen-producing neoplasms in males, and, to a lesser degree, females; as part of the diagnosis and work-up of precocious and delayed puberty in females, and, to a lesser degree, males; as part of the diagnosis and work-up of suspected disorders of sex steroid metabolism, eg, aromatase deficiency and 17 alpha-hydroxylase deficiency; as an adjunct to clinical assessment, imaging studies and bone mineral density measurement in the fracture risk assessment of postmenopausal women, and, to a lesser degree, older men; monitoring low-dose female hormone replacement therapy in post-menopausal women; monitoring antiestrogen therapy (eg, aromatase inhibitor therapy)
AliasesE2, estradiol,
Specimen TypeSerum (Yellow)
Volume of sample>0.25ml
Refrigerated stability7 days
Interfering substancesNo significant cautionary statements
Clinical InformationE2 is produced primarily in ovaries and testes by aromatisation of testosterone. Small amounts are produced in the adrenal glands and some peripheral tissues, most notably fat. E2 levels in premenopausal women fluctuate during the menstrual cycle. They are lowest during the early follicular phase. E2 levels then rise gradually until 2 to 3 days before ovulation, at which stage they start to increase much more rapidly and peak just before the ovulation-inducing lutenising hormone (LH)/folicle stimulating hormone (FSH) surge at 5 to 10 times the early follicular levels. This is followed by a modest decline during the ovulatory phase. E2 levels then increase again gradually until the midpoint of the luteal phase and thereafter decline to trough, early follicular levels. Measurement of serum E2 forms an integral part of the assessment of reproductive function in females, including assessment of infertility, oligo-amenorrhea, and menopausal status. In addition, it is widely used for monitoring ovulation induction, as well as during preparation for in vitro fertilisation.
InterpretationOestradiol (E2) levels below the premenopausal reference range in young females indicate hypogonadism. If luteinising hormone (LH) and follicle stimulating hormone (FSH) levels are elevated, primary gonadal failure is diagnosed. The main causes are genetic (eg, Turner syndrome, familial premature ovarian failure), autoimmune (eg, autoimmune ovarian failure, possibly as part of autoimmune polyglandular endocrine failure syndrome type II), and toxic (eg, related to chemotherapy or radiation therapy for malignant disease). If LH/FSH levels are low or inappropriately "normal," a diagnosis of hypogonadotrophic hypogonadism is made This can have functional causes, such as starvation, overexercise, severe physical or emotional stress, and heavy drug and/or alcohol use. It also can be caused by organic disease of the hypothalamus or pituitary. Further work-up is usually necessary, typically including measurement of pituitary hormones (particularly prolactin), and possibly imaging.
Retention Time7 days
ReferencesMayo Clinic Laboratories
Lab Tests On Line