Biochemistry

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Serum Oestradiol (E2)

Oestrogens are involved in development and maintenance of the female phenotype, germ cell maturation, and pregnancy. The major biologically active oestrogens in nonpregnant humans are oestrone (E1) and oestradiol (E2), while oestriol (E3) is the main pregnancy oestrogen.

 Oestradiol (E2) is produced primarily in ovaries and testes by aromatization of testosterone. Small amounts are also produced in the adrenal glands and some peripheral tissues, most notably fat.

Ostradiol (E2) levels are much lower in men and postmenopausal women compared to nonpregnant women.

E2 levels can fluctuate during the menstrual cycle. They are lowest during the early follicular phase but rise gradually until 48-72 hrs before ovulation. At this stage there is a rapid increase which reaches a peak just before the ovulation-inducing luteinizing hormone (LH)/follicle stimulating hormone (FSH) surge. E2 levels decline during the ovulatory phase but gradually increase until the midpoint of the luteal phase at which point there is a further decline to the trough levels of the early follicular stage of the menstrual cycle

Clinical Utility of Serum Oestradiol (E2)

Measurement of serum E2 is very useful in the assessment of reproductive function in females, including assessment of infertility, oligo-amenorrhea, and menopausal status. Moreover, in reproductive medicine practice it is widely used for monitoring ovulation induction, as well as during preparation for in vitro fertilization. 

Specific applications of E2 analysis include

• Evaluation of hypogonadism and oligo-amenorrhea in females
• Assessing ovarian status, including follicle development, for assisted reproduction protocols e.g, in vitro fertilization
• Monitoring of oestrogen replacement therapy in hypogonadal premenopausal women
• Evaluation of feminization, including gynecomastia, in males
• Diagnosis of oestrogen-producing neoplasms in males and females
• As part of the diagnosis and workup of precocious and delayed puberty in females
• Diagnostic work-up of inborn errors of sex steroid metabolism
• Monitoring low-dose female hormone replacement therapy in postmenopausal women
• Monitoring anti-oestrogen therapy e.g. aromatase inhibitor therapy

Helpful links

https://www.mayocliniclabs.com/test-catalog

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Reference range

Males                 41.4 - 159 pmol/L

Follicular.            114 - 332 pmol/L

Ovulation            222 - 1959 pmol/L

Luteal                  222 - 854 pmol/L

Post Menop        <18.4 - 505 pmol/L

Please Note: Median is <18.4 pmol/L in post menopausal women.

Last updated

Fri, 04 Apr 2025 17:26:28 IST