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Latest Edit: Iva Lloyd, ND 2016-02-28 (EDT)

See Also Lab Tests

The testing of estrogen levels is often done if a woman has unexplained abnormal menstrual cycles, abnormal or heavy bleediing, infertility, symptoms of menopause, or any other hormone-related conditions.[1], [2]


  • There are over 20 different forms of estrogen. The most common include:
  • Estrone (E1)
Article Estrogen Metabolism: Advances in Prediction of Disease Risk, IHP ; April/May 2013
Estrone is derived from metabolites from the adrenal gland and is often made in adipose tissue (fat).
  • Estrone can be converted into estradiol or estriol when needed.
  • After menopause, it becomes the major estrogen, with E2 and E3 levels diminishing greatly.
  • Estrone is the major estrogen in men and is the product of the peripheral aromatization of androstenedione in fat and muscle tissue.
  • Estradiol (E2), also known as estradiol-17 beta
  • Estradiol is the predominant form and is produced primarily in the ovaries with additional amounts produced by the adrenal glands in women and in the testes and adrenal glands in men.
  • In menstruating women, levels vary throughout the month, rising and falling in concert with FSH, LH, and progesterone as follicles are stimulated in the ovaries.
  • The level is lowest at the beginning of the menstrual cycle and rise to their highest level just before the release of an egg from the ovary (ovulation).
  • Normal levels of estradiol provide for proper ovulation, conception, and pregnancy, in addition to promoting healthy bone structure and regulating cholesterol levels.
  • Estradiol is an estrogen with more proliferative properties. It is formed partially in the testes, but mostly by aromatase enzyme action in peripheral tissues from both testicular and adrenal androgens.
  • Estriol (E3)
  • Estriol is the major estrogen in pregnancy, with relatively large amounts produced by the developing placenta.
  • Estrogens are a group of steroids that regulate the menstrual cycle and function as the main female sex hormones.
  • Symptoms associated with estrogen dominance vary and can include: mood swings, irritability, depression, irregular periods, heavy menstrual bleeding, hot flashes, vaginal dryness, water retention, weight gain in the hips, thighs or abdomen, insomnia or other sleep disturbances, decreased libido, headaches, fatigue, short term memory loss, lack of concentration, thinning of scalp hair, dry, thin, wrinkled skin, increased facial hair, osteoporosis and diffuse aches and pains.
  • Testing is commonly done when assessing any of the following conditions:
  • hormone imbalances
  • abnormal vaginal bleeding
  • unusal and/or early sex organ development in a female
  • during pregnancy to monitor the health of placenta and fetus
  • if a man shows signs of feminization

Patient Preparation

  • No fasting required.
  • Estrogen levels can be assessed in blood, 24-hour urine sample, or saliva.
  • Factors which can cause increased levels
  • Medications such as hormone-replacement therapy, birth control pills
  • Factors which can cause decreased levels

Clinical Implications

High levels may indicate:

Low levels may indicate:

Associated Tests


  1. Pagana Kathleen D, Pagana Timothy J (2006) Mosby's Manual of Diagnostic and Laboratory Tests, Mosby.
  2. Weatherby Dicken, Ferguson Scott (2002) Blood Chemistry and CBC Analysis: Clinical Laboratory Testing from a Functional Perspective, Bear Mountain.