Estradiol: the norm in women, causes of deviations,why raised, lowered

Update: December 2018

The hormonal background of a woman is one of her main criteria.
health And the most “female” hormone is estradiol. Any
abnormalities of this substance affect regularity
cycle, the ability to conceive and the general condition of the body.

Menstrual cycle

In the ovaries, women produce sex hormones: progesterone,
estrogens and androgens. The group of estrogen include three

  • estrone (E1)
  • estradiol (E2)
  • estriol (E3)

The ovaries, in turn, are controlled “from above,” by
brain interactions with endocrine organs.

The normal menstrual cycle consists of a follicular phase,
ovulation and luteal phase. From the first day of menstruation in the ovaries
follicles develop, the largest of which becomes
dominant and produces estrogen.

Under the influence of this hormone on the 14th day of the cycle ovulation occurs,
the egg cell leaves, and the follicle turns into a yellow body. It
secretes estrogen and progesterone. If pregnancy is not
came, the yellow body gradually disappears, the hormonal level
falls, the result – menstruation.

Estrogens during pregnancy

Formed after successful conception the yellow body of pregnancy
begins to actively synthesize progesterone and estrogen. Until term 6
weeks estradiol prevails in the mother’s blood, then several
estrone level rises. At a later date, the main
The source of these hormones are the adrenal glands of the fetus. So
Thus, the level of estrogen rises smoothly all 40 weeks, and
reaching the maximum level, perhaps playing one of the main
roles at the beginning of labor.

Estrogen Effects

  • Formation of female genital organs
  • The growth of uterine muscle and endometrium
  • The growth of the alveoli and ducts of the mammary glands
  • Strengthening the formation of blood vessels in the uterus
  • The retention of water and sodium in the body
  • Cholesterol lowering
  • Increased blood clotting

Hormone rates in the blood

Estradiol, like all sex hormones, has periods and even
daily fluctuations. It is estimated that between 15 and 18 hours he
we reach a maximum, and between 24 and 2 hours – a minimum.

Hormone estradiol, the norm in women after 18 years of age

Follicular phase of the MC (1-14 day) 68 – 1269 pmol / l
Ovulation 131 – 1655 pmol / l
Luteal phase (14-28 day) 91 – 861 pmol / l
Postmenopause less than 73 pmol / l

In pregnant women:

Estradiol Norm weekly during pregnancy (click to

It should be noted that the rate of estradiol for weeks during pregnancy
very relative. Its quantity does not allow to put this or
a different diagnosis, predict the threat of miscarriage or malformations
fetus. This is just a reason to conduct additional examinations (ultrasound,
CTG, etc.)

Causes of Estradiol Reduction

  • Very low body weight
  • Severe stress
  • Climacteric syndrome
  • Hyperprolactinemia
  • Ovarian exhaustion syndrome and resistant ovary syndrome
  • Hypopituitarism
  • Genetic disorders
  • Medication intake

Very low body weight

Sharp weight loss (more often – with strict diets) affects
all organs and systems. The brain is no exception. Pituitary
ceases to allocate the necessary gonadotropins, this in turn
reduces the production of sex steroids in the ovaries. Estradiol besides
falls due to a decrease in body fat, because in it
a small amount is synthesized. As a result, stop
menstruation, and deteriorating state of health. For such an effect
quite sharply lose 10-15% of adipose tissue (or 5-18% by weight

The treatment of such a condition is one – return to the original weight.
Sometimes this requires the help of a nutritionist or even a psychotherapist.
(with the development of anorexia nervosa).

Severe stress

Many people know that in difficult times (during the war,
for example) the birth rate is sharply reduced. This is due, among other things, to
hormonal disruption in women: the ovaries stop secreting
estrogens, menses disappear, the ability to conceive decreases.
Treatment in such cases is not required after normalization.
The psychological state of the ovaries begin to work normally.

Climacteric syndrome

The period of extinction of the reproductive function of a woman is called
menopausal period. It starts at the age of 45-55 years and
is inevitable. Ovaries in menopause decrease, lose
hormone receptors, resulting in reduced synthesis of all genital
steroids, including estrogen.

Symptoms and effects of menopause Analyzes for menopause: Treatment
  • interruptions in the menstrual cycle and then complete cessation
  • hot flashes
  • urination disorders (incontinence, frequent cystitis)
  • libido change, vaginal dryness
  • emotional imbalance
  • osteoporosis
  • development of atherosclerosis
estradiol is reduced, FSH is increased. In some cases of menopausal women
quality of life decreases. Frequent bone fractures, progressive
atherosclerosis, sexual dysfunction – direct indications for
replacement therapy with estrogen drugs. The same applies to
early menopause (up to 45 years).


Pituitary hormone prolactin inhibits the production of genital hormones
therefore, its excess affects the reproductive health of women.
A common cause of this condition is a pituitary tumor –
prolactinoma. With its growth characteristic symptoms appear:

  • galactorrhea (expiration of breast milk outside of pregnancy and
  • interruptions in the menstrual cycle
  • headache
  • sometimes – hirsutism (appearance of facial hair, acne)
  • sometimes infertility

The above symptoms combined with elevated levels
prolactin and low estrogen are a reason to examine
pituitary. When a tumor is detected on CT or MRI,
appropriate treatment depending on the desire to get pregnant
(bromkriptin or surgical intervention).

Ovarian dysfunction

Syndromes of resistance and exhaustion (FAT, SIA) – one of the reasons
lack of menstruation and low levels of sex hormones.
With SAD, the ovaries are normally developed, they have follicles, but
hormonal effects of the brain, they do not respond. Reasons for this
unknown. It is believed that congenital
defects, autoimmune diseases and irradiation of the pelvic area. The result
становится постепенное прекращение monthly, бесплодие при
no symptoms of menopause. The amount of estradiol is reduced.

SIA is a similar condition. But in this case, the follicles are few
or absent, and in addition to menstrual dysfunction
tides and other signs of menopause are added.
Both of these syndromes develop up to 35-38 years old, representing a large
the problem. You can cure only unpleasant symptoms with medication,
whereas infertility can be managed using donor


Partial or complete loss of pituitary function is called
hypopituitarism. This happens for various reasons. More often
This part of the brain is affected by tumors, infections, radiation. Have
women emit a special condition – Skien syndrome that occurs after
childbirth. It occurs with massive bleeding and falling.
blood pressure resulting in pituitary undergoes ischemia
(decrease in blood flow), which leads to its death.

Complete loss of pituitary function leads to severe symptoms:
exhaustion, weakness, bone damage, impaired consciousness and
coma. If the syndrome is partial, then individual organs may suffer, in
including the sex glands. The amount of all hormones decreases:
estradiol, progestins, androgens. Menstruation stops,
mammary glands are reduced, pubic hair and axillary hair fall out
hollows. Diagnose this condition by symptoms and decreased
hormone levels of the pituitary gland. Treatment состоит в заместительной терапии.
If it is correctly selected, then the forecast is favorable.

Genetic disorders

Have здоровой женщины хромосомный набор имеет вид 46ХХ, что и
determines the structure of its genitals, the ability to make
child and anatomical features. Sometimes chromosomes are grouped
wrong, causing various syndromes.

  • Shereshevsky-Turner syndrome

In the classical form of the syndrome, the karyotype of a woman is 45X. Such
In cases of diagnosis, a diagnosis is made in the maternity hospital, as there are characteristic
external signs (swelling of the hands and feet, winged folds of the neck). AT
Further girls have short stature, the wrong structure of the ear
shells and palate, underdevelopment of the genitals.

If a part of the body cells has a 45X karyotype, and some –
a normal set of 46XX, then such an erased syndrome often remains
unnoticed until adolescence. AT этом случае первым
and the only symptom is the absence of menstruation
term (to 16 years). AT анализах будет повышение ФСГ (в 10 и более
times) and extremely low estradiol values. ATнешние признаки
several erased: there is an underdevelopment of the genitals,
mammary glands. The only treatment for these girls is
estrogen replacement therapy. It allows you to make a figure
more feminine, cause menstrual cyclical
bleeding and improve the quality of life.

Medication intake

There are quite a few medications that reduce hormone levels.
The main ones are drugs for chemotherapy, cimetidine, danazol,
dexamethasone, nandrolone, some COCs, mifepristone,

Reasons for increasing estradiol

  • Obesity
  • Hyperandrogenism
  • Hormone-producing tumors and ovarian cysts
  • Tumors secreting hCG (blistering,
    chorionic carcinoma)
  • Severe liver damage
  • Medication intake


Adipose tissue – a kind of endocrine organ. AT нем происходят
complex processes of the transformation of male sex hormones (androgens)
in estrogens. This is an important aspect in the life of a woman, necessary for
беременности и childbirth. But if the body fat gets too
massive, then the process of turning hormones is disturbed. AT крови
an increased amount of estradiol can be determined, while
ovulation and ability to conceive may be absent. After
menopause obesity also plays a cruel joke. One side,
excess estrogen reduces the appearance of menopause (hot flashes, dryness
vagina, etc.), on the other hand, leads to an increased risk
hyperplasia endometrium and tumors of the breast, ovary and uterus.


The term means increased levels of androgens (male
hormones) in the blood. Since they are predecessors
estrogen, their excess leads to an increase in the level of female

Clinically, hyperandrogenism may manifest itself in different ways. Easy
degree causes skin problems (acne, seborrhea), baldness,
excessive growth of facial hair. Severe syndrome leads to
отсутствию monthly, бесплодию, изменению фигуры по мужскому
to type.

The most common disease with an excess of male hormones is
women is polycystic ovary syndrome (Stein-Leventhal).
Its causes are diverse and still poorly understood. It is known that
based on the malfunction of the hypothalamus and pituitary,
indirectly leading to active synthesis of androgens by the ovaries.
Additional risk factors are obesity, pathology.
thyroid and high insulin levels in the blood.

Диагностика синдрома основывается на жалобах женщины, данных HaveЗИ
(polycystic ovaries), as well as determining the level of androgens
blood. And the last point is not decisive for
making a diagnosis.

The method of treatment depends on reproductive plans. If in
soon there is a desire to have a baby, it is recommended
take clomiphene. AT противном случае назначают комбинированные
low estrogen oral contraceptives and
antiandrogenic effect.

Hormone-producing ovarian tumors

Some ovarian formations (granulosa,
TEKA-cell tumors) can actively produce female genital
hormones, causing characteristic symptoms.

  • Have девочек наступает преждевременное половое созревание.
  • Have женщин среднего возраста возникают маточные кровотечения и
    loop faults.
  • After менопаузы появляются кровяные выделения различной
    Intensity, while the condition of the skin does not match the age
    (less wrinkles, more elasticity).

ATсе эти изменения вызывает высокий уровень эстрогенов в blood.
Если при таких симптомах на HaveЗИ обнаруживают новообразование, то
requires its removal and histological examination. Treatment
carried out depending on the type of tumor, its goodness or
malignancy. After излечения анализы приходят в норму,
the symptoms disappear.

Tumors secreting hCG

A major cause of hormonal imbalance is
skid and horioncarcinoma. These conditions occur when villi
chorion uncontrolledly implanted in the uterus, grow there, and sometimes
– give metastases and affect other organs. The reason for this is
abnormal set of chromosomes during fertilization. Tumor is active
secretes hCG, which in turn leads to an increase in progesterone
and estrogen. Главный способ диагностики – HaveЗИ и анализ на
human chorionic gonadotropin. AT зависимости от степени
malignant doctor prescribes observation either
chemotherapeutic drugs.

Severe liver damage

Sex hormones end up in the liver, are metabolized
there and then excreted. With cirrhosis and other diseases with
liver failure this process is disturbed, the level
estrogen in plasma exceeds the norm.

Medication intake

AT некоторых случаях эстрадиол повышен у женщин, принимающих
various drugs. These include anabolics,
carbamazepine, cimetidine, clomiphene, ketoconazole, nafarelin,
mifepristone, phenytoin, tamoxifen, valproic acid,
estrogen preparations (COC).

When do I need an estradiol test?

  • For violations of the menstrual cycle
  • With endocrine infertility
  • In case of violation of puberty
  • For the diagnosis of fetal abnormalities

How to donate blood for estrogen?

The analysis must be taken in the morning (from 8 to 11), on an empty stomach. On the eve of
It is advisable to avoid food excesses and severe physical
load. Unless otherwise indicated, blood is better for blood sampling.
choose 2-4 day of the menstrual cycle.

Independently assign yourself this analysis should not be. Big
разброс нормальных значений не позволит ATам правильно оценить
results that will cause unnecessary anxiety and unrest. Estimate
picture of hormonal background can only the attending physician.

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