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What is an Estrogen Total test?

An oestrogen total test is a measure of the female sex hormone oestrogen in body. It is found in several forms, such as estrone (E1), estradiol (E2) or estriol (E3). Oestrogen in women, along with other hormones, regulates the menstrual cycle and development of eggs in ovary; maintains pregnancy; prepares breasts for the process of lactation; and promotes the development and maintenance of female secondary sex characteristics, such as widening of hips and enlargement of breasts at puberty. Small amounts of estradiol are also present in males due to the conversion of testosterone, a main male sex hormone. Levels of oestrogen vary through the different stages of menstrual cycle and pregnancy. For example, it is high during the ovulation stage of the menstrual cycle and declines thereafter; during pregnancy, the placenta secretes high amounts of oestrogen, which declines sharply after delivery.

  1. Why is an Estrogen test performed?
  2. How do you prepare for an Estrogen test?
  3. How is an Estrogen test performed?
  4. What do Estrogen Total test results iIndicate?

An oestrogen test may be performed on the basis of based on the age and gender of the individual.

In men, this test is done in cases of abnormal enlargement of breast. This is more common in boys of pubertal age (10-15 years) than adult men.

In women, oestrogen test is performed for various reasons:

  • Delayed puberty, ie if there is no breast enlargement over the age of 13 years or no menstruation above the age of 15 years
  • Early (precocious) puberty seen in girls below the age of 8 years. It can also be seen in boys in the form of development of facial hair and a drastic increase in the growth of reproductive organs prior to 9 years of age.
  • Difficulties in getting pregnant
  • Irregular menstruation
  • Menopausal symptoms, such as hot flashes, night sweats, irregular bleeding and vaginal dryness (Read more: Menopause management)

It is also used to detect tumours that may secrete oestrogen and check the effectiveness of various hormonal treatments.

No special preparation is required prior to this test.

An oestrogen test can be performed using either a blood, urine or saliva sample.

For a blood sample, a needle is inserted into a vein, and a small quantity of blood is withdrawn into a syringe and stored in a container.

For a urine analysis, a 24-hour sample is required. The individual will be provided with a sample container. The first urine of the day passed immediately after the night’s sleep must be discarded and the time must be noted. Thereafter, every time urine is passed, it must be collected over the next 24 hours in a sample container and stored in a refrigerator.

For a saliva sample, a kit is provided to the individual, and he or she will be explained how to store the sample and provide it for testing.

Normal results:

  • Estradiol

    • Males: 10-40 picograms per millilitre (pg/mL)
    • Premenopausal females: 15-350 pg/mL (levels vary through the menstrual cycle)
    • Postmenopausal females: <10 pg/mL
  • Estrone
    • Males: 10-60 pg/mL
    • Premenopausal females: 17-200 pg/mL(levels vary through the menstrual cycle)
    • Postmenopausal females: 7-40 pg/mL[20]

Normal results indicate proper functioning of this hormone However, the results must be interpreted with caution as many factors are involved with sex hormones, such as the functioning of hypothalamus and pituitary gland.

Abnormal results: Higher than normal levels of estradiol or estrone will be seen in case of tumours of ovaries, testicles or adrenal gland; cirrhosis; early puberty in girls; or delayed puberty in boys.

Lower than normal levels of these two hormones could be an indication of the following conditions:

  • Primary ovarian insufficiency, which causes early menopause before the age of 40 years. It is associated with absence of periods for more than 3-6 months.
  • Turner syndrome, a chromosomal abnormality of the X chromosome, may also show ovarian insufficiency.
  • Anorexia nervosa is an eating disorder in which an individual restricts food intake to an extent that it affects the development and maintenance of the body.
  • Polycystic ovarian syndrome (PCOS), a highly prevalent condition in women of child-bearing age, which can lead to infertility. In this condition, insulin abnormalities and obesity are also commonly observed. Symptoms of PCOS are observed after the onset of the menstrual cycle in a girl’s life and may be more pronounced later in life. PCOS is diagnosed using an ultrasound that shows multiple cysts in ovaries.

Estriol levels usually rise to higher than normal levels during pregnancy, and a lower than normal value indicates Trisomy 21 or Down’s Syndrome in the foetus.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational perspective and is in no way a substitute for medical advice from a qualified doctor.

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  1. Tortora GJ, Derrickson B. Principles of Anatomy and Physiology. 14th ed. USA: John Wiley & Sons, Inc; 2014. Chapter 18.11, Ovaries and Testes pp 646.
  2. Tripathi KD. Essentials of Medical Pharmacology. 6th edition. New Delhi: Jaypee Brothers Medical Publishers Pvt Ltd; 2009. Chapter 22. Estrogens, Progestins and Contraceptives pp 297-318
  3. Jameson JL, Kasper DL, Fauci A.S, Longo DL, Hauser S.L, Loscalzo J. Harrison’s Principles of Internal Medicine. 20th ed. USA: McGraw Hill education; 2018. Chapter 385, Disorders of the female reproductive system pp 2787-2793.
  4. Jameson JL, Kasper DL, Fauci AS, Longo DL, Hauser SL, Loscalzo J. Harrison’s Principles of Internal Medicine. 20th ed. USA: McGraw Hill education; 2018. Chapter 384, Disorders of the Testes and the Male reproductive system pp 2769-2786.
  5. Jameson JL, Kasper DL, Fauci AS, Longo DL, Hauser SL, Loscalzo J. Harrison’s Principles of Internal Medicine. 20th ed. USA: McGraw Hill education; 2018. Chapter 388, Menopause and post menopausal hormone therapy pp 2803-2809.
  6. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Estrogen Levels Test
  7. Lab Tests Online. Washington D.C.: American Association for Clinical Chemistry; Progesterone
  8. US Food and Drug Administration (FDA) [internet]; Ovulation (Saliva Test)
  9. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Ectopic Pregnancy
  10. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; Health Information: Progesterone
  11. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; Health Information: Primary Ovarian Insufficiency