Estradiol
Code:9019|CPT:82670|LOINC:2243-4
| Includes | Estradiol |
|---|
Analysis details
Methodology
- Electrochemiluminescence immunoassay (ECLIA)
Expected Turnaround Time
1 day
Special Instructions
- Do not eat for 2–3 hours before the blood draw; water is allowed.
- For children 1–5 years old, withhold food for 2–3 hours before collection.
- If clinically acceptable, pause steroid and thyroid hormone medications for 48 hours prior to collection.
- Avoid strenuous exercise and minimize emotional stress for 24 hours before collection.
- Do not smoke during the 3 hours before collection.
- Confirm biotin use; discontinue high-dose biotin for at least 72 hours before the test.
How to use
The Estradiol (E2) test, also known as serum 17β-estradiol, supports assessment of ovarian function and the evaluation of amenorrhea in contexts that require distinguishing physiologic states such as pregnancy from pathologic causes. It aids investigation of disorders of pubertal timing (for example, precocious puberty in girls) and informs the evaluation of gynecomastia or feminization in men. In women of reproductive age, estradiol testing contributes to fertility assessment and is used to monitor follicular development during controlled ovarian stimulation and in vitro fertilization cycles.
Limitations
Estradiol is the principal estrogen driving development of female reproductive organs and secondary sexual characteristics. Concentrations vary across the menstrual cycle, reaching a peak near ovulation and falling to a trough in the early follicular phase. Circulating levels are substantially lower in children, men, and postmenopausal women than in women of reproductive age. During the perimenopausal transition, estradiol levels fluctuate widely, and values may overlap with those seen in normal cyclic physiology. For serial testing, results should be generated with the same assay methodology because inter-method differences can affect comparability.
| Unit | pg/mL |
|---|---|
| Reference interval | — |
| Indications | Assessment of pelvic pain in females, Workup of abnormal uterine bleeding, Irregular menstrual cycles, including oligomenorrhea and amenorrhea, Female infertility evaluation and monitoring during controlled ovarian stimulation, Evaluation of early or delayed puberty in girls, Perimenopausal or menopausal symptoms—such as vasomotor complaints or insomnia—and amenorrhea, Gynecomastia or feminization in males; concern for an estrogen-producing tumor |
Possible Causes of Abnormal Results
Increased levels
- ampicillin
- biotin supplementation (high dose)
- cascara sagrada
- estrogen therapy
- fulvestrant
- glucocorticoids
- phenothiazines
- tetracyclines
Decreased levels
- high-carbohydrate, low-fat diet (eg, vegetarian diet)
Specimen Requirements
| Specimen | Serum |
|---|---|
| Container | Gold/Tiger Top (SST, Gel Separator) |
| Volume | 1 mL (min 0.7 mL) |
| Storage Instructions | Room temperature, Refrigerated, Frozen |
References
Gordon CM. Clinical practice. Functional hypothalamic amenorrhea. N Engl J Med. 2010 Jul 22; 363(4):365-371. PubMed 20660404Kiel DP, Baron JA, Plymate SR, Chute CG. Sex hormones and lipoproteins in men. Am J Med. 1989 Jul; 87(1):35-39. PubMed 2787120Pont A, Goldman ES, Sugar AM, Siiteri PK, Stevens DA. Ketoconazole-induced increase in estradiol-testosterone ratio. Probable explanation for gynecomastia. Arch Intern Med. 1985 Aug; 145(8):1429-1431. PubMed 4040740Segal KR, Dunaif A, Gutin B, Albu J, Nyman A, Pi-Sunyer FX. Body composition, not body weight, is related to cardiovascular disease risk factors and sex hormone levels in men. J Clin Invest. 1987 Oct; 80(4):1050-1055. PubMed 3654969Stewart MO, Whittaker PG, Persson B, Hanson U, Lind T. A longitudinal study of circulating progesterone, oestradiol, hCG and hPL during pregnancy in type 1 diabetic mothers. Br J Obstet Gynaecol. 1989 Apr; 96(4):415-423. PubMed 2751954Studd J, Savvas M, Waston N, Garnett T, Fogelman I, Cooper D. The relationship between plasma estradiol and the increase in bone density in postmenopausal women after treatment with subcutaneous hormone implants. Am J Obstet Gynecol. 1990 Nov; 163(5 Pt 1):1474-1479. PubMed 2240090