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Estradiol in the blood

Medical expert of the article

Endocrinologist
, medical expert
Last reviewed: 04.07.2025

Estradiol is the main representative of estrogens, possessing the highest biological activity. Estrone is formed from estradiol by enzymatic means and has less pronounced biological activity (due to the low ability to bind to cell receptors). During pregnancy, estrone can be determined in increasing concentrations. In this case, the hormone is synthesized from DHEAS, formed in the adrenal cortex of the fetus. Thus, estrone is one of the indicators characterizing the condition of the fetus.

In the female body, estradiol is synthesized in the ovaries, in the membrane and granulosa cells of the follicles. In the luteal phase of the menstrual cycle, estradiol is synthesized exclusively by the cells of the follicle membrane, while the granulosa cells are luteinized and switch to progesterone synthesis. When pregnancy occurs, massive production of estrogens is carried out by the placenta. Other sites of estrogens, primarily estrone in postmenopause, include the adrenal cortex and peripheral adipose tissue, due to their ability to aromatize androgens. Determination of estradiol concentration is necessary to assess ovarian function.

Reference values (norm) of estradiol concentration in blood serum

Age

Estradiol, pg/ml

Children under 11 years old

<15

Women:

Follicular phase

20-350

Ovulation phase

150-750

Luteal phase

30-450

Menopause period

<20

Men

10-50

There is no reliable evidence of the presence of estrogen secretion in the male body; they are usually formed from testosterone.

The target organs of estrogens in women include the uterus, vagina, vulva, fallopian tubes, and mammary glands. Estrogens are responsible for the development of secondary sexual characteristics and determine the characteristic physical and mental features of women. Estrogens cause the closure of the epiphyseal growth points.

Estradiol levels remain low during the early and mid-follicular phase of the menstrual cycle. Three to five days before the LH peak, estradiol levels begin to rise and peak approximately 12 hours before the LH peak. After a sharp drop to a nadir 48 hours after the LH peak, estradiol levels begin to rise again (biphasic progression). The peak concentration is reached on the 9th day after ovulation, and then the hormone concentration declines again toward the end of the cycle as the corpus luteum atresia occurs.

Low concentrations of estradiol in the blood are characteristic of diseases of the hypothalamus or pituitary gland; high concentrations are observed in estrogen-secreting tumors or follicular ovarian cysts; in such cases, excess estradiol suppresses the secretion of LH and FSH, leading to anovulation.

Causes of increase and decrease of estradiol

Diseases and conditions in which the concentration of estradiol in the blood serum changes

Estradiol is elevated

Estradiol is low

Gynecomastia

Uterine bleeding during menopause

Estrogen-producing tumors

Cirrhosis

Feminization in children

Use of gonadotropins, clomiphene, estrogens

Turner syndrome

Primary and secondary hypogonadism

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