What determines the normal levels of the female hormone estradiol? Norms of estradiol in women and its biological role Estradiol on the 3rd day of the cycle is below normal

Estradiol (E2) belongs to the female hormones - estrogen. It plays an important role in the implementation of the reproductive function, affects the functioning of many organs and affects the metabolism.

Determining the concentration of estradiol is used to assess the state of the reproductive system. When interpreting the results of the study, it must be taken into account that the level of the hormone depends on the day of the menstrual cycle and the age of the woman.

Characteristics of the hormone

Estradiol is the most active estrogen. It is formed from the male hormone testosterone under the influence of the aromatase enzyme. The source for its production, as for all other steroid compounds, is cholesterol. Estradiolproduced in the gonads and on the periphery. In the female body, its synthesis is carried out in the following organs and tissues:

• ovarian granulosa cells;
• adrenal cortex;
• adipose tissue.

The newly formed estrogen is secreted into the blood, where it binds to transport proteins or circulates in a free, biologically active state. Its metabolism is carried out in the liver. The hormone is excreted in the urine in the form of estriol, a substance that does not have significant physiological effects.

The regulation of estrogen production is carried out by the higher levels of the reproductive system:

• the cerebral cortex - with the help of neurotransmitters;
• hypothalamus - through the production of gonadotropin-releasing factor, which stimulates the production of tropic hormones;
• pituitary - with the participation of gonadotropins - follicle-stimulating (FSH) and luteinizing (LH) hormones, which enhance the synthesis of estradiol and prolactin.

The organs that control the work of the ovaries respond to changes in the concentration of estrogen in the blood - with its increase, the secretion of stimulating substances decreases, and with a decrease, it increases. This mechanism is called negative feedback. There are also positive interactions between structures. An increase in the synthesis of estradiol in the preovulatory follicle leads to a sharp release of LH and FSH and the onset of ovulation.

The role of estrogen in the body

The biological role of the hormone is to regulate the functioning of the reproductive system. He is responsible for the formation of a normal menstrual cycle, the ability to conceive and bear a fetus. In addition to affecting reproductive function, estrogen affects other organs and target tissues: the nervous system, heart, blood vessels, skin, sebaceous glands, hair follicles, muscles, bones, large intestine, urinary system.

Target Organs for Estrogens

To realize the biological effect, estradiol forms a complex with specific receptors located in the cell nucleus or on its membrane. In the first case, the genomic action of the steroid is carried out, associated with a change in the synthesis of protein molecules, and in the second, a rapid response develops, which is often opposite to the nuclear one.

The main effects of the hormone in the body:

During pregnancy, estradiol promotes the growth of the uterus, improves blood supply to organs and tissues. The hormone also takes part in the preparation of the mammary glands for the release of milk.

Blood test for estradiol

A blood test for hormone content is a method of laboratory diagnosis of gynecological pathology. The level of estradiol is assessed in the followingcases:

• in violation of the menstrual cycle;
• in the absence or cessation of menstruation;
• with anovulation;
• when it is impossible to conceive a child;
• with the development of dyscirculatory uterine bleeding.

A blood test is taken on an empty stomach on the 3rd, 4th or 5th day of the menstrual cycle. If necessary, the doctor prescribes another time for the examination. Before the procedure, it is necessary to follow the generally accepted rules of preparation, which include not eating for 8-14 hours, the absence of heavy physical exertion, and maintaining emotional peace. After consultation with the attending physician, medications that can distort the results of laboratory testing are temporarily canceled. Do not smoke or drink alcohol before the procedure.

Indirectly, the amount of estradiol can be judged by the thickness of the endometrium on the 12–14th day of the cycle (calculated by ultrasound) and the nature of the cervical mucus during examination. Valuable information about the state of the hormonal background is provided by pharmacological tests using tableted gestagens.

Laboratory norms

The concentration of the hormone depends on the age of the woman, her physiological state, the day of the menstrual cycle. Activation of the hypothalamus-pituitary-ovaries system occurs during sexual development. With regular menstruation, an increase in the level of estradiol is observed in the follicular phase. The indicator reaches its maximum value shortly before ovulation, and then the estrogen content in the blood decreases sharply. After the rupture of the dominant follicle, a tendency to increase the amount of the hormone is again recorded, especially towards the middle of the luteal phase.

Estradiol levels in different phases of the menstrual cycle

In the early stages of pregnancy, the content of the substance in the blood increases. The high level of the indicator persists throughout the entire period of bearing a child and returns to its previous value a few weeks after childbirth. In menopause, estrogen synthesis gradually decreases, and testosterone in adipose tissue becomes the main source of its production.

The table shows the norms of estradiol in women by age and days of the menstrual cycle:

After receiving the form with the result, you must familiarize yourself with the norms indicated in it. When conducting research in different laboratories, they may differ. The analysis is interpreted by a doctor who, in addition to the E2 level, takes into account other indicators that characterize women's health.

Causes of changes in estradiol levels

A change in the concentration of the hormone is observed when the hypothalamus, pituitary gland, and ovaries are affected. Its deviation from normal values ​​can occur with diseases of the endocrine system, obesity, liver diseases.

Low estrogen levels are recorded in the following conditions:

• Organic or functional hyperprolactinemia.
• Malformations (dysgenesis) of the ovaries.
• Resistant ovary syndrome.
• Depleted ovary syndrome.
• Postpartum hypopituitarism.
• Syndrome of the "empty" Turkish saddle.
• Starvation, sudden weight loss.
• Stress.
• Kallman syndrome.

Interpretation of the results of a comprehensive laboratory examination:

The high concentration of the hormone in non-pregnant women is associated with its excessive secretion by hormonally active tumors:

• functional ovarian cysts;
• granulosa cell formations of the gonads;
• teratomas and teratocarcinomas;
• pituitary adenomas.

Update: December 2018

Women are one of the main criteria for her health. And the most "female" hormone is estradiol. Any deviations from the norm of this substance affect the regularity of the cycle, the ability to conceive and the general condition of the body.

Menstrual cycle

A woman's ovaries produce sex hormones: progesterone, estrogens, and androgens. The group of estrogens includes three substances:

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

The ovaries, in turn, are controlled "from above" through the interaction of the brain with the endocrine organs.

The normal menstrual cycle consists of the follicular phase, ovulation and the luteal phase. From the first day of menstruation, follicles develop in the ovaries, 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 is released, and the follicle turns into a corpus luteum. It secretes estrogens and progesterone. If pregnancy does not occur, then the corpus luteum gradually disappears, the hormonal level drops, the result is menstruation.

Estrogens during pregnancy

Formed after a successful conception, the corpus luteum of pregnancy begins to actively synthesize progesterone and estrogens. Until the period of 6 weeks, estradiol predominates in the mother's blood, then the level of estrone slightly increases. In later periods, the main source of these hormones are the fetal adrenal glands. Thus, the level of estrogen rises smoothly throughout the 40 weeks, and reaching a maximum level, perhaps play one of the main roles in the onset of labor.

Effects of estrogens

Hormone levels in the blood

Estradiol, like all sex hormones, has monthly and even daily fluctuations. It is believed that between 15 and 18 hours it reaches a maximum, and between 24 and 2 hours - a minimum.

The hormone estradiol, the norm in women after 18 years of age outside of pregnancy:

In pregnant women:

The rate of estradiol by week during pregnancy (click to enlarge)

It should be noted that the rate of estradiol for weeks during pregnancy is very relative. Its quantity does not allow one or another diagnosis to be made, to predict the threat of miscarriage or fetal malformations. This is just an excuse to conduct additional examinations (ultrasound, CTG, etc.)

Causes of a decrease in estradiol

• Very low body weight
• severe stress
• climacteric syndrome
• Hyperprolactinemia
• Ovarian Waste Syndrome and Resistant Ovarian Syndrome
• hypopituitarism
• Genetic disorders
• Taking medication

Very low body weight

Sudden weight loss (more often with strict diets) affects all organs and systems. The brain is no exception. The pituitary gland ceases to secrete the necessary gonadotropins, which in turn reduces the production of sex steroids in the ovaries. Estradiol also falls due to a decrease in body fat, because a small amount of it is synthesized in it. As a result, menstruation stops, and well-being worsens. For this effect, it is enough to sharply lose 10-15% of adipose tissue (or 5-18% of body weight).

There is only one treatment for this condition - a 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 drops sharply. This is due, among other things, to hormonal disruptions in women: the ovaries stop secreting estrogens, menstruation disappears, and the ability to conceive decreases. Treatment in such cases is not required, after the normalization of the psychological state, the ovaries begin to work normally.

climacteric syndrome

The period of extinction of the reproductive function of a woman is called menopause. It starts at the age of 45-55 and is inevitable. The ovaries in menopause decrease, lose receptors for hormones, as a result, the synthesis of all sex steroids, including estrogens, decreases.

Hyperprolactinemia

The pituitary hormone inhibits the production of sex hormones, so 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 (leakage of breast milk outside of pregnancy and lactation)
• interruptions in the menstrual cycle
• headache
• sometimes - hirsutism (the appearance of facial hair, acne)
• sometimes infertility

The above symptoms, combined with elevated prolactin levels and low estrogen levels, are a reason to examine the pituitary gland. If a tumor is detected on CT or MRI, appropriate treatment is prescribed depending on the desire to become pregnant (bromocriptine or surgery).

Impaired ovarian function

Resistance and wasting syndromes (RSS, SIS) are one of the reasons for the absence of menstruation and a reduced amount of sex hormones. In PSOS, the ovaries are normally developed and have follicles, but they do not respond to brain hormonal influences. The reasons for this are unknown. Birth defects, autoimmune diseases, and pelvic radiation are thought to play some role. The result is a gradual cessation of menstruation, infertility in the absence of symptoms of menopause. The amount of estradiol is reduced significantly.

SIA is a similar state. But in this case, the follicles are few or absent, and in addition to the violation of the menstrual function, hot flashes and other signs of the menopause are added. Both of these syndromes develop up to 35-38 years, presenting a big problem. Only unpleasant symptoms can be cured with medication, while infertility can be cured by using a donor egg.

hypopituitarism

Partial or complete loss of pituitary function is called hypopituitarism. This happens for various reasons. Most often, this part of the brain is affected by tumors, infections, and radiation exposure. In women, a special condition is distinguished - Shien's syndrome, which occurs after childbirth. This occurs with massive bleeding and a drop in blood pressure, as a result, the pituitary gland undergoes ischemia (reduced 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, including the sex glands, may suffer. The amount of all hormones decreases: estradiol, progestins, androgens. Menstruation stops, mammary glands decrease, pubic and armpit hair falls out. This condition is diagnosed by symptoms and reduced levels of pituitary hormones. Treatment consists of replacement therapy. If it is correctly selected, then the prognosis is favorable.

Genetic disorders

In a healthy woman, the chromosome set looks like 46XX, which determines the structure of her genital organs, the ability to bear a child and anatomical features. Sometimes the chromosomes don't group together correctly, causing various syndromes.

• Shereshevsky-Turner syndrome

In the classic form of the syndrome, the karyotype of a woman is 45X. In such cases, the diagnosis is made even in the maternity hospital, as there are characteristic external signs (edema of the hands and feet, pterygoid folds of the neck). In the future, girls have short stature, an irregular structure of the auricles and palate, and underdevelopment of the genital organs.

If some of the body's cells have a 45X karyotype, and some have a normal 46XX set, then such an erased syndrome often goes unnoticed until adolescence. In this case, the first and only symptom will be the absence of menstruation on time (by the age of 16). In the analyzes there will be an increase in FSH (10 times or more) and an extremely low value of estradiol. External signs are somewhat erased: there is an underdevelopment of the genital organs, mammary glands. The only treatment for these girls is estrogen replacement therapy. It allows you to make the figure more feminine, cause menstrual-like cyclical bleeding and improve the quality of life.

Taking medication

There are quite a few drugs that lower the level of the hormone. The main ones are chemotherapy drugs, cimetidine, danazol, dexamethasone, nandrolone, some COCs, mifepristone, pravastatin.

Reasons for increasing estradiol

• Obesity
• Hyperandrogenism
• Hormone-producing tumors and ovarian cysts
• Tumors that secrete hCG (chorionic carcinoma)
• Severe liver damage
• Taking medication

Obesity

Adipose tissue is a kind of endocrine organ. It undergoes complex processes of transformation of male sex hormones (androgens) into estrogens. This is an important aspect in a woman's life, necessary for pregnancy and childbirth. But if the fat layer becomes too massive, then the process of converting hormones is disrupted. An increased amount of estradiol can be determined in the blood, while ovulation and the ability to conceive may be absent. After menopause, obesity also plays a cruel joke. On the one hand, excess estrogen reduces the manifestations of menopause (hot flashes, vaginal dryness, etc.), on the other hand, leads to an increased risk of endometrial hyperplasia and tumors of the breast, ovaries and uterus.

Hyperandrogenism

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

Clinically, hyperandrogenism can manifest itself in different ways. A mild degree causes skin problems (acne,), baldness, excessive facial hair growth. A severe degree of the syndrome leads to the absence of menstruation, infertility, and a change in the figure according to the male type.

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

Diagnosis of the syndrome is based on the woman's complaints, ultrasound data (polycystic ovaries), as well as determining the level of blood androgens. Moreover, the last point is not decisive for the diagnosis.

The method of treatment depends on reproductive plans. If in the near future there is a desire to have a child, then it is recommended to take clomiphene. Otherwise, combined oral contraceptives with low estrogen content and antiandrogenic effect are prescribed.

Hormone-producing ovarian tumors

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

• Girls experience precocious puberty.
• Middle-aged women experience uterine bleeding and cycle failures.
• After menopause, blood discharge of varying intensity appears, while the skin condition does not correspond to age (less wrinkles, more elasticity).

All these changes cause a high level of estrogen in the blood. If, with such symptoms, a neoplasm is detected on ultrasound, then its removal and histological examination are required. Treatment is carried out depending on the type of tumor, its benignity or malignancy. After treatment, the tests return to normal, the symptoms disappear.

Tumors that secrete hCG

A serious cause of hormonal disorders is hydatidiform mole and choriocarcinoma. These conditions occur if chorionic villi uncontrollably invade the uterus, grow there, and sometimes metastasize and affect other organs. The reason for this is an abnormal set of chromosomes during fertilization. The tumor actively secretes hCG, which in turn leads to an increase in progesterone and estrogen. The main diagnostic method is ultrasound and analysis for human chorionic gonadotropin. Depending on the degree of malignancy, the doctor prescribes observation or chemotherapy drugs.

Severe liver damage

Sex hormones finish their journey in the liver, are metabolized there and then excreted from the body. In other diseases with liver failure, this process is disturbed, the level of estrogen in the plasma exceeds the norm.

Taking medication

In some cases, estradiol is elevated in women taking various medications. These include anabolics, carbamazepine, cimetidine, clomiphene, ketoconazole, nafarelin, mifepristone, phenytoin, tamoxifen, valproic acid, estrogen-containing drugs (COCs).

When is an estradiol test needed?

• For menstrual irregularities
• With endocrine infertility
• In violation of puberty
• For the diagnosis of fetal pathologies

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, it is desirable to avoid food excesses and heavy physical exertion. If there are no special instructions, then it is better to choose days 2-4 of the menstrual cycle for blood sampling.

You should not self-assign this analysis to yourself. A large spread of normal values ​​will not allow you to correctly evaluate the results, which will lead to unnecessary anxiety and unrest. Only the attending physician can evaluate the picture of the hormonal background.

Estradiol, the norm in women, is one of the main factors in maintaining health, sexual beauty, and reproductive function. This is one of the main hormones of the body, but mostly female. Throughout life, it is necessary to monitor the required amount of this substance in the body. Then the woman will protect herself from a large number of diseases and will live a healthy and happy life.

Functions

Estradiol is an important component of the human reproductive system, it is also called the beauty hormone. It has a significant impact on mental as well as physical health. Estradiol is classified as a steroid, produced in women by the adrenal glands, ovaries, adipose tissue, during pregnancy by the placenta, and in men it is the adrenal cortex and testicles.

At the birth of a boy or girl, the amount of estradiol is the same. As they grow older, the difference gradually increases, that is, in girls, the amount of the hormone increases several times and has a maximum value by the period of ovulation.

Hormone functions:

1. affects the development of the female figure, as well as sexual characteristics: the formation of the mammary glands, uterus, ovaries;
2. responsible for the presence and frequency of the menstrual cycle;
3. affects the preparation of the whole organism and creates favorable conditions for bearing a baby;
4. controls the internal operations of the body: removal of excess cholesterol from the blood, stabilization of blood pressure, participates in the reconstruction of the bone skeleton;
5. is responsible for attraction in the sexual sphere;
6. influences mental processes;
7. at the onset of menopause, it controls the water-salt balance of the body and lipid metabolism.

Thanks to this hormone, the body produces neurotransmitters. They fight irritability and thereby relieve the nervous overexcitation of a person and make him resistant to stress.

The main function of estradiol is to ensure the maturation of the egg, create conditions for its fertilization and prepare the endometrium for the safe bearing of the unborn child.

Norm

The indicators of estradiol in a woman in the blood fluctuate within a month and a day. In the interval between 15–18 hours, estradiol has a maximum value, and from 24–2 hours a minimum.

In addition, the rate of estradiol e2 in women depends on:

• phases of the menstrual cycle;
• from the presence of pregnancy and its duration.

The indicators of the amount of the hormone in the body are affected by: the content of the menu, the time of day, the number and frequency of sexual contacts.

By the age of eleven, in girls, the level of the hormone rises and reaches 27.0 pg / ml (picograms per milliliter). From the beginning of the first menstruation, its indicators increase sharply.

Rapid production of the substance begins on the first day of the cycle. On day 3 or day 4, the rate of estradiol in the follicular phase increases. In the middle of the menstrual cycle, it reaches its maximum. This peak occurs 36 hours before the egg is ovulated. Then the follicle bursts and hormone production declines.

Table - The rate of estradiol by day of the cycle

If after the second phase the amount of the substance does not decrease, then this indicates the conception of a child. With age, in the fairer sex, the body begins to produce the hormone in smaller quantities. Thus, the rate of estradiol in the blood of women during menopause drops to 100.0 pg / ml.

Further, the rate of the hormone estradiol in women with menopause is 20.0–82.0 pg / ml. This comes from the fading of the functioning of the ovaries: the ability to produce follicles. Therefore, from this point on, the hormone is produced only by the adrenal glands and fat layers.

Deviations

When a woman is pregnant, the level of the hormone in the blood increases. The longer the period, the more estradiol. This process is laid down by nature, since thanks to the hormone, the mucous membrane of the uterus is prepared for a long period of gestation.

The longer the gestation period and the closer the day of delivery, the more the hormone is contained in the woman's blood.

Table - The rate of estradiol by trimester

On the 5th day after birth, the content of estradiol falls and reaches normal levels. If estradiol is below normal in women, then the body reacts:

• failure of the menstrual cycle or its complete absence up to 6 months;
• decrease in the volume of the mammary glands;
• sudden weight loss without any action;
• no menstruation, no conditions to conceive a baby;
• dry skin and changes in the mucous membrane of the penis.

It is quite rare in the body, more often the reverse process occurs.

The normal amount of the hormone in the body allows it to fully work. If there is any fluctuation from the norm, then this is a signal of the presence of some kind of disease.

The reaction of the body to a large amount of the hormone in the blood:

1. long, as well as profuse menstruation;
2. mammary glands become sensitive;
3. sudden change of mood;
4. nervousness that is provoked by noise.

The reasons for increasing estradiol above normal are thyroid diseases, cirrhosis of the liver, tumors of various origins in the uterus, mammary glands and ovaries.

Analysis

Before taking the test, the woman is warned that one should not smoke, drink alcohol-containing drinks during the day and exclude physical activity. The best period for donating blood is the 6-7th day of menstruation. But sometimes the timing changes.

When you need to take a test for the hormone content in the blood:

• pain during menstruation;
• pregnancy does not occur for a long time;
• anovulation;
• poor functioning of the sex glands;
• uterine bleeding;
• severe symptoms of PMS;
• osteoporosis;
• tumors of a different nature;
• preparation for IVF.

The analysis is taken on an empty stomach from 8 to 11 hours. In the evening, it is recommended to refrain from heavy meals and sexual intimacy. Having fulfilled all the conditions, the patient guarantees that the correct result of the analysis will be obtained.

Estradiol, a hormone that plays a big role in a woman's life. It is important for the smooth functioning of the whole organism. Its most important function is to create conditions for bearing a long-awaited baby.

Maybe many people do not even know about it, but both men and women constantly have hormones of both sexes in different ratios in the blood. However, if the male body needs testosterone for its normal development, the content of which in the blood should be relatively stable, then in the "weaker sex" the hormone that determines development is estradiol, the norm in women of which can vary greatly depending on various factors.

Estradiol is an estrogen-type steroid hormone that is responsible for regulating a variety of processes, from sexual development to strengthening muscles and bones.

In the human body, estradiol is produced in the organs of the endocrine system - in women, these are the adrenal glands, ovaries, and, to some extent, the placenta. In men, the hormone is produced in a small amount in the testes, but its content can increase significantly with the modification of testosterone.

For both sexes, it is very important to maintain the correct ratio between the substances that regulate the development of the body according to a certain type - otherwise, serious diseases and deviations from the normal development of the body may occur.

For males, this threatens with brittle bones, an increased risk of cardiovascular disease, infertility and fatigue during physical exertion.

But a hormone level above normal is also not a good indicator. For women, this can result in a malfunction of the menstrual cycle, rapid weight gain and diseases of various organs. In men, it is still more serious - under the influence of estradiol, their body loses its main features - the body takes on a feminine shape, testosterone production is inhibited, and sexual desire decreases.

How to set the rate?

Such serious consequences of hormonal imbalance, both in women and men, make us think about regular examinations. In this case, it is necessary to know what is the norm of estradiol in certain circumstances.

For representatives of the "stronger sex" everything is very simple - a blood test should show a value at the level of 40-161 pmol per liter. If this parameter is higher or lower, this is a serious reason to visit an endocrinologist, because a deviation from the norm can be caused by serious diseases, including prostatitis, cirrhosis of the liver and others.

In women, everything is much more complicated - the content of the hormone varies depending on many factors:

1. Ovulation. Since estradiol regulates the production of luteinizing hormone, which gives rise to ovulation, its content increases significantly on days 7-10 of the menstrual cycle.
2. Pregnancy. At the same time, a very significant increase in the level of a substance in the blood is also observed - an increase in the indicator is noticeable already at 3 weeks.
3. pre-climatic period. Estradiol is produced in smaller volumes after the age of 35 - a regularly performed blood test will show its decrease to a minimum level by the age of 60.
4. Climax. With it, its content is also very small, which can lead to an imbalance in the development of the body, accompanied by accelerated aging and the occurrence of diseases.

Deviations from the norm can occur in many cases. So, the reason for the content of estradiol in the body below normal, in addition to age over 35 years, can be smoking and an unbalanced diet containing little fat. This is especially true during pregnancy.

In addition, a decrease is also associated with diseases of the genital organs - in particular, inflammation of the ovaries. This is diagnosed quite simply - in this case, the analysis does not show changes in the hormonal background on the 5-7th day of the menstrual cycle.

An indicator higher than natural can be a consequence of taking hormonal contraceptives, as well as tumors and other diseases.

In some cases, a positive deviation may mean the presence of an undiagnosed pregnancy with a short term (2-3, and in some cases even 4 weeks).

Regulatory indicators

The minimum value of the content of estradiol in women is achieved in the phase of menstruation. Then on the 3rd or 4th day of the cycle, the folliculin phase begins, when the indicator increases. This is a consequence of the preparation of the body for ovulation - the release of the egg from the follicle.

After 7-10 days, the next stage begins - the ovulation phase, which lasts 2-3 days. During this period, estradiol is produced with a very high intensity.

After its completion, menstruation occurs again, which lasts 5-7 days, and the level of estradiol drops to a minimum.

In women over 35 years of age, these fluctuations are gradually smoothed out - during menstruation, estradiol is produced more intensively, and during ovulation, the peak of its production decreases.

During pregnancy, the rate of hormone content increases every week.

As mentioned above, an increase in the level of estradiol can occur as early as 2-4 weeks, when there is an excess of the usual rate by 2-3 times. Further, every week of pregnancy there is an increase in the norm by 1100-1300 pmol / l. 2-3 weeks before delivery, the analysis shows a record figure of 50,000-10,000 pmol / l. But already on the 4th or 5th day after the end of pregnancy, the indicator begins to fall to its usual value - this process takes from 7 days to a month.

But if your levels are below or above the norm - do not rush to prescribe treatment yourself - it is quite possible that the level of estradiol is changed as a result of a short-term surge in testosterone or other factors - for example, age-related changes after 35 years. The final conclusions should be formed only by a doctor.

The ratio of female and male hormones

Speaking about the balance of two hormones, we should also mention the importance that their ratio has. Normal for women is the case when estradiol is 10 times the level of testosterone in the blood. In some circumstances, this ratio can decrease to 1 to 7 or 1 to 5 - this is also normal, but if there is no improvement during a second examination, you need to contact an endocrinologist.

A dangerous signal is the situation when the testosterone content is only 2-4 times lower than that of estradiol. This can lead to a general hormonal imbalance, impaired development of the body and infertility. But after 35 years, the rate of estradiol in women decreases, and this picture may be evidence of approaching menopause.

The imbalance can also be caused by menstrual disorders that are not related to hormones - if there is no release of estradiol on the 5th day of the cycle, then a blood test will show its insufficient level, since testosterone production may become higher.

Despite this, a decrease in the ratio to 1 to 4-5 is a reason for a visit to the doctor even at the age of over 35 years or the absence of menstruation on the desired day of the cycle.

Timely treatment when hormone levels fall below normal will help prevent the development of many diseases, restore fertility and achieve a stable menstrual cycle.

Estradiol (E2) is a hormone produced by the ovaries and adrenal cortex, as well as the fetal site during pregnancy. The main role of estradiol is to maintain the stability of menstrual and sexual functions. Since the norm of estradiol in women is a variable value, in this topic we want to tell in detail what level of this hormone is considered normal and what affects it.

Estradiol is extremely necessary for women for the normal functioning of both the reproductive system and the whole organism. For example, estradiol helps to activate the contractile function of the myocardium, strengthen the vascular walls and lower the level of cholesterol in the blood.

Also, this hormone increases the tone of smooth muscle fibers of the intestinal wall and bladder, which improves the functioning of these organs.

In addition to smooth muscles, estradiol has a positive effect on the activity of skeletal muscles, contributing to their regular contraction and relaxation. Thus, the endurance and resistance to stress of the human body increases, and the body becomes elastic.

Estradiol is rightly called the hormone of good mood, because thanks to it we have positive emotions. Depressive states are often observed in persons with estradiol below normal.

In addition to a good mood, estradiol helps women to be beautiful and sexy. This is due to the fact that this hormone allows secondary sexual characteristics to appear, such as rounded breasts, steep hips, a thin waist, smooth skin, a soft voice, etc. Estradiol is also significant in the formation of libido.

In the process of numerous medical studies, it has been proven that estradiol helps maintain a toned body shape and body weight. For example, in menopausal women, as a result of a decrease in the level of estradiol in the blood, the problem of overweight and bone fragility often arises.

Estradiol plays an important role in creating favorable conditions for fertilization, loosening the endometrium so that successful implantation of the zygote occurs.

Estradiol and the menstrual cycle: the relationship

Estradiol is synthesized and released into the blood throughout the entire monthly cycle, only in different quantities. Its synthesis occurs in the ovaries, adrenal cortex and adipose tissue, during pregnancy - in the fetal site.

During the follicular phase of the monthly cycle, estradiol is produced in a minimal amount, under the influence of follicle-stimulating and luteinizing hormones. Before the ovulatory phase, the amount of the hormone increases three times, after which it decreases, reaching a minimum level before menstruation.

Estradiol during the monthly cycle can turn into estrone and estriol.

Also, the level of estradiol in women changes every hour of the day. The greatest amount of the hormone is synthesized between 15 and 18 hours of the day, and the smallest - between 24 and 2 hours of the night.

Factors affecting the level of estradiol in the body

Once again, I would like to say that the norms of the hormone estradiol in women can change under the influence of various factors, namely:

• phase of the menstrual cycle;
• age;
• pregnancy;
• changing climatic conditions;
• body weight fluctuation;
• harmful environmental factors
• psycho-emotional shock;
• harmful (alcohol abuse, smoking);
• taking medications.

Each of these facts, as a rule, causes fluctuations in the level of estradiol in the blood within the acceptable range.

In a blood test, the level of this hormone is usually displayed in picograms per milliliter (pc / ml), but this indicator can also be expressed in picomoles per liter (pmol / l).

A blood test for estradiol is prescribed by specialists in such cases as:

• hormonal failure in the body, as a result of which the monthly cycle was disturbed;
• lack of ovulation;
• infertility;
• disruption of the sex glands;
• periodic uterine bleeding not associated with the menstrual cycle;
• severe manifestations of premenstrual syndrome;
• malfunction of the pituitary gland;
• polycystic ovaries;
• fragility of bone tissue;
• neoplasms of the ovaries;
• neoplasms of the adrenal glands;
• preparation for in vitro fertilization.

Blood for research on estradiol is taken strictly in the period from 4 to 6 days of the menstrual cycle. The control analysis is carried out in the period from 20 to 21 days of the cycle.

In order for the result of a blood test for estradiol to be the most objective, when preparing for the study, it is necessary to adhere to the following recommendations:

• 2-3 days before the study is not recommended to transfer;
• 24 hours before blood sampling, limit physical and mental stress;
• exclude sex for 24 hours;
• 24 hours before blood sampling, it is forbidden to smoke and drink alcohol;
• if you are taking any medications, tell the doctor who ordered the tests. In this case, the question of temporary withdrawal of drugs may be considered, since they may distort the results of the study on estradiol;
• The last meal should be no later than 12 hours before blood sampling. The analysis is carried out strictly on an empty stomach.

The optimal time for blood sampling for research is 8-11 am. Blood is taken from the cubital vein in the amount of 5-10 ml.

Waiting for the result of an estradiol blood test can take three to seven days. In emergency cases, the result can be ready five hours after blood sampling.

Estradiol: the norm in women

Table of norms of estradiol in women by age.

In addition to age, estradiol in the blood is affected by the phases of the menstrual cycle and pregnancy.

The norms of estradiol for the phases of the menstrual cycle are as follows.

1. Follicular phase - from 68 to 1265 pmol / l.
2. Ovulatory phase - from 130 to 1657 pmol / l.
3. The corpus luteum phase is from 90 to 860 pmol / l.

With menopause, the amount of estradiol in the blood is reduced and averages 50 pc / ml.

The rate of estradiol during pregnancy depends on the trimester, namely:

• in the first - from 210 to 6300 pc / ml;
• in the second - from 800 to 19000 pc / ml;
• in the third - from 11800 to 37000 pc / ml.

Estradiol and testosterone: ratio

When evaluating the results of a study on the sex hormonal panel, experts evaluate not only the absolute values ​​​​of the estradiol indicator, but also its ratio with other hormones (prolactin, progesterone, testosterone).

The most significant in assessing women's health is the ratio of estradiol and testosterone, which should normally be 10:1, but also an acceptable ratio of 7:1. That is, the result of hormones in which the level of estradiol is 7-10 times higher than testosterone testifies to the normal activity of the female body.

In cases where the level of estradiol is only five times higher than testosterone or less, then such a condition is called hyperandrogenemia in medicine.

Symptoms of hyperandrogenemia may include:

• violation of the menstrual cycle;
• acne
• causeless;
• change in voice timbre from high to low.

They also distinguish a condition such as hypoandrogenemia, when the level of estradiol is much higher than testosterone (12 times or more). Hypoadrogenemia is characterized by the following symptoms:

• severity of manifestations of premenstrual syndrome;
• profuse menstruation;
• irritability;
• appearance .

The most dangerous consequence of hyperandrogenemia is diabetes mellitus, and hypoandrogenemia - tumors of the ovaries and uterus.

Estradiol during pregnancy

Once again, we note that the level of estradiol during pregnancy is higher than in non-pregnant women.

In the early stages of pregnancy, the amount of estradiol in the blood of the expectant mother corresponds to normal levels, but in the process of increasing the uterus, it gradually increases.

The highest rate of this hormone is observed in the third trimester of pregnancy. After 5-6 days after birth, the level of estradiol gradually returns to normal.

The role of estradiol during pregnancy is that it contributes to the normal development of the fetus and prevents miscarriage or premature birth. Also, this hormone strengthens the walls of the blood vessels of the birth canal to avoid ruptures during childbirth.

Estradiol with menopause

Menopause in women occurs at the age of 45-55 years, although it happens earlier.

With menopause in women, there is a decline in reproductive function and a decrease in the level of estrogens, in particular estradiol, which is manifested by violations of the sexual sphere and the functioning of all body systems.

Among the menopausal symptoms, the most common are:

• violation of the menstrual cycle with the subsequent cessation of menstruation;
• hot flashes;
• urinary incontinence;
• decrease in sexual desire;
• dryness of the vaginal mucosa;
• emotional lability;
• fragility of the bones.

Also, with menopause, hypertension, atherosclerotic vascular lesions and other diseases of the cardiovascular system may appear.

When evaluating the result of a blood test for estradiol in a woman who is in menopause, the specialist takes into account the following factors:

• how old is the woman;
• what is the duration of menopause;
• the presence of health complaints;
• the presence of diseases of the cardiovascular, nervous, digestive, endocrine and other systems.

With menopause, all women have low levels of estradiol in the blood.

Causes, symptoms and treatment of low estradiol

The most common cause of low estradiol levels is medication, including oral hormonal contraceptives and chemotherapy drugs. Most often, such an adverse reaction occurs with the following drugs:

• Dexamethasone;
• Pravastatin;
• Mifepreston;
• Cimetedine;
• Danazol;
• Nafarelin.

Also, a decrease in the amount of estradiol in the blood can be caused by a high-carbohydrate or low-fat diet, vegetarianism, alcohol abuse and menopause. Among the diseases that most often lead to a decrease in this indicator, it is necessary to highlight polycystic ovaries and chronic inflammatory diseases of the reproductive system.

Symptoms of low estradiol in the blood are as follows:

• acne on the skin of the face;
• dry skin;
• constant feeling of fatigue;
• feeling of coldness in the upper and lower extremities;
• swelling;
• baldness;
• the appearance of hair on the face, chest, abdomen and buttocks;
• failure of the menstrual cycle;
• anovulatory cycle;
• infertility;
• tendency to diarrhea;
• soreness of the mammary glands;
• insomnia or drowsiness;
• irritability;
• decreased sex drive.

The diagnosis and treatment of estradiol deficiency in women is carried out by a gynecologist together with an endocrinologist.

Treatment for low blood estradiol in women of childbearing age is hormone replacement therapy. In this case, Estrofem, Proginova, Estradiol and Estraderm TTS 25 are highly effective.

Self-medication is strictly prohibited, since an inadequate dose or duration of treatment with drugs that contain estradiol threatens with irreversible consequences, such as a complete cessation of the synthesis of this hormone in the body.

In addition to drug therapy, experts recommend sticking to a diet with a predominance of protein foods and intensifying your sex life.

Causes, symptoms and treatment of elevated estradiol

Estradiol above normal is observed during pregnancy. But also high levels of this hormone can be the result of various diseases, namely:

• benign and malignant neoplasms of the ovaries;
• polycystic ovaries;
• hyperthyroidism;
• obesity;
• liver failure;
• chronic alcoholism;
• neoplasms of the mammary glands.

In addition, elevated levels of estradiol are often observed as a side effect of certain medications, including hormonal oral contraceptives, anticonvulsants, and fungicides.

An increase in estradiol in the blood can be suspected by the following signs:

• too short or long periods;
• painful periods;
• acne disease;
• increased sensitivity and soreness of the mammary glands;
• sleep disturbance;
• headache;
• hair loss;
• emotional lability;
• disruption of the intestines.

Treatment is primarily aimed at eliminating the cause, but if the estradiol indicator is not normalized, then hormonal drugs are prescribed. It is also important to normalize the daily routine, get enough rest, protect yourself from stress and eat right.

Watch a video about estradiol.