Estrogen test: have your estradiol measured

Your body makes three kinds of estrogen. Estradiol (E2) is the main one in the years you menstruate, and your ovaries make most of it. Estrone (E1) is the main form after the menopause, and is made mostly in fat tissue. Estriol (E3) plays its main role during pregnancy.

In an estrogen blood test the laboratory looks at estradiol. This estrogen test therefore measures one value:

• Estradiol (E2): the form of estrogen doctors look at when they want to measure estrogen in your blood.

Estrogen drives your menstrual cycle and plays a part in your bones, your skin and your mucous membranes. When your hormonal balance is disturbed, you often notice it in your cycle first. An estradiol measurement shows how high this hormone is at that moment.

Women have their estrogen tested for example when:

• their period becomes irregular or stops;
• they have questions about how their ovaries work while trying to conceive;
• they have complaints that look like the menopause while under 40;
• they want to record a baseline value.

A hormonal imbalance is not something you establish with one blood value. The result gives you a number to work with, together with your complaints and your cycle.

If you menstruate, blood is usually drawn on day 2 to 5 of your cycle. Day 1 is the first day of your period. In that early phase estradiol is at its lowest and most stable, so your value compares well with the reference range.

Just before ovulation estradiol peaks, and in the second half of your cycle it rises again. A measurement on a random day can come out high or low without anything being wrong. So remember which cycle day your blood was drawn.

If you no longer menstruate, or your cycle is very irregular, you can have blood drawn on any day.

During the menopause your ovaries work less and your estradiol falls. In the years before your last period the value does swing a lot. One measurement therefore says little about whether you are in the menopause.

If you are 40 or older, your GP recognises the menopause from your complaints and your cycle, without a blood test. If you are under 40 and your periods stop, FSH and estradiol are part of the investigation. The early menopause test is meant for that, and measures estradiol together with FSH.

If you use the combined pill, it suppresses your body's own estradiol. Your result then says more about the pill than about your ovaries. A hormonal IUD or other hormones can also change your value.

Do you use estrogen as menopausal hormone therapy, such as a gel, spray or patch? Then your estradiol rises because of it. Keep that in mind when you read your result, and mention it when you discuss the result with your GP.

When you look into estrogen testing you come across different routes. They do not measure the same thing.

In routine care, estradiol is measured in blood from a vein. A result from saliva or a finger prick is therefore not read against the same reference range.

Looking for an estrogen dominance test? That is about the ratio between estrogen and progesterone. This test only measures estradiol. If you also want to test your progesterone, that is a separate test.

You see your estradiol value with its unit and the laboratory's reference range. Those ranges differ between laboratories. They also depend on your cycle phase, on the menopause and on pregnancy. So do not compare your value with a table from the internet.

A low value can fit the start of your cycle, the menopause, the pill or ovaries that work less. A high value can fit the days around ovulation, a pregnancy or hormone use. A BIG-registered doctor assesses your result. Which explanation fits you is something to discuss with your GP.

Estradiol is one of the hormones that together regulate your cycle. For a broader picture, look at the hormone test for women. It measures estradiol together with FSH, LH, progesterone and prolactin.

After your order we arrange your referral through ZorgDomein, which takes one business day. Orders placed in the evening or at the weekend start on the next business day. The ZorgDomein email carries a barcode, which you show on your phone at the draw location. Without a BSN there is no barcode: you then print your referral form through the link in the email and bring it to the draw location.

You choose a draw location near you. Many have walk-in hours, others take an appointment. You do not need to fast for this test.

Our indicative planning is about 48 hours, counted from the draw. A doctor then assesses your result and you can see it online in your account.