You open the result, see "Oestradiol: 320 pmol/L" and below it a reference range running from 45 to 1500. All within the lines, so fine? Not so fast. An oestradiol value of 320 is perfectly normal on day 10 of your cycle and suspiciously low around ovulation. Without knowing which cycle day you were drawn on, the number alone says almost nothing.
That is my stance straight away: an oestradiol table without the cycle day attached is misleading. The phase you are in often matters more than the number itself.
Oestradiol reference table by cycle phase
Oestradiol (E2) is the most active oestrogen and is made mainly in your ovaries. In women of reproductive age the value swings considerably, and that is how it should be. Below are guide values in pmol/L (picomoles per litre), the unit most Dutch laboratories use.
| Cycle phase | Cycle day | Guide value (pmol/L) | What happens |
|---|---|---|---|
| Early follicular phase | Day 1-5 | 45-180 | Baseline, lowest point |
| Late follicular phase | Day 6-13 | 150-850 | Rises as an egg matures |
| Ovulatory peak | Around day 14 | 400-1500 | Peak triggers ovulation |
| Luteal phase | Day 15-28 | 80-800 | Dips slightly, stays elevated |
Does your lab use pg/mL instead of pmol/L? Convert using the factor 3.67: 50 pg/mL equals about 183 pmol/L. Always compare your result against the specific reference range printed on your own report, as labs sometimes use slightly different cut-offs.
One thing stands out in the table: the ranges overlap considerably. A value of 200 pmol/L fits both the late follicular phase and the luteal phase. That is not imprecision but a consequence of how your cycle works: oestradiol rises and falls smoothly, without sharp borders between phases. So the table is a compass, not a ruler. It points you in a direction, but the exact number depends on precisely where you are in your cycle on the day of the draw.
Oestradiol normal values by life stage
Besides your cycle day, your life stage decides what is normal. The Dutch Health Council (Gezondheidsraad) describes menopause as a gradual process in which the ovaries make less oestrogen, and you see that reflected in the values.
| Life stage | Typical oestradiol value (pmol/L) |
|---|---|
| Prepubertal | Under 55 |
| Reproductive age | Per the cycle table above |
| Perimenopause | Highly variable, low to high month to month |
| Postmenopause | Usually under 100, often under 55 |
| During hormone therapy | Depends on type and dose; your doctor sets the target |
How to read your own oestradiol result
Do not lay your number next to an average, but next to your situation. Take into account:
- Your cycle day. 200 pmol/L is normal on day 10 but low around ovulation.
- Your age. In perimenopause the value can swing sharply month to month, so a single reading rarely tells the whole story.
- Your lab's reference range. Compare within the same lab if you track values over time.
- Medication. Hormonal contraception suppresses your own oestradiol, so the value is not representative of your natural balance.
Two common reading mistakes
The first mistake is confusing units. If you accidentally check a pg/mL value against a pmol/L table, your oestradiol suddenly looks far too low, while the problem lies only in the conversion. So always check which unit is on your report before you panic or feel reassured.
The second mistake is laying the value next to an average instead of next to your own phase. A table shows broad ranges because it must cover the whole cycle; your value belongs in exactly one row of it. If you are unsure about your cycle day, for example due to an irregular cycle, the value is harder to place and a repeat measurement or a broader panel can help. Always discuss a result that worries you with a doctor, who places it in your broader picture.
When is your oestradiol off?
A value clearly below or above the expected range for your phase can be a reason to discuss with a doctor. A low value can fit menopause, intensive exercise or being underweight. A high value can relate to excess weight (fat tissue produces oestrogen) or certain medicines. Per the Dutch GP guideline (NHG) on menopause, an abnormal oestradiol value on its own is rarely the basis for a diagnosis; the broader picture of your symptoms and cycle counts too.
If you want your value measured in context, a women's hormone panel can map oestradiol alongside your other hormones. Then feel free to dig into the single marker oestradiol (E2) or progesterone, since it is the ratio between the two that explains many symptoms. To see which tests make sense when, read our overview of hormone testing for women.
Frequently asked questions
How do I convert pg/mL to pmol/L?
Multiply the pg/mL value by 3.67. For example, 50 pg/mL comes to about 183 pmol/L. Most Dutch laboratories report in pmol/L.
Do I need to fast for an oestradiol test?
Fasting is not required for oestradiol. It is best to have blood drawn in the morning, ideally on day 2-5 of your cycle for a baseline value.
Can my oestradiol be normal while I still have symptoms?
Yes, it can. Your symptoms may relate to the ratio between oestrogen and progesterone, or to other hormones such as cortisol or your thyroid. A broader panel can, in consultation with a doctor, offer more insight.
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