What Do Estradiol Blood Test Results Mean?

Typical question of a patient: I got my estrogen levels tested and here are the results. I’m not sure what they mean however. Anybody got any clues? 

The report show this phrase: Estradiol value appears low by immunoassay. Suggest repeat testing by Tandem Mass Spectrometry for Estradiol, Males or Children, Test Code 0093247.

Hormones actually in relations to Girls and periods

  • Primarily: follicle stimulating hormone (FSH) –> makes eggs mature 
  • Lutenizing hormone (LH) –> when the eggs are mature, makes the follicle rupture, so that eggs are released
  • Estrogens (Estradiol, E2)–> makes cervical mucus get thinner and less acid, so that sperms can swim through it
  • Progesterone –> is produced after releasing the egg. It makes the womb walls thicken to prepare them for a pregnancy. When no pregnancy is detected, production of progesterone stops and a period starts.
  • If a girl is pregnant she produces Beta-HCG (Beta human chorionic gonadotropin), which is also a female hormone.

E2 Normal Ranges:

  • Estradiol, Adult Premenopausal Female <20 pg/mL 
  • Follicular phase: 27-122 pg/mL
  • Mid-Cycle phase (ovulation): 95-433 pg/mL
  • Luteal phase: 49-291 pg/mL
  • Post-Menopausal: less than 41 pg/mL

Example 1: 13 years old girl and have been on her period for 2 months> the cause may be something called endometriosis, especially if your periods are particularly painful. In the meantime, make sure to drink plenty of water and increase your protein intake or take an iron supplement so you don’t become anemic, then have a doctor visit.

Hormonal Imbalance

From the women I’ve known, it’s actually not uncommon for a woman not to ovulate regularly. I knew a girl once who stopped for six months for no apparent reason; her parents were convinced she was pregnant, but she was a virgin so that wasn’t even a remote possibility.

The most common cause I’ve heard cited by doctors is stress. When the mind and body are stressed, it can cause the body to want to conserve resources because it senses the stress hormones and thinks you’re in some sort of survival emergency. A university health service nurse once told me it’s not uncommon for women to stop ovulating during the school semesters, particularly during exam season.

However, if you’re having other symptoms like mood swings and appetite loss, the most likely cause might be a hormone imbalance. These, again, are pretty common in young women. Ovulation is actually dictated by the interaction of like seven different hormones, so if any of these is out of balance it could prevent ovulation.

The most common hormone imbalance in young women is thyroid imbalance. Hypo or hyperthyroidism are associated with changes in ovulation, changes in appetite, changes in mood, and excess energy or fatigue. Hypothyroidism (having too little thyroid) usually causes heavy, frequent periods, increases in appetite, weight gain, fatigue, and depression. But for me, I’m hypothyroid and I actually experienced a loss of ovulation. So I guess it can go either way. Hyperthyroidism is somewhat more rare and is supposed to have the opposite symptoms, i.e. loss of ovulation, appetite decrease, weight loss, excess energy, irritability and anxiety.

Not ovulating is not in itself an urgent medical matter. There are a lot of reasons this could happen, and most of them are not reasons to worry. However if you’re uncomfortable with the other symptoms you’re experiencing, what with mood, appetite, physical symptoms, etc., it would be worth your time to talk to your doctor about getting tested for hormone levels. I’d specifically mention thyroid since I know a lot of girls with thyroid imbalances. They might also want to check more hormones such as estrogen and testosterone that could be effecting your mood and ovulation.

Good luck getting this resolved! It’s no fun when your brain does things and you don’t know why. The good news is it’s almost certainly fixable.

Period, Stress, Estrogen Relationships

Stress doesn’t exactly make your period late, it causes late ovulation – if stressed (enough to make you ill, a few bad days doesn’t mean you’re suffering from stress) your body will prevent itself from ovulating to avoid risking you getting pregnant during a time of stress.

As ovulation is what triggers menstruation this is thus what makes menstruation late when you’re stressed – it’s the stress around the time of ovulation that causes delay, but stress around the time of menstruation can cause you to tense-up so that the cervix doesn’t relax to release flow so make you a few days late.

Other things that can make your period late; 

  • Interrupted E2 Levels
  • Illness. 
  • Medication. 
  • Travel. 
  • Poor Diet. 
  • General poor health. 

basically anything that may make your body want to prevent pregnancy, and obviously hormonal imbalance can lead to late periods too, sometimes this just happens but sometimes underlying medical conditions can lead to imbalanced hormones and late periods…if you’re in your teens irregular cycles are normal due to hormonal imbalance during puberty.

Dr.Megan Ralf

A Medical laboratory Scientist who devoted his life to medical and laboratory sciences, writes his everyday expertise dealing with various pathological conditions through laboratory diagnosis of different body fluids, also participating in many workshops for first aids, infection control, and urgent care. Also Dr Megan Ralf coaching many medical teams.

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