Estrogen Blood Test - Types, Procedure, and Results

Introduction:

An estrogen test assesses the level of estrogen in the blood and occasionally in urine. Estrogens are crucial for female reproductive health, such as during puberty, menstruation, pregnancy, and menopause. They are also significant for the health of the heart, bones, and brain in both males and females, though males require less estrogen.

What Are the Types of Estrogen?

There are many types of estrogen, but only three are commonly tested:

• Estrone (E1) is the only estrogen that females continue to produce after menopause. Both males and females produce estrone in the adrenal glands and body fat, but females also produce it in their ovaries.

• Estradiol (E2) is the primary estrogen in non-pregnant females of childbearing age, mostly produced in the ovaries. It is crucial for fertility, bone health, and brain health. Males produce small amounts of this estrogen in their testicles.

• Estriol (E3) is an estrogen that increases during pregnancy and is made by the placenta. Monitoring estriol levels can help assess the health of a pregnancy and the fetus. Non-pregnant females and males have very low levels of estriol.

Females experience significant fluctuations in estrogen levels throughout their lives, whereas males undergo comparatively minor changes. However, if estrogen levels remain excessively high or low, it could indicate an underlying health issue.

What Are the Purposes and Its Usage?

In females, estrogen tests can be used to diagnose medical conditions that may result from either elevated or deficient levels of estrogen in the body. These conditions include:

• Early or late puberty.

• Menstrual problems.

• Abnormal vaginal bleeding.

• Infertility or problems getting pregnant.

Estrogen testing can also be used for monitoring purposes, such as:

• Tracking the effectiveness of infertility treatments.

• Hormone replacement therapy for menopause.

• Hormone treatment for specific cancers, like breast cancer.

An estriol hormone test can be utilized during pregnancy for the following purposes.

• To aid in the diagnosis of certain birth defects.

• To monitor high-risk pregnancies.

In males, estrogen testing can also be used to determine whether excessive estrogen levels are causing certain medical conditions, such as delayed puberty, gynecomastia (breast growth in males), infertility, or erectile dysfunction (inability to achieve or maintain an erection).

What Is the Requirement of an Estrogen Test?

Females require estrogen testing for the following reasons:

• Early or delayed puberty.

• For childbearing age, abnormal menstrual cycles, or no periods at all.

• Need help getting pregnant or have a high-risk pregnancy.

• If one experiences symptoms of menopause like night sweats or hot flashes, then estrogen testing is essential.

• Undergo hormone replacement therapy following menopause.

• Encounter vaginal bleeding after menopause.

• Have a tumor that may be producing estrogen.

During pregnancy, a healthcare provider may recommend an estriol test be conducted between weeks 15 and 20 of the pregnancy. This test is usually included in a group of prenatal tests called the triple screen or quad screening tests. By measuring the levels of estriol, the test can determine whether the unborn baby is at high risk for a genetic birth defect, such as Down syndrome. Some factors that may increase the likelihood of having a baby with a birth defect include a family history of birth defects, being over the age of 35, having diabetes, or having had a viral infection during pregnancy.

In the case of a male patient, estrogen testing might be necessary if one experiences the following:

• Late onset of puberty.

• Symptoms related to excessive estrogen production, such as enlarged breasts.

• Presence of a tumor that could produce estrogen.

How to Perform the Blood Test?

The healthcare provider will select the appropriate estrogen to be tested and the type of sample to be collected. Although blood is the most commonly used type of sample, urine, saliva, or amniotic fluid may also be used to measure estrogen levels.

• No special preparation is needed before the test.

• To conduct an estrogen blood test, a healthcare provider will take a sample of blood from a vein in the arm using a needle. The needle insertion site will be disinfected with an alcohol wipe, and a rubber tourniquet may be tied around the upper arm to locate the vein. Minor discomfort may be experienced during needle insertion, and the blood specimen will be collected in a tube.

• Following the estrogen blood test, the patient will be instructed to apply slight pressure to the punctured spot and cover it with a bandage for a few minutes. They can remove the bandage after a couple of hours. Usually, there are no significant side effects except for minor bruising. However, in rare cases, patients may experience dizziness or lightheadedness, which they should inform their healthcare provider about.

What Does the Test Results Mean?

Normal estrogen levels vary depending on the person's sex, age, menstrual cycle (in females), and pregnancy status (in females). Laboratories may have different reference ranges and units for normal values. Estrogen levels can be affected by various metabolic conditions and illnesses, including hypertension, anemia, and impaired liver and kidney function. It is important to consider daily and cycle variations when interpreting estrogen test results, and a healthcare provider monitoring a woman's hormones will typically look for trends in the levels over time. Test results cannot provide a definitive diagnosis but can give healthcare providers insight into potential causes of symptoms or conditions. Here are some medical conditions that may lead to higher or lower levels of estrogen in the body:

Increased Levels of E2 or E1

Girls and Women:

• Early (precocious) puberty.

• Tumors of the ovary or adrenal glands.

Boys and Men:

• Enlarged breasts (gynecomastia).

• Tumors of the testicles (testicular cancer) or adrenal glands.

• Delayed puberty.

Decreased Level of Estrogen: In women, decreased estrogen indicates:

• Underdeveloped female sex characteristics due to Turner syndrome, an inherited condition caused by a missing or abnormal X chromosome.

• Low levels of pituitary hormones (hypopituitarism).

• Dysfunction of the ovaries (female hypogonadism).

• Failing pregnancy (estriol).

• Eating disorders such as anorexia nervosa.

• Post-menopause.

• Polycystic ovary syndrome (PCOS), also known as Stein-Levanthal syndrome.

• Extreme endurance exercise.

Conclusion

Estrogen blood testing measures levels of estrogen in the blood or urine are important for reproductive health, fertility, and bone, brain, and heart health. It helps diagnose and monitor conditions like menstrual problems, abnormal bleeding, infertility, and cancer. Results do not give a definitive diagnosis but can offer insight into potential causes. A blood sample is taken from the arm, and normal levels vary depending on sex, age, menstrual cycle (in females), and pregnancy status (in females).