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Hormones

Oestradiol (E2): what the hormone does and what a high or low level means

According to the NVKC, the Dutch society of clinical chemists, oestradiol is the main female sex hormone and belongs to the oestrogens. It is made mainly in the ovaries, in the maturing egg cells (follicles), and together with progesterone it develops and matures the lining of the womb in every menstrual cycle, so that a fertilised egg can implant. According to the NVKC, oestradiol is also needed for healthy and strong bones, in women and in men.

According to the NVKC, a low oestradiol occurs among other things in women during and after menopause, with severe underweight and with early failure of the ovaries; a raised oestradiol among other things in pregnancy, with hormone treatment for IVF and with obesity. Only a blood test shows how much oestradiol is in the blood.

Star-SHL uses 45.4 to 854 pmol/l for women in the follicular phase and 41.4 to 159 pmol/l for men; Certe counts the follicular phase as day 1 to 12 of the cycle.

Doctor's Assessment Included

Oestradiol is the main female sex hormone; it is made mainly in the ovaries and is needed for strong bones in women and men. According to the NVKC, the result depends on sex, age, cycle phase, pregnancy and measuring method.

  • Star-SHL uses 41.4 to 159 pmol/l for men and 45.4 to 854 pmol/l for women in the follicular phase; Certe uses 95 to 223 pmol/L for men older than 18.
  • According to Thuisarts, a blood test makes no sense for finding out whether someone is in menopause, because that number is not reliable.
  • According to Certe, the medicine fulvestrant (Faslodex) cross-reacts in the oestradiol test, which may produce falsely raised results.

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Male Your group
pmol/l
Low 41 Normal 159 High
Female Your group
pmol/l
Low 46 Normal 607 High

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

Estradiol (E2): what Dutch laboratories use

Reference ranges by group, in pmol/l
Star-shl · Female · follicular phase 45.4–854.0 pmol/l
45.4 854
Star-shl · Female · ovulatory phase 151–1461 pmol/l
151 1461
Star-shl · Female · luteal phase 81.9–1251.0 pmol/l
81.9 1251
Star-shl · Female · after menopause 18.4–505.0 pmol/l
18.4 505
Star-shl · Male 41.4–159.0 pmol/l
41.4 159
Unilabs · Female · 14 years and older · follicular phase 70–950 pmol/l
70 950
Unilabs · Female · 14 years and older · mid-cycle 140–2400 pmol/l
140 2400
Unilabs · Female · 14 years and older · luteal phase 80–1150 pmol/l
80 1150
Unilabs · Female · 14 years and older · after menopause 0–125 pmol/l
0 125
Unilabs · Male · 20 years and older 40–162 pmol/l
40 162
Certe · Female · a limit, not a range · follicular phase < 854 pmol/L
854
Certe · Female · ovulation peak 151–1461 pmol/L
151 1461
Certe · Female · a limit, not a range · luteal phase < 1251 pmol/L
1251
Certe · Female · a limit, not a range · after menopause < 505 pmol/L
505
Certe · Male · 18 years and older 95–223 pmol/L
95 223
Diagnostiek voor U · Female · follicular phase 72–529 pmol/L
72 529
Diagnostiek voor U · Female · mid-cycle 235–1309 pmol/L
235 1309
Diagnostiek voor U · Female · luteal phase 205–786 pmol/L
205 786
Diagnostiek voor U · Female · a limit, not a range · after menopause < 118 pmol/L
118
Diagnostiek voor U · Male · a limit, not a range < 146.1 pmol/L
146.1
0 2640 pmol/l

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

Estradiol (E2): what this test measures

The oestradiol test measures the amount of oestradiol in the blood, in picomoles per litre (pmol/l). According to the NVKC, there are no exact reference values: the result depends on sex, age, the moment in the menstrual cycle, any pregnancy and the laboratory's measuring method.

Star-SHL measures oestradiol with an electrochemiluminescence immunoassay, Certe with an ECLIA based on competitive binding and Unilabs with a competitive immunoassay.

Estradiol (E2): why this value matters

According to the NVKC, oestradiol is measured to establish a shortage in women or an excess in men and women. According to the NVKC, oestradiol is responsible for the development of outward female sex characteristics, such as breast development and a female fat distribution, and bone growth and bone structure depend on oestradiol in women and men.

Estradiol (E2): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
Hormone checkup for men · €169,- · Hormone checkup for women · €169,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Estradiol (E2): how to prepare

  1. Do you have a cycle? Pick the right day

    Required

    If you have a menstrual cycle, count the first day of your period as day 1 and have the draw on day 2 to 5. On hormonal contraception, or without a cycle, any day works.

  • Water is always fine. Drink as usual beforehand, it makes the draw easier.
  • Take your usual medication, unless your own doctor told you otherwise.

Estradiol (E2): when is testing worthwhile?

According to the NVKC, an oestradiol test is requested when a shortage or excess is suspected, for example in women with many menopausal symptoms or who seem to be entering menopause too early, with an irregular menstrual cycle, with hormone treatment for IVF, with anti-hormone treatment for breast cancer and in men with breast development (gynaecomastia).

Estradiol (E2): symptoms of a high or low value

Low Levels

According to the NVKC, a low oestradiol occurs in women during and after menopause, with damage to the pituitary or hypothalamus, with late puberty in girls, with anorexia nervosa or another cause of severe underweight such as heavy physical training, with Turner syndrome, with early failure of the ovaries from chemotherapy, radiation or antibodies against the ovaries, and with oestrogen-blocking treatment of oestrogen receptor-positive breast cancer.

According to Thuisarts, during menopause the body makes less oestrogen, because the egg cells have run out or no longer mature.

High Levels

According to the NVKC, a raised oestradiol occurs in pregnancy, with a tumour of the ovaries, testes or adrenal glands, with early puberty in girls, with hormone treatment for IVF and with obesity, through conversion of androgens in fat tissue. According to the NVKC, in IVF the large number of follicles maturing at the same time brings a risk of ovarian hyperstimulation syndrome (OHSS).

According to Certe, the medicine fulvestrant (Faslodex) cross-reacts in the oestradiol test, which may produce falsely raised results.

Estradiol (E2): causes of a low or high value

What lowers the value

  • Menopause

    A low oestradiol occurs in women during and after menopause.

  • Severe underweight, as from heavy training

    Anorexia nervosa and other causes of severe underweight, such as heavy physical training, go with a low oestradiol.

  • Damage to the pituitary or hypothalamus

    Damage to the pituitary or the hypothalamus can give a low oestradiol.

  • Early failure of the ovaries

    Early failure of the ovaries from chemotherapy, radiation or antibodies against the ovaries gives a low oestradiol.

  • Oestrogen-blocking breast cancer treatment

    Oestrogen-blocking treatment of oestrogen receptor-positive breast cancer can lower oestradiol.

What raises the value

  • Pregnancy

    Oestradiol is raised during pregnancy.

  • Obesity

    With obesity, oestradiol can be raised through conversion of androgens in fat tissue, and oestrone is then often raised as well.

  • Hormone treatment for IVF

    With hormone treatment for IVF, many follicles mature at once and a lot of oestradiol is formed, with a risk of ovarian hyperstimulation syndrome (OHSS).

  • Tumour of the ovaries, testes or adrenal glands

    A tumour of the ovaries, the testes or the adrenal glands can give a raised oestradiol.

  • Fulvestrant (measurement error)

    The medicine fulvestrant (Faslodex) cross-reacts in the oestradiol test, which may produce falsely raised results.

Estradiol (E2): lifestyle and this value

An abnormal oestradiol is one to discuss with your GP. According to the NVKC, women in menopause with many symptoms, such as hot flushes, night sweats and insomnia, can be prescribed hormone replacement therapy; according to the NVKC, long-term treatment seems to come with a higher risk of breast cancer, which is why the therapy is now only given short-term for severe symptoms and to women who are in early menopause.

Estradiol (E2): frequently asked questions

Can an oestradiol test show whether someone is in menopause?

No, according to Thuisarts an oestradiol test to find out whether someone is in menopause makes no sense, because that number is not reliable.

Why do reference limits differ between laboratories?

The reference limits for oestradiol differ between laboratories because, according to the NVKC, the result also depends on the measuring method. For women in the luteal phase, Star-SHL uses 81.9 to 1251 pmol/l, Unilabs 80 to 1150 pmol/l for women older than 14 and Diagnostiek voor U 205 to 786 pmol/L.

Do men have oestradiol too?

Yes, men make oestradiol too: according to the NVKC, in men oestrogens, the group oestradiol belongs to, are formed mainly in fat tissue, from testosterone and other androgens with the enzyme aromatase. Star-SHL uses 41.4 to 159 pmol/l for men and Certe 95 to 223 pmol/L for men older than 18.

Estradiol (E2): sources

  1. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  2. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  3. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  4. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  5. NVKC, Alles over testen: Oestradiol, allesovertesten.nl, geraadpleegd 2026-10-13 (retrieved 2026) allesovertesten.nl

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Estradiol (E2)

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