Oestrogens . Patient guide

Oestradiol (E2) Blood Test

Also known as: Estradiol

What is E2

Oestradiol (E2) is the principal oestrogen of the reproductive years, produced mainly by the ovaries and varying markedly across the menstrual cycle. According to the Roche Elecsys assay widely used in UK labs, follicular phase (days 1-14) ranges approximately 46 to 607 pmol/L, mid-cycle 315 to 1828 pmol/L, luteal phase 161 to 774 pmol/L, and postmenopausal women under 184 pmol/L. NICE NG23 menopause guidance notes that oestradiol is supportive but not confirmatory for the menopausal transition; in women over 45 with typical symptoms the diagnosis is clinical, not biochemical.

This biomarker entry is being clinically reviewed by our team. The factual content draws on UK guidance (NICE, NHS, Royal Colleges and the relevant speciality society where cited).

Reference range

Reported in pmol/L. Final reports always carry the issuing laboratory's range, which is what your clinician will interpret against.

Group Range Note
Pre-menopausal women, follicular phase (days 1 to 14) 46 to 607 pmol/L
Pre-menopausal women, mid-cycle peak 315 to 1828  
Pre-menopausal women, luteal phase 161 to 774  
Post-menopausal women under 184  
Adult men under 191  

What it is

In pre-menopausal women, oestradiol is produced mainly by developing ovarian follicles, with peaks before ovulation and during the luteal phase. After menopause, levels fall sharply. In men, oestradiol is mostly produced by aromatisation of testosterone, and acts on bone and the brain.

Why a clinician would order it

In women: perimenopausal symptoms, irregular cycles, suspected hypogonadism, fertility work-up, hair shedding (oestrogen withdrawal can unmask androgen effects). In men: gynaecomastia, breast tenderness, infertility, monitoring patients on anabolic steroids or aromatase inhibitors.

If your level is outside the range

Symptoms of low E2

  • Hot flushes
  • Night sweats
  • Vaginal dryness
  • Reduced libido
  • Mood changes
  • Hair thinning

What low can indicate. Perimenopause or menopause, premature ovarian insufficiency, hypothalamic amenorrhoea (low body weight, stress), post-oophorectomy, pituitary disease.

Symptoms of high E2

  • In women: breast tenderness, bloating. In men: gynaecomastia, reduced libido.

What high can indicate. In women: cycle stage variation (interpret with cycle context), pregnancy, ovarian tumour (rare). In men: aromatisation from testosterone or anabolic-steroid use, obesity, liver disease.

Testing tips

For pre-menopausal women, day 2 to 5 of the menstrual cycle gives the cleanest baseline. Post-menopausal women can test any day. Morning sample is preferable. Tell us about any HRT or hormonal contraception so the clinical review accounts for it.

Where you can get this tested

Oestradiol is included in the following WMG Health panels. Same-day appointments at our Harley Street clinic, with results clinician-reviewed.

Advanced Hair & Hormone Check
£389
View panel
The Hormone Specialist
£299
View panel

Want a specific combination of markers we do not have a panel for? Build a custom panel and our clinicians will design one for you.

Symptoms often investigated with Oestradiol

Oestradiol is commonly tested when patients present with the following symptoms. If any of these resonate with you, the linked guides explain what to look for and which test pathway is appropriate.

Excessive Hair Shedding: When to Test Shedding more than 100 hairs a day for weeks? Iron, thyroid, vitamin D and stress can all drive it. Here is... Read symptom guide → Receding Hairline (Male Pattern): What the Blood Work Shows A receding hairline is usually androgenetic (DHT-driven), but iron, thyroid and vitamin D also affect the r... Read symptom guide → Thinning at the Crown: Hormonal and Nutritional Causes Crown thinning is the classic site of androgenetic alopecia in men and FPHL in women. Blood tests pin down ... Read symptom guide → Female Hair Loss: What to Test Female hair loss is rarely one thing. Iron, thyroid, oestrogen, androgens and ferritin all overlap. Test th... Read symptom guide → Post-Pregnancy Hair Loss (Postpartum Shedding) Heavy shedding 2 to 4 months after birth is usually telogen effluvium. Testing rules out iron deficiency, t... Read symptom guide → Hair Loss After COVID-19 or a Viral Illness Heavy shedding 2 to 4 months after COVID-19 is well documented (a viral telogen effluvium). A targeted pane... Read symptom guide →

Related markers

Total Testosterone Androgens Dihydrotestosterone (DHT) Androgens

Sources

UK guidance our clinicians use when interpreting this marker.

This page is general patient information, not personal medical advice. A GMC-registered clinician will review your results and tailor any interpretation to you. See our Editorial Policy for how we write and review content.

Common questions about E2

What is a normal E2 range?

Pre-menopausal women, follicular phase (days 1 to 14): 46 to 607 (pmol/L). Pre-menopausal women, mid-cycle peak: 315 to 1828. Pre-menopausal women, luteal phase: 161 to 774. Post-menopausal women: under 184. Adult men: under 191. Always interpret your own results against the laboratory range printed on your report, since assay-specific reference ranges vary.

What does a low E2 result mean?

Perimenopause or menopause, premature ovarian insufficiency, hypothalamic amenorrhoea (low body weight, stress), post-oophorectomy, pituitary disease.

What does a high E2 result mean?

In women: cycle stage variation (interpret with cycle context), pregnancy, ovarian tumour (rare). In men: aromatisation from testosterone or anabolic-steroid use, obesity, liver disease.

Do I need to fast or prepare for the E2 blood test?

For pre-menopausal women, day 2 to 5 of the menstrual cycle gives the cleanest baseline. Post-menopausal women can test any day. Morning sample is preferable. Tell us about any HRT or hormonal contraception so the clinical review accounts for it.

Can I order a E2 blood test privately in London?

Yes. WMG Health offers E2 as part of bespoke panels and several pre-built panels at our 134 Harley Street clinic. Results are clinician-reviewed by a GMC-registered doctor within 4 hours for the most common assays. All panels are custom-built around your specific question; bookings via /contact/ or 020 3239 3378.