Elevated estradiol in women and men: causes, symptoms, treatment, consequences
The content of the article:
- The action of estradiol
- Fluctuations in estradiol levels
- Causes of increased estradiol in women and men
- Symptoms of elevated estradiol in women and men
- Determination of estradiol level
- Estradiol content standards
- Treatment
- Consequences of elevated estradiol in women and men
Elevated estradiol can occur in both men and women. The method of correcting the level of the hormone is determined by the cause of the deviation, most often treatment of the underlying disease is required. Increased estradiol can lead to the development of serious consequences: in men - obesity, erectile dysfunction, prostate tumors, in women - uterine bleeding, infertility.
Estradiol is a female sex hormone secreted by the follicular apparatus of the ovaries and the placenta in women, the testes in men, as well as the adrenal cortex and adipose tissue in both sexes. In the male body, its main source is the conversion of androgens to estrogens in peripheral tissues, carried out through aromatase.
A blood test for estradiol is indicated for infertility, menstrual irregularities and recurrent miscarriage
The action of estradiol
Estradiol belongs to estrogens, among which it has the greatest biological activity. Estrogens have a pronounced feminizing effect on the body, ensure timely endometrial rejection and periodic bleeding, reduce the level of antithrombin III, stimulate the production of a number of transport proteins, and cause compensatory water and sodium retention. Estrogens increase the blood levels of iron, copper and thyroxin, have an anti-atherosclerotic effect, reduce the concentration of low-density lipoproteins and total cholesterol, and increase the content of high-density lipoproteins.
Estradiol affects the menstrual cycle and the course of pregnancy, improves skin elasticity, increases the timbre of the voice, is responsible for the distribution of body fat in the female type and libido. It prepares the lining of the uterus for the implantation of a fertilized egg. During pregnancy, the level of the hormone rises significantly, reaching maximum values before childbirth. In a pregnant woman's body, estradiol improves blood circulation in the uterine vessels, increases blood clotting (is of great importance for preventing bleeding during childbirth).
During postmenopausal women, the production of estradiol decreases, which may be accompanied by disturbances in thermoregulation and vasomotor instability (so-called hot flashes), sleep disturbances, and atrophic changes in the organs of the genitourinary system. Against the background of estrogen deficiency in women after 40 years, osteoporosis develops.
In men, estradiol takes part in the production of sperm, increases oxygen metabolism, stimulates metabolism, reduces the amount of calcium in bone tissue, and regulates the activity of the nervous system.
In women, the determination of the concentration of estradiol is an integral part of the diagnosis of menstrual irregularities, miscarriage, infertility, early menopause, ovarian pathologies, dysfunctions of the hypothalamus and / or pituitary gland, etc.
In men, determining the level of estradiol is included in the diagnosis of the causes of feminization, in adolescents - delayed puberty or premature puberty.
Fluctuations in estradiol levels
In non-pregnant women, the concentration of estradiol in the blood is regulated by luteinizing and follicle-stimulating hormones. The concentration of estradiol in the female body correlates with the degree of follicle maturation. So, the level of the hormone gradually increases towards ovulation, reaches its maximum values in the middle of the cycle, gradually decreases in the luteal phase of the menstrual cycle, reaching a minimum by the beginning of menstruation.
Daily fluctuations in the level of estradiol in the blood are associated with the rhythm of the production of luteinizing hormone. The maximum values are observed between 15:00 and 18:00, and the minimum values are between 00:00 and 02:00.
Causes of increased estradiol in women and men
Elevated estradiol in women can be due to the following conditions:
- endometriosis;
- follicle persistence;
- follicular ovarian cyst;
- hormone-producing neoplasms of the ovaries and uterus.
The reasons for the excess of this hormone in both sexes include:
- cirrhosis of the liver;
- diseases of the thyroid gland;
- overweight (due to increased aromatization of peripheral androgens);
- taking a number of medicines (oral contraceptives, which include estrogens, anabolic steroids, etc.).
In addition, estrogen-producing testicular tumors may be the cause of elevated estradiol in men.
Symptoms of elevated estradiol in women and men
Signs of increased estradiol in women include:
- menstrual irregularities;
- bleeding during menopause;
- hair loss;
- acne;
- convulsions.
With increased estradiol, persons of both sexes are characterized by:
- female obesity (fatty deposits on the chest, thighs);
- swelling of the face and / or limbs;
- disorders of the gastrointestinal tract;
- fast fatiguability;
- irritability;
- excessive sweating;
- headaches;
- sleep disorders;
- cooling of the upper and lower extremities, regardless of the ambient temperature.
In addition, high estradiol in men is manifested by gynecomastia, sexual disorders.
Increased estradiol in men causes erectile dysfunction and decreased libido
Determination of estradiol level
Endocrinologists or gynecologists-endocrinologists (for women) are engaged in the diagnosis and correction of elevated estradiol.
The indications for testing for estradiol are usually:
- amenorrhea, oligomenorrhea;
- anovulation;
- hypogonadism;
- dysfunctional uterine bleeding;
- osteoporosis;
- hirsutism;
- neoplasms;
- premenstrual syndrome;
- bacterial vaginosis;
- the threat of termination of pregnancy;
- feminization in men.
In women, depending on the purpose of the study, blood sampling to determine the concentration of estradiol is performed at different phases of the menstrual cycle. Blood for analysis for estradiol must be taken in the first half of the day (preferably before 11:00) on an empty stomach, after the last meal, 8-12 hours should pass. Before donating blood for analysis for estradiol, physical activity, sex and smoking, the use of alcoholic beverages and fatty foods should be excluded, and the need to cancel the drugs used should be agreed with the doctor.
Glucocorticoids, estrogen-containing drugs, tetracyclines, phenothiazines, anabolic steroids can increase the level of estradiol. Gonadoliberin agonists, combined hormonal contraceptives, chemotherapeutic agents, etc., can lower the concentration of estradiol in the blood.
Estradiol content standards
Normal levels of estradiol in children:
- up to 15 days - less than 32 pg / ml in boys and up to 36 pg / ml in girls;
- from 15 days to 10 years - up to 21 pg / ml in boys and up to 36 pg / ml in girls;
- from 10 to 18 years old - up to 42 pg / ml in boys, for girls - no more than 277 pg / ml (depending on the Tanner stage or the phase of the menstrual cycle).
In men over 18 years of age, the content of estradiol in the blood should not exceed 56 pg / ml. In women of reproductive age, the estradiol concentration rate depends on the phase of the menstrual cycle:
- in the follicular phase - 19.5-144 pg / ml,
- in the middle of the menstrual cycle - 64–356.7 pg / ml;
- in the luteal phase - 37-280 pg / ml.
In postmenopausal women, an indicator not exceeding 32.2 pg / ml is considered normal.
Treatment
Correction of elevated estradiol depends on the cause that caused it. The main efforts are aimed at treating the underlying disease. In some cases, hormone therapy is needed. If neoplasms are found, surgical treatment may be required.
Diet is indicated for patients with elevated estradiol. They reduce the amount of carbohydrates consumed, increase the protein content, and include foods rich in omega-3 unsaturated fatty acids in the diet. In the case of increased body weight, the calorie content of the daily diet is reduced. Adequate physical activity is recommended.
Consequences of elevated estradiol in women and men
The consequences of increased estradiol in men include erectile dysfunction, decreased libido, obesity, chronic diseases of the cardiovascular system, gynecomastia, prostate tumors (benign hyperplasia or cancer), depression. In women, elevated estradiol causes uterine bleeding and associated anemia, malignant neoplasms of the ovaries, and infertility.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
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