Think about this hormone as the “conductor of the ovary orchestra.” Estradiol (E2) is the primary female sex hormone, responsible for maintaining the reproductive system. Fluctuating levels of this hormone during the course of your menstrual cycle prompts maturation of follicles, release of an egg, and thickening of the uterine lining (corpus luteum) should fertilization occur. When you're ovulating, your E2 levels are at their peak, and when your period starts, they're at their lowest.1

What Is Estradiol?

Estradiol (E2), also known as oestradiol, is an important form of the reproductive hormone estrogen. It is a steroid hormone built from cholesterol which plays an important role in sexual development. E2 is produced in the ovaries by special cells called granulosa cells inside the ovarian follicles (little sacs that hold the eggs). It can also be produced by the placenta during pregnancy.

Role Of Estradiol

There are four different kinds of estrogen: estrone (E1), estradiol (E2), estriol (E3) and estetrol (E4 ). Estradiol (E2) is the most potent and most abundant estrogen during a woman's reproductive years. E2 plays an important role in first maturing and then maintaining the reproductive system. It helps in growth and development of sexual organs such as breast, vagina, uterus and fallopian tubes. It is also important in the regulation of the cardiovascular system, neurologic system, skeletal system, vascular system, and many more 2.

1. Understanding Primary Ovarian Insufficiency (POI)


Primary Ovarian Insufficiency (POI) occurs due to the dysfunction of ovarian follicles which results in early cessation of the menstrual cycle (before the age of 40). It is also known as early menopause. POI is estimated to prevail among 1% of the general population 3. Generally, women suffering from POI are more likely to show elevated FSH levels and low levels of E2 in their bodies, indicating the occurance of early menopause.4


In the event you are at an elevated risk of POI, take corrective measures and initiate a conversation with your fertility specialist to ensure your future plans are not compromised.

2. Understanding Functional Hypothalamic Amenorrhea (FHA)


Functional Hypothalamic Amenorrhea (FHA) is a form of amenorrhea (absence of menstruation) that results due various causes such as stress, weight loss and excessive exercise. FHA contributes to the prevalence of 30% of secondary amenorrhea and 3% of primary amenorrhea approximately 5. This condition is characterized by abnormal GnRH (Gonadotropin Releasing Hormone) secretion which inturn disturbs the secretion of gonadotropins - LH and FSH. This impairment leads to reduction of E2 production in the ovaries. 


Should your results indicate an elevated risk for FHA, consulting your doctor and understanding the cause of the condition coupled with medications and follow-up treatment procedures can help you manage the condition effectively and efficiently.

When Can I Take the E2 Test?

Testing Estradiol levels can determine your general hormonal health and overall ovarian function. During the reproductive years, your E2 levels naturally fluctuate throughout the menstrual cycle — they’re highest toward the middle and lowest during your period. At the onset of menopause, when periods come to a complete stop, the levels drop. Thus, E2 needs to be tested on day 3 and ideally, your levels should be low at this point.

What Can Differing E2 Levels Tell You?

1. Normal Estradiol Levels

The normal level of estradiol ranges from 20-250 pg/ml. 

2. High Estradiol Levels

High levels of E2 also known as ‘Estradiol Dominance’ may be attributed to taking certain medications such as hormonal birth control or an elevated body-fat percentage. Common signs to look out for are: 6

  • Weight gain
  • Infrequent menstrual cycles
  • Elevated symptoms of premenstrual syndrome (PMS)
  • Anxiety or Depression
  • Loss/Decrease of sex drive
  • Non Cancerous (Benign) Breast Lumps
  • Uterus fibroids
  • Fatigue

3. Low Estradiol Levels 

Typically, as women get closer to menopause, their E2 levels fall. High levels of FSH and low levels of E2 can therefore indicate early menopause or premature ovarian insufficiency (POI). Common signs of low estradiol levels  to look out for are: 6

  • Irregular or absent menstrual cycles
  • Breast tenderness
  • Hot flashes and/or night sweats
  • Mood swings
  • Decreased sexual desire
  • Sleeping issues
  • Menstrual migraines 
  • Dry skin

Also, low E2 levels coupled with the reduction in LH and FSH levels may indicate the risk of Functional Hypothalamic Amenorrhea. 

Where Can I Get My E2 Levels Tested?

Curious to know more about your E2 levels and how you can manage your fertility better? We  have got you covered.

Order your OvaScore kit and learn all about your reproductive hormones and the relevant insights from the comfort and privacy of your home.