Oestradiol (Oestrogen)

July 21, 2020

What is Oestradiol?

Oestradiol, a steroid hormone, is the most potent of the three naturally produced oestrogens.[1] Oestrogens are responsible for the development of female sex organs and secondary sex characteristics. It is a major female sex hormone but it is present in males, too. Oestrogen has a key role in the female menstrual cycle and is involved in the interplay between follicle stimulating hormone (FSH) and luteinising hormone (LH).[2]

Why take an Oestradiol blood test?

Because of the role oestrogen plays in the female menstrual cycle, oestradiol levels can be used to evaluate ovarian function. It can also be used to diagnose one of the potential underlying causes of gynaecomastia in men (enlarged breasts).

Low oestrogen is associated with hypothalamic amenorrhoea and menopause. Low oestrogen is a consequence of amenorrhea which is diagnosed according to WHO criteria on levels of LH and FSH.

Oestradiol is also used to diagnose early puberty, known as precocious puberty (before the age of 8) as well as delayed puberty (after the age of 13 in girls and 14 in boys).

However, the main function of an oestradiol test is to diagnose the cause of the absence of periods (amenorrhoea), usually menopause or pregnancy.

You can test your oestradiol level along with other key fertility hormones by purchasing a simple at-home finger prick test kit which is then analysed at an accredited lab. Forth offers a number of blood tests which include oestradiol such as Female FertilityMale HormonesPerimenopause & Menopause Health

What function does Oestradiol have in the body?

Oestradiol is a hormone required in both males and females. In males, oestradiol is produced from testosterone and has a major role in bone health, together with the regulation of sexual function, particularly libido, erectile function and sperm production.[3]

Female oestrogen levels rise naturally during the menstrual cycle. The natural rise causes an egg to mature and be released from an ovary, a process called ovulation. Oestrogen also thickens the uterus lining to allow a fertilised egg to implant itself and develop into a foetus.

Oestradiol is mainly made by the ovaries in premenopausal women with levels being at their highest during ovulation and is at its lowest when a female has her period. As a female increases in age, her oestradiol levels fall slowly with an even larger decrease during the menopause when the ovaries stop working.

During pregnancy, the placenta produces a lot of oestradiol, particularly during the third trimester.

Oestradiol is an important hormone for the growth and development of the female’s reproductive system such as the linings of the vagina, fallopian tubes and the endometrium. Some other roles of oestradiol in females include:

  • Breast development
  • Body shape changes
  • Bone density regulation
  • Fat deposition
  • Pregnancy maintenance
  • Contraception and hormone replacement therapy[4]
  • Bone health
  • Cardiovascular health and cognitive function in women

How do changes in Oestradiol affect health and wellbeing?

The fluctuation in oestrogen levels during the female menstrual cycle means oestrogen levels should be recorded at the right time during the cycle. As oestrogen levels fall naturally as a woman ages, once oestradiol falls below a certain threshold, menopausal symptoms tend to present. The fall in oestrogen is to blame for the vasomotor and psychological symptoms of the menopause, including:

  • hot flushes
  • changes in mood
  • decreased bone density
  • fatigue
  • sleep disorders
  • sexual dysfunction [5]

The reduction in oestrogen at the time of the menopause has been linked to the development of osteoporosis in postmenopausal women. A natural fall in oestrogen in men can cause osteoporosis in elderly men, too. A fall in oestradiol of less than <18.35 pmol/L has been associated with a 2.5-fold increase in hip and vertebral fractures in older females.[6]

In men, increased levels of oestradiol and decreased levels of testosterone can increase the risk of erectile dysfunction severity. The main symptom is difficulty getting and maintaining an erection. However, erectile dysfunction can have a psychological and emotional impact both individual and on relationships. [7]

If you are worried about your oestradiol levels or just want to check where you fall on the range, you can test your level with a simple at-home blood test.

What can cause Oestradiol to change?

A major cause of changing oestradiol levels, for females, is the menopause, subsequently causing many of the associated symptoms.

Oestradiol levels naturally fall in males and females as they both get older, leaving both more vulnerable to the development of osteoporosis.

What are the most common symptoms?

The common symptoms of the menopause are a result of the falling oestrogen levels. The common symptoms of the menopause are:

  • Hot flushes
  • Night Sweats
  • Sleeping difficulties
  • Reduced sex drive
  • Vaginal dryness
  • Changes in mood
  • Palpitations
  • Reduced muscle mass
  • Stiff joints
  • Recurrent urinary tract infections[8]

The falling levels of oestrogen are also associated with an increased risk of osteoporosis. Osteoporosis is a condition where the bones are weakened, making them fragile and more likely to break.[9]

How to keep Oestradiol in the healthy range

Eating a healthy, balanced diet is key before, during and after the menopause, particularly as there are some things which can make the symptoms worse. Some handy tips are:

  • to avoid stimulants as these can cause or worsen hot flushes.
  • avoid coffee, alcohol, chocolate and spices.
  • swap sugary treats for fruit. fruit can help to prevent fatigue.
  • eat foods such as oats and legumes can help with irritability.
  • incorporate foods which include phyto-oestrogens into the diet to help prevent symptoms of the menopause. phyto-oestrogens are found in soya products.[10]

Diet can also help to reduce the risk of osteoporosis. Vitamin D and calcium are essential for maintaining bone health. Good sources of calcium are:

  • milk
  • yoghurt
  • cheese
  • green, leafy vegetables
  • wholegrains

The skin makes vitamin D after being exposed to the UVB rays of the sun. However, how much vitamin D the body makes and stores depends on the time of day, season, skin pigmentation, age and the country you are in. The three ways to get vitamin D are:

  • sunlight exposure
  • food
  • supplements

Age affects the skins ability to produce vitamin D and some people are at greater risk of low vitamin D, such as individuals in care homes or those who spend lots of time indoors. Alternatively, there are very few food sources which contain vitamin D such as:

  • oily fish
    • mackerel
    • salmon
    • tuna
  • fortified milk and dairy products
  • fortified cereals

If you are still unable to get enough vitamin D from sun exposure and diet, you may consider supplements. European Guidance for the Diagnosis and Management of Osteoporosis in Postmenopausal Women states women require over 1000 mg/day calcium, 800 IU of vitamin D and 1mg/kg of body weight of protein, all of which should be achieved by consuming a healthy, high in dairy diet.[11]

Exercise is equally beneficial for menopausal women and is also key for improving bone health. The benefits of exercise include:

  • improves cardiovascular and lung health
  • increases good cholesterol and reduces bad cholesterol levels
  • reduces the risk of high blood pressure, heart attacks and strokes
  • prevents weight gain
  • improves mood and releases endorphins which make you feel happy
  • reduces the risk of back pain
  • increases bone mass
  • improves social life which positively impacts mental health
  • osteoporosis can also be prevented through strength training like weights and impact exercise like walking, running and jogging.

- Health scores calculated



[1] You and Your Hormones. (2018). Oestradiol. Available at: https://www.yourhormones.info/hormones/oestradiol/

[2] Lab Tests Online UK. (2014). Oestrogen. Available at: https://labtestsonline.org.uk/tests/oestrogen

[3] Schulster, M., Bernie, A, M and Ramasamy, R. (2016). The Role of Estradiol in Male Reproductive Function. Asian J Androl: 18(3), pp 434-440.

[4] Stillwell, W. (2016). Chapter 20 – Bioactive Lipids. In: An Introduction to Biological Membranes (Second Edition).

[5] Freedman, M, A. (2002). Quality of Life and Menopause: The Role of Estrogen. J Womens Health (Larchmt): 11(8), pp 703-18.

[6] Cauley, J, A. (2015). Estrogen and Bone Health in Men and Women. Steroids: 99(part A), pp 11-15.

[7] El-Sakka, A, I. (2013). Impact of the Association Between Elevated Oestradiol and Low Testosterone Levels on Erectile Dysfunction and Severity. Asian Journal of Andrology: 15, pp 492-496.

[8] NHS. (2018). Symptoms Menopause. Available at: https://www.nhs.uk/conditions/menopause/symptoms/

[9] NHS. (2019). Overview Osteoporosis. Available at: https://www.nhs.uk/conditions/osteoporosis/

[10] Lewin, J. (2017). Eat to Ease the Menopause. Available at: https://www.bbcgoodfood.com/howto/guide/eat-beat-menopause

[11] Rizzoli, R., Bischoff-Ferrari, H., Dawson-Hughes, B and Weaver, C. (2014). Nutrition and Bone Health in Women After the Menopause. Women’s Health: 10(6).

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This information has been medically reviewed by Dr Nicky Keay

Nicola has extensive clinical and research experience in the fields of endocrinology and sport and exercise medicine. Nicky is a member of the Royal College of Physicians, Honorary Fellow in the Department of Sport and Exercise Sciences at Durham University and former Research Fellow at St. Thomas' Hospital.

Dr Nicky Keay

Dr Nicky Keay

BA, MA (Cantab), MB, BChir, MRCP.