What is oestradiol?
Oestradiol is the main oestrogen, the hormone that carries the first half of the cycle in women. It is made in the ovaries, in the maturing follicle, and in the weeks after menstruation it builds up the lining of the womb, makes the mucus around ovulation permeable and, once it is high enough, gives the brain the signal for the LH surge that sets ovulation in motion. After ovulation it falls back and progesterone takes over. It does more than the cycle. Oestradiol keeps bone strong, keeps the artery wall supple, helps cholesterol the right way and acts on skin, sleep and mood. That is why the years after the menopause, when it falls away, bring osteoporosis and cardiovascular disease closer. And it is present in men too: a small part of testosterone is converted into oestradiol in fat tissue and bone, and that small part keeps bone intact in men as well. Your report shows oestradiol in pmol/L, and in women not with one range but with a range per phase of the cycle: low at the start, a peak around ovulation, an intermediate level in the second half and a low value after the menopause. Those phases differ by multiples, not margins, so without a cycle day the number cannot be read. In men there is one range, about 40 to 162 pmol/L at most labs.
Why is oestradiol relevant?
For anyone who wants to stay healthy, oestradiol is above all a signal that your cycle is doing what it should. A regular cycle with ovulation is one of the most reliable signs that your body has enough energy, rest and fat, and it is one of the first things to switch off when it does not. Eating too little for what you burn, training a lot, losing weight fast or lasting stress turn the signal from the brain down low, and oestradiol falls with it. Missed periods in a sporty, lean woman are then not fitness but a deficit, and bone pays the price. The second reason is the menopause. In the years before it oestradiol starts to fluctuate, high and low by turns, while FSH climbs; afterwards it stays low. That explains hot flushes, worse sleep, dry mucous membranes and the faster bone loss of those years. An oestradiol value shows that, but one measurement says little in a phase that fluctuates by definition: symptoms and the absence of periods say more, and the menopause is not diagnosed on the number. In men oestradiol is the value that gives away belly fat. Fat tissue converts testosterone into oestradiol, so the more belly fat, the higher the oestradiol and the lower the testosterone: the pattern behind breast tissue, less desire and less muscle in men with excess weight. Too low rarely happens by itself in men; it goes with drugs that block the conversion, and then bone suffers. Anyone using hormone therapy or contraception measures something else. The pill suppresses production of your own, and hormone therapy after the menopause supplies oestradiol from outside; the number then says something about the dose, not about your ovaries.
Oestradiol reference ranges
What counts beside the number:
- Your cycle day, or whether you are in or past the menopause: without that phase the number cannot be placed
- Contraception or hormone therapy, which suppress production of your own or supply oestradiol from outside
- FSH and LH, which show whether a low value lies with the ovaries or with the signal from the brain
- Progesterone in the second half, which shows whether ovulation has happened
- Your energy balance: food, training hours, weight loss and stress, the things that switch a cycle off
- In men: testosterone and waist size
The bands above are where the labs overlap; the range on your own report may be slightly wider, and there is no national normal value. Pick the phase that applies to you, because without a phase an oestradiol value cannot be read. Pregnancy values sit in the table below and not in the chart: they climb to twenty to forty times the rest of the axis.
What Dutch labs actually use
The three labs that publish oestradiol per cycle phase agree on the shape and not on the edges. In the follicular phase Unilabs starts at 70 pmol/L where Star-shl starts at 45.4 and Certe prints only a ceiling of 854. Around ovulation Unilabs runs to 2400 where the other two stop at 1461. And after menopause Unilabs stops at 125 where Star-shl and Certe run to 505, four times as high. The biggest surprise sits with the men. Unilabs and Star-shl sit almost on top of each other, 40 to 162 and 41.4 to 159, but Certe publishes 95 to 223: a floor more than double the other two. The same man is normal at one lab and low at another, and that difference sits in the assay, not in his blood.
70 – 854pmol/L
Between 0 and 70 and between 854 and 950 it differs per lab, because each lab sets its limits on its own method and population. Above 950 every lab calls it abnormal.
Pregnancy, per trimester
These values are deliberately not in the chart: on the same axis they would make every other phase unreadable.
| Star-shl | Certe | |
|---|---|---|
| 1st trimester | 563–11902 pmol/L | 563–11900 pmol/L |
| 2nd trimester | 5729–78098 pmol/L | 5730–78100 pmol/L |
| 3rd trimester | > 31287 pmol/L | 34290–110100 pmol/L |
Every age, per lab
| Laboratory | Group | Reference range |
|---|---|---|
| Unilabs(Saltro, Medlon, SHO, Atalmedial)2026 | Women follicular phase | 70–950 pmol/L |
| Women mid-cycle | 140–2400 pmol/L | |
| Women luteal phase | 80–1150 pmol/L | |
| Women post-menopausal | 0–125 pmol/L | |
| Men from 20 yrs | 40–162 pmol/L | |
| Star-shl2026 | Women follicular phase | 45.4–854 pmol/L |
| Women ovulatory phase | 151–1461 pmol/L | |
| Women luteal phase | 81.9–1251 pmol/L | |
| Women post-menopausal | 18.4–505 pmol/L | |
| Women pregnancy 1st trimester | 563–11902 pmol/L | |
| Women pregnancy 2nd trimester | 5729–78098 pmol/L | |
| Women pregnancy 3rd trimester | > 31287 pmol/L | |
| Men | 41.4–159 pmol/L | |
| Certe2026 | Women follicular phase | < 854 pmol/L |
| Women ovulation peak | 151–1461 pmol/L | |
| Women luteal phase | < 1251 pmol/L | |
| Women post-menopausal | < 505 pmol/L | |
| Women pregnancy 1st trimester | 563–11900 pmol/L | |
| Women pregnancy 2nd trimester | 5730–78100 pmol/L | |
| Women pregnancy 3rd trimester | 34290–110100 pmol/L | |
| Men from 18 yrs | 95–223 pmol/L |
Each band as the lab publishes it, retrieved in 2026, unless marked otherwise.
Oestradiol high or low: what it means
A high oestradiol in women is almost always a matter of timing: around ovulation the value belongs a multiple higher than at the start of the cycle, and setting a value from those days against the range of the first half turns a normal peak into an abnormality. In pregnancy oestradiol climbs to a multiple of any cycle value. In men high is usually belly fat, and sometimes testosterone from outside, because that too is partly converted. A low oestradiol is the ordinary picture at the start of the cycle and after the menopause. Beyond those the question is what it comes from. In a woman of reproductive age with a missing cycle, a low oestradiol together with a low FSH and LH points at the signal from the brain, and that is usually an energy deficit, overtraining, fast weight loss or stress; together with a high FSH it points at ovaries responding less, as in the years before the menopause. The pill also gives a low oestradiol of your own, and that is then the intention. The levers are those of your energy balance and your fat mass. With a cycle that switches off from eating too little or training too much, oestradiol recovers once the balance returns: more food, especially carbohydrates and fat, fewer training hours, more sleep; that usually takes months, not weeks. In men with a high oestradiol and a low testosterone, losing weight around the middle works both ways: less conversion and more testosterone of your own. After the menopause the lever is not the hormone itself but bone and heart: strength training, calcium and vitamin D, and the ordinary lifestyle for your vessels. Hormone therapy is there for anyone with many symptoms, and that is a choice you make together with a doctor. Never read oestradiol on its own. FSH and LH tell you how hard the brain is pulling on the ovaries, progesterone whether ovulation has happened, and in men testosterone belongs beside it. Note your cycle day, and whether you use contraception or hormones, because without that context the number cannot be placed.
What lowers it
At the start of the cycle and after the menopause the ordinary picture; beyond those usually the signal from the brain.
| Cause | How often |
|---|---|
| Drawn early in the cycleIn the first days after menstruation oestradiol is low and still building up; low is then the rhythm itself | Often |
| MenopauseOnce the ovaries stop, oestradiol stays low; in the years before it fluctuates and FSH climbs | Often |
| Hormonal contraceptionThe pill, the implant and the injection suppress production of your own; the low number is then the intention | Often |
| Eating too little, training too much or lasting stressWith an energy deficit the brain turns the signal to the ovaries down low; the cycle switches off and oestradiol falls with it, together with FSH and LH | Sometimes |
What raises it
In women usually timing, in men usually belly fat.
| Cause | How often |
|---|---|
| The wrong phase as comparisonAround ovulation oestradiol belongs a multiple higher than at the start of the cycle; setting a peak value against the range of the first half turns a normal peak into an abnormality | Often |
| PregnancyOestradiol climbs to a multiple of any cycle value; the labs publish separate bands for it | Sometimes |
| Belly fat in menFat tissue converts testosterone into oestradiol; the more belly fat, the higher the oestradiol and the lower the testosterone | Sometimes |
How does an oestradiol blood test work?
- Referral
- Not needed. You can have oestradiol measured without going through your GP.
- Fasting
- Not needed.
- When to draw
- For questions about the cycle at the start, day 2 to 5 after the first day of menstruation, together with FSH and LH; note the day. In men the moment matters little.
- The draw
- One tube of blood from a vein in your arm.
- The result
- A single number in pmol/L, in women with a range per cycle phase; pick the phase that applies to you. Usually available within a few days.
- Measured together
- FSH, LH and progesterone, and in men testosterone. Oestradiol takes its meaning from that company.
- Where to draw
- You can draw at 250+ locations near you, no referral needed. See the locations
Frequently asked questions
What is oestradiol?
Oestradiol is the main oestrogen. In women the ovaries make it, in the maturing follicle, and it carries the first half of the cycle: it builds up the lining of the womb and gives the signal for ovulation. Beyond that it keeps bone strong and the artery wall supple. In men a small amount arises from testosterone, mainly in fat tissue, and that too keeps bone intact.
What is a normal oestradiol level?
In women that depends on the cycle phase, and the differences are multiples rather than margins. Where the labs overlap: first half 70 to 854 pmol/L, around ovulation 151 to 1461, second half 81.9 to 1150, and after the menopause 18.4 to 125. For men one range applies, at most labs about 40 to 162 pmol/L. The range on your own report may be slightly wider.
Why does the normal range differ by cycle phase?
Because oestradiol does not follow the cycle but drives it. It builds up in the first half, peaks around ovulation to set it in motion, and then drops to an intermediate level while progesterone takes over. The same value is therefore ordinary mid-peak and too high a week later. That is why your cycle day belongs with the result.
What does a low oestradiol level mean?
At the start of the cycle and after the menopause low is the ordinary picture. Beyond those it depends on FSH and LH beside it. If those are low too and your cycle is missing, your brain is turning the ovaries down low, and in young women that is almost always eating too little, training too much, fast weight loss or stress. If FSH is high instead, the ovaries are responding less, as in the years before the menopause. On the pill a low oestradiol of your own is the intention.
What does a high oestradiol level mean?
In women almost always timing: around ovulation or in pregnancy the value belongs a multiple higher, and setting a peak value against the range of the first half turns a normal peak into an abnormality. In men high is usually belly fat, which converts testosterone into oestradiol; losing weight around the middle reverses that.
My periods have stopped and I exercise a lot; is that related to oestradiol?
Often, yes. With eating too little for what you burn, many training hours, fast weight loss or lasting stress, the brain temporarily switches reproduction off to save energy: FSH and LH drop, ovulation stays away and oestradiol falls. That feels like fitness but is a deficit, and bone pays for it. It recovers with more food, especially carbohydrates and fat, fewer training hours and more sleep, and that usually takes months.
What does oestradiol say in men?
Mainly something about belly fat. Fat tissue converts testosterone into oestradiol, so with excess weight oestradiol rises while testosterone falls: the pattern behind breast tissue, less desire and less muscle. Too low rarely happens by itself in men and goes with drugs that block the conversion; then bone suffers. In men always read the value beside testosterone.
Can oestradiol tell me whether I am in the menopause?
Not reliably. In the years before the menopause oestradiol fluctuates from month to month, high and low by turns, so one measurement says little. The menopause is diagnosed on age, symptoms and the absence of periods, not on a hormone value. After the menopause oestradiol stays low and FSH stays high.
Do these values apply in pregnancy or on the pill?
No. In pregnancy oestradiol climbs to a multiple of any cycle value, and the labs publish separate bands for it. On the pill or hormone therapy you measure something else: the pill suppresses production of your own, hormone therapy supplies oestradiol from outside. The number then says something about the dose, not about your ovaries.
Which tests include oestradiol?
Oestradiol is in the Hormones men test (€129, also as an add-on for €109).
Related biomarkers
Read on
Sources
- 1.Unilabs, test catalogue (Dutch): oestradiol, 17ß. 2026. bepalingenklapper.nl
- 2.Star-shl, test catalogue (Dutch): oestradiol. 2026. star-shl.nl
- 3.Certe, test catalogue (Dutch): oestradiol. 2026. bepalingenwijzer.certe.nl
Educational information only, not medical advice. Consult a healthcare professional for clinical decisions.
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