Estradiol (E2)
Primary female sex hormone
16 of 22 providers
Sex Hormones (Female)
elevated estradiol can cause gynecomastia and reduced testosterone effects.
What is Estradiol (E2)?
Estradiol (E2) is the most potent and predominant form of estrogen in the body, and it's critically important for BOTH men and women. In women, it's produced primarily by the ovaries and drives sexual development, menstrual cycle regulation, bone health, cardiovascular protection, cognitive function, and more. In men, estradiol is produced by aromatization of testosterone in fat tissue and other organs, and it's essential for bone density, libido, cardiovascular health, and brain function.
Here's what most people misunderstand:estradiol isn't just a "female hormone,"and testosterone isn't just a "male hormone."Men need estradiol for optimal bone density and cardiovascular health—too low is as problematic as too high. Similarly, women need testosterone for muscle mass, libido, and energy. The key is balance. In men on testosterone replacement therapy (TRT), excessive aromatization can elevate estradiol, causing gynecomastia (breast development), water retention, and mood issues. Conversely, blocking estradiol too aggressively with aromatase inhibitors can harm bone density and lipid profile.
Estradiol levels vary dramatically across the menstrual cycle in premenopausal women (low in follicular phase, peak at ovulation, moderate in luteal phase) and plummet after menopause. Postmenopausal women have estradiol levels similar to men unless on hormone replacement therapy (HRT). Optimal estradiol levels are context-dependent:cycling women should be tested on specific cycle days, while men and postmenopausal women have static targets.
Why Estradiol Matters for Longevity (Men and Women)
- Bone density:Estradiol is THE most important hormone for maintaining bone mineral density in both sexes. Low estradiol=accelerated osteoporosis.
- Cardiovascular protection:Estradiol improves endothelial function, raises HDL, lowers LDL, and reduces arterial stiffness (premenopausal women have lower CVD risk than men).
- Brain health:Estradiol supports cognitive function, memory, mood, and may protect against Alzheimer's disease. Estradiol decline at menopause linked to cognitive decline.
- Libido and sexual function:Optimal estradiol supports libido in both sexes. Too low OR too high impairs sexual function in men.
- Metabolic health:Estradiol improves insulin sensitivity and body composition. Loss at menopause drives visceral fat accumulation.
- Skin and connective tissue:Estradiol maintains skin thickness, collagen, and elasticity.
Optimal vs Standard Ranges
Optimal (Men)20-40 pg/mL▼
- Sweet spot for men
- Higher levels (>50 pg/mL) may cause gynecomastia, water retention, mood issues
- Lower levels (<20 pg/mL) harm bone density and lipids
Optimal (Premenopausal Women - Follicular)30-100 pg/mL▼
- Early follicular phase (days 1-7 of cycle)
- Estradiol is low after menstruation, then rises
Optimal (Premenopausal Women - Ovulation)100-400 pg/mL▼
- Midcycle (days 12-16)
- Estradiol peaks at ovulation to trigger LH surge
Optimal (Premenopausal Women - Luteal)80-200 pg/mL▼
- Luteal phase (days 17-28)
- Estradiol is moderate;progesterone dominates in this phase
Scientific Evidence
Low estradiol in men <15 pg/mL harms bone density and libido. In postmenopausal women, low estradiol causes hot flashes and bone loss.
Gynecomastia (breast enlargement in men)|Water retention, bloating|Mood swings, irritability, emotional lability|Decreased libido, erectile dysfunction (men)|Acne, oily skin|Weight gain, especially hips/thighs (women)|Breast tenderness (women)|Increased risk of blood clots (VTE) if very high|Migraine headaches (women)|Heavy menstrual bleeding (premenopausal women)|Increased cancer risk (endometrial, breast) if chronically elevated without progesterone balance
Menopause:Ovarian follicles depleted, estradiol production drops to <30 pg/mL. Most common cause of low estradiol in women >45.|Premature ovarian insufficiency (POI):Ovarian failure before age 40. Autoimmune, genetic (Turner syndrome), chemotherapy/radiation.|Hypothalamic amenorrhea:Excessive exercise, low body fat, chronic stress, eating disorders suppress GnRH→LH/FSH→estradiol axis.|Aromatase inhibitor overuse (men):Excessive AI use on TRT crashes estradiol.|Anorexia nervosa, extreme calorie restriction:Body shuts down reproductive axis to conserve energy.|PCOS with anovulation:Some PCOS women have low estradiol due to chronic anovulation (others have estrogen dominance).|Pituitary or hypothalamic disorders:Tumors, trauma, Sheehan syndrome suppress LH/FSH, lowering estradiol.
Obesity in men:Excess fat tissue contains aromatase enzyme, converting testosterone→estradiol.|Excessive testosterone replacement therapy (TRT) in men:More substrate for aromatization=higher estradiol.|Estrogen-secreting tumors:Rare ovarian or adrenal tumors (granulosa cell tumor).|Liver disease (cirrhosis):Impaired estrogen clearance leads to accumulation.|Hyperthyroidism:Increased SHBG and altered estrogen metabolism.|Exogenous estrogen use:HRT, oral contraceptives, or inadvertent exposure (phytoestrogens, xenoestrogens).|Aromatase excess syndrome (rare genetic condition).
Estradiol and Bone Density
Estradiol is the dominant hormone regulating bone remodeling in both sexes. Men with estradiol <10 pg/mL have 3x higher fracture risk. Postmenopausal estradiol decline causes rapid bone loss (~2-3%/year for first 5 years). HRT reduces fracture risk by ~30%.
Source:Khosla S, et al. Estrogen and the skeleton. Trends Endocrinol Metab. 2012;23(11):576-581. (PubMed)
Menopause HRT and Cardiovascular Disease
The WHI (Women's Health Initiative) initially suggested HRT increased CVD risk, but reanalysis shows timing matters. Starting HRT within 10 years of menopause (<60 years) reduces CVD events by 30-50%. Starting HRT >10 years post-menopause or >60 years old may increase risk.
Source:Manson JE, et al. Menopausal hormone therapy and long-term all-cause and cause-specific mortality. JAMA. 2017;318(10):927-938.
Estradiol and Alzheimer's Risk
Observational studies suggest estradiol supports cognitive function and may reduce Alzheimer's risk. Estradiol enhances synaptic plasticity, neurogenesis, and cerebral blood flow. Early HRT initiation (within 5 years of menopause) associated with 30-50% lower dementia risk;late initiation shows no benefit or potential harm.
Source:Maki PM, Henderson VW. Hormone therapy, dementia, and cognition:the Women's Health Initiative 10 years on. Climacteric. 2012;15(3):256-262.
Which Providers Test Estradiol (E2)?
Full Provider Comparison
| Provider | Includes | Annual Cost | Biomarkers |
|---|---|---|---|
 Superpower | ✓ | $199 | 100+ (150 with ratios) |
 WHOOP Advanced Labs | ✓ | $349 | 65 |
 Labcorp OnDemand | — | $398 | 30+ |
| ✓ | $486 | 40+ | |
| ✓ | $444 | 288 | |
| ✓ | $349 | 100+ | |
| ✓ | $761 | 54 | |
 Function Health | ✓ | $365 | 160+ |
| — | $250 | 65 | |
| ✓ | $495 | 70+ | |
| ✓ | $895 | 100+ | |
| ✓ | $1950 | 150+ | |
| ✓ | $375 | 80+ | |
| — | $Varies | 75+ | |
| — | $190 | 100+ | |
| — | $99 | 50 | |
| ✓ | $124 | 60 | |
| — | $199 | 50 | |
| ✓ | $499 | 120+ | |
| ✓ | $4188 | 70-80+ | |
| ✓ | $375 | 85 | |
| ✓ | $700 | 128 |
Frequently Asked Questions
What is Estradiol (E2)?
Primary female sex hormone
What is the optimal range for Estradiol (E2)?
The standard reference range for Estradiol (E2) is elevated estradiol can cause gynecomastia and reduced testosterone effects.. Optimal ranges may differ based on individual health goals and expert recommendations.
Which blood test providers include Estradiol (E2)?
16 out of 22 blood testing providers include Estradiol (E2) in their panels. This biomarker is widely available across major providers.
What category does Estradiol (E2) fall under?
Estradiol (E2) is categorized under Sex Hormones (Female). This category includes biomarkers that help assess related aspects of health and wellness.
Medical Disclaimer
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.
Last reviewed:2026-02-20