Estradiol: the norm in women, the causes of abnormalities, treatment
One of the main criteria for women's health is the hormonal background, and "most female" hormone is estradiol.If there are abnormalities, the woman has menstrual irregularities, there may be problems with conception, and the general condition of the body begins to deteriorate.Table of contents: Estrogen in the menstrual cycle Estrogen during pregnancy Common estrogen effects Norm of estradiol in the blood Why does estradiol decrease Why does estradiol increase? Estradiol tests
Estrogen in the menstrual cycle
Each woman in the ovaries produces three groups of hormones - androgens, Progesterones and estrogens. Estrogen, in turn, includes estriol, estradiol and estrone. Ovarian work is "controlled" by the brain - it closely interacts with the endocrine organs.
A healthy, regular menstrual cycle consists of three phases - follicular, ovulatory( ovulation) and luteal.From the first day of menstruation, follicles develop in the ovaries, one of them will necessarily become the largest, the dominant one - it just produces estrogen.
Under the influence of estrogen on the 14th day of the menstrual cycle, ovulation occurs, the egg leaves, and the follicle turns into a yellow body that secrete estrogen and progesterone.In case of non-occurrence of pregnancy, the yellow body disappears, the level of hormones falls and menstruation occurs.
Estrogen during pregnancy
If a conception occurs, the yellow body of pregnancy actively secretes estrogens and progesterones.Before 6 weeks of pregnancy, the mother's blood contains a large amount of estradiol, and later the level of estrone significantly increases.
In the second and third semesters of pregnancy, the adrenal glands are responsible for the synthesis of estradiol.Thus, during the 40 weeks of pregnancy, the level of estrogen is gradually rising and, according to many doctors, this plays an important role in the beginning of childbirth.
Common effects of estragens
Why do we need estrogens? To understand this, you need to remember what effect these female hormones have:
- genitals are formed exclusively by the female type;
- muscular tissue of the uterus and endometrium grows;
- ducts and alveoli of the mammary glands grow;
- in the uterus vessels are vigorously formed;
- the level of "bad" cholesterol in the blood decreases;
- blood clotting is enhanced.
Estradiol norm in the blood
Estradiol has monthly and even diurnal fluctuations, however, this applies to all female hormones.During the research it was accurately determined that the maximum amount of estradiol is observed in the period of 15-18 hours, and the minimum - from 22 to 24 hours.
Estradiol hormone levels in women over 18 years of age in the absence of pregnancy:
- 1-14 day of the menstrual cycle( follicular phase) - 68-1269 pmol / l;
- ovulation phase - 131-1655 pmol / l;
- 14-28 day of the menstrual cycle( luteal phase) - 91-861 pmol / l;
- of postmenopause - less than 73 pmol / l.
If we talk about the level of estradiol during pregnancy, then there are no exact norms - the indications fluctuate and the elevated and / or lowered level of the considered female hormone is not indicative of the threat of miscarriage or the existing developmental defects of the fetus.
Why estradiol is reduced
What can cause a decrease in the level of estradiol:
- suffered severe stress;
- a sharp decrease in body weight;
- menopause in a woman;
- is diagnosed and progressing hyperprolactinaemia;
- is a diagnosed syndrome of resistant ovaries;
- diagnosed ovarian malnutrition syndrome;
- various genetic disorders;
- long-term use of certain medications.
Low body weight
Most often, a sharp loss occurs against a background of strict diets. If a woman loses 10-15% of the total fat mass, the following changes can be expected:
- worsens well-being;
- the menstrual cycle is disrupted;
- a woman can not become pregnant, although she does not use any contraceptive.
Just these listed signs and indicate a decrease in the level of estradiol in the body.The problem can be solved only by returning to the normal body weight.To do this, you may need to consult a dietician and this happens really often, the therapist.
Remember, during the military operations the birth rate of the population is sharply reduced.This, of course, is due in some way to the lack of a male population or its small number, but doctors emphasize that an important role in this is played by the level of estradiol.Against the backdrop of severe stress, the ovaries stop producing estrogens, the monthly stops, and conception does not occur.
This is a natural process of aging of the female body - the ovaries cease to function, and the synthesis of all sex hormones decreases, including estrogens.
Note: if the climacteric period is accompanied by the development of osteoporosis, blood pressure disorders, the doctor may prescribe hormone replacement therapy.
If a woman develops a tumor of the pituitary gland( prolactinoma), then the following characteristic symptoms can develop:
- Out of pregnancy and lactation period, milk begins to separate from the mammary glands;
- disorders of the menstrual cycle;
- is a regular headache.
It is extremely rare for a woman to develop hirsutism( expressed by the appearance of facial hair) and infertility.
If the listed symptoms are present against a background of low estrogen( it is found out by a laboratory test), the doctor will definitely prescribe a pituitary examination( computed tomography, magnetic resonance imaging).
In principle, any ovarian disease can lead to a decrease in the production of estrogens, but most often a lack of estradiol is present in the syndrome of depleted ovaries and the syndrome of resistant ovaries.
With such diseases, the menses practically stop, infertility is diagnosed.Often, drugs can save a woman only from unpleasant symptoms, restore the menstrual cycle, but infertility can not be cured - for conception you will need to use a donor egg.
Complete loss of pituitary functions - this is hypopituitarism.Such a disease can develop for various reasons, but most often in the course of diagnostic activities, a pituitary tumor or serious infections are detected.
In this disease, the female genitalia suffer, the synthesis of progesterones and estrogens is disrupted. This condition is manifested by the following symptoms:
- on the pubic region and in the armpits hair falls out;
- mammary glands are diminishing;
- first menstruation is broken, and then completely cease.
Diagnose this disease for the above symptoms and examine the patient.Treatment consists in the appointment of a course of hormone replacement therapy and if the therapy was conducted on time and full course, then the prognosis is favorable.
This is a complex situation that leads to problems in life - a woman can not conceive a child, she does not have menstrual bleeding, the figure has a male outline.The only solution to the problem is hormonal replacement therapy - you will not be able to completely improve your health, but it is quite possible to alleviate your health condition.
If a woman is forced to take a certain category of medicines for a long time, she may also experience a decrease in the level of estradiol.These medications include cimetidine, mifepristone, danazol, nandrolone, drugs for chemotherapy.
Why does the level of estradiol
There are several reasons that can lead to an increase in the level of estradiol:
- of the ovarian tumor;
- ovarian cysts;
- a pathological liver lesion occurring in severe form;
- is a cirrhosis.
In some cases, the level of estradiol rises due to the long-term administration of certain medications.
Assays for estradiol
The woman should take the estradiol test for the following cases:
- , there are irregularities in the menstrual cycle of the unexplained etiology;
- is diagnosed with infertility on the background of endocrine disorders;
- there are violations of the puberty of the girl;
- there is a need for early diagnosis of fetal abnormalities.
To get a reliable result, blood should be taken in the morning on an empty stomach, and a day before the laboratory test, a woman is recommended to refuse fatty foods and sweets, avoid physical exertion.
The level of estradiol is an important indicator of a woman's health.Therefore, you need not only to have information about possible violations of the functioning of the reproductive system of a woman, but also to understand when it is necessary to take tests.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category